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Lean implementations in hospitals tend to be lengthy or lack the desired results. In addressing the question, how can lean be implemented effectively in a hospital-wide setting, this paper aims to examine two opposing approaches.

The authors studied two Dutch university hospitals which engaged in different lean implementation approaches during the same four-year period: top-down vs bottom-up. Inductive qualitative analyses were made of 49 interviews; numerous documents; field notes; 13 frontline meeting observations; and objective hospital performance data. Longitudinally, the authors depict how the sequential events unfolded in both hospitals.

During the six implementation stages, the roles played by top, middle and frontline managers stood out. While the top managers of one hospital initiated the organization-wide implementation and then delegated it to others, the top managers of the other similar hospital merely tolerated the bottom-up lean activities. Eventually, only the hospital with the top-down approach achieved high organization-wide performance gains, but only in its fourth year after the top managers embraced lean in their own daily work practices and had started to co-create lean themselves. Then, the earlier developed lean infrastructure at the middle- and frontline ranks led to the desired hospital-wide lean implementation results.

Change-management insights, including basic tenets of social learning and goal-setting theory, are shown to advance the knowledge of effective lean implementation in hospitals. The authors found lean implementation “best-oiled” through role-modeling by top managers who use a phase-based process and engage in close cross-hierarchical or co-creative collaboration with middle and frontline managerial members.

In the context of the COVID-19 pandemic, this study investigates a variety of approaches to supply disruption risk management for achieving effective responses for resilience at the supply management subunit level (e.g. category of items). Drawing on the attention-based view of the firm, the authors model the attentional antecedents of supply resilience as (1) attentional perspectives and (2) attentional selection. Attentional perspectives focus on either supply risk sources or supply network recoverability, and both are hypothesised to have a direct positive association with supply resilience. Attentional selection is top down or bottom up when it comes to disruption detection, and these are hypothesised to moderate the association between disruption risk management perspectives and resilience.

Conducted at the early phases of the COVID-19 pandemic, this study employs a hierarchical regression analysis on a multicountry survey of 190 procurement professionals, each responding from the perspective of their own subunit area of supply responsibility.

Both attentional disruption risk management perspectives are needed to achieve supply resilience, and neither is superior in terms of achieving supply resilience. Both the efficiency of the top down and exposure to the unexpected with the bottom up are needed – to a balanced degree – for improved supply resilience.

The results encourage firms to purposefully develop their supply risk management practices, first, to include both perspectives and, second, to avoid biases in attentional selection for disruption detection. Ensuring a more balanced approach may allow firms to improve their supply resilience.

The results contribute to the understanding of the microfoundations that underpin firms' operational capabilities for supply risk and disruption management and possible attentional biases.

Universities are large, complex and highly hierarchical organisations with deeply engrained gendered values, norms and practices. This chapter reflects on the experiences of two universities in initiating structural change towards gender equality as supported by the TARGET project. A common aspect thereby is the lack of a national policy in higher education and research providing specific support for implementing gender equality policies. The process of audit, design, implementation, monitoring and evaluation of the first gender equality plan (GEP) in each of these universities was conceived as a first step in a long journey, providing a framework for engaging different institutional actors and fostering reflexive, evidence-based policy making. The analysis deals with reflexivity and resistance and seeks to draw lessons from bottom-up and top-down experiences of GEP implementation. It is the result of shared reflection between the GEP ‘implementers’ in the two universities and the team who provided support and acted as ‘critical friends’.

The study aims to analyze the previous literature on government initiatives to implement health information systems (HISs).

Proknow-C (Knowledge Development Process-Constructivist) was used in the selection of the literature and in the bibliometric and systematic analysis.

The research identified a portfolio composed of 33 articles aligned with the research theme and with scientific recognition, as well as periodicals, authors, papers and keywords that stood out the most. Amongst the government initiatives in the 24 identified countries, England has been the most studied nation, and there is a certain prominence of research arising from developed countries. Electronic health records (EHRs) have been the most explored technology. Efficiency and safety of health care delivery, integration of information and among health organizations, cost reduction and economicity are the most expected benefits from government programs. The difficulties found are related to the broader context in which the system is inserted, to the management of the program, to technology itself and to individuals. The most emphasized difficulties identified in most countries were previous context marked by a lack of standardization/interoperability, acceptance of providers and users and project financing. The findings of the present article provide a theoretical framework for future studies, in addition to yielding a replicable process for future use.

This research may be considered original as it analyzes – through a constructivism-structured process (Proknow-C) – the phenomenon under investigation by gathering bibliometric and systematic review data concomitantly. The countries and technologies reported emerge from the process itself.

Although innovation ecosystems (IEs) are generally considered capable of creating shared value (SV), this potentiality has often been taken for granted and not deeply analysed, yet. As a result, in the literature, there is not a framework that defines the process of SV creation in IEs or which aspects should be considered for understanding it. Moving from these considerations, this paper aims to propose a conceptual model of how IEs can create SV, identifying the main building blocks of the process and the aspects that characterize these building blocks.

The authors reviewed the literature on IEs and value creation over the last 15 years, by structurally analysing 120 articles. On the basis of such review, the authors identified main dimensions of analysis focusing on the conceptualization of SV in IEs.

First, the authors developed a conceptual model relying on a process-based logic and framing the SV creation in terms of inputs, here intended as four key characteristics (actors, structure, governance and relations), internal processes (strategies and internal mechanisms) and outputs (the value created). Second, each element of value creation is explored, highlighting the main evidence emerging from prior studies in connection to each block.

This paper drives the identification of some relevant relationships that connect the characteristics of the IEs, the strategies and the internal mechanisms to the output of the process, i.e. the SV created.

This chapter explores the empirical and empathetic approaches employed by a group of fieldworkers from Japan who collaborated with individuals from different parts of Southeast Asia. Their objective was to address shared societal challenges and mentor the next generation of future talents. Additionally, research administrators at Kyoto University conducted an online survey and organized study group meetings focused on Science, Technology and Innovation (STI) coordination, engaging approximately 700 partners in ASEAN. While formal job guidelines for hiring full-time research administrators are rare in the region, many researchers and government officials in ASEAN recognised the importance of these coordination skills and values in advancing STI projects. Coordinating ASEAN-Japan projects has demonstrated that practical experiences with skilled professionals and strong interpersonal skills aligned with Asian cultural values that prioritize conscience and altruism. As a next step, the region will require appropriate human resource training and assessment programs tailored to local STI needs.