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Teachers of primary education experience high levels of stress but lack rational coping strategies to reduce their work stress. The paper develops a value stream mapping for education approach and examines its use as a rational coping strategy for teams of teachers and other employees to overcome work-related stressors.

The research process consists of two phases. First, a value stream mapping approach for education is developed, based on literature research. Next, the approach is validated in an action research study to reduce work stress of teachers in educational services. The processes that have been selected by the teachers relate to coping with increased variety, long and uncertain throughput times and unclear specifications.

Value stream mapping for education (VSM4EDU) is a well-structured improvement method based on principles of visualization, participation and process thinking, which helps teachers without background in lean thinking to analyse their processes. Using this method has enabled the team to develop rational coping strategies to reduce their work-related stress.

VSM4EDU has been validated using action research at a single school, which implicates deep insight, but further testing at other schools is welcome. Moreover, VSM4EDU has not been used to develop a future state map.

Value stream mapping is useful in educational settings as long as the educational context is respected in the approach.

VSM4EDU empowers teachers and helps to develop co-operation in teams.

The validation of value stream mapping for education is well-documented and original.

Lean Thinking is an operation management discipline which aims to identify, map and analyse the activities forming a process to detect “value waste” and outline the most effective flow of activities to execute in sequence. Process mapping is often developed in lean projects through the use of the Value Stream Map (VSM). Like many other management tools, the VSM adopts a static and non-systemic perspective in the representation of an organizational process. This may result in the implementation of Lean projects inconsistent with the overall organizational long-term strategy, thus leading to dysfunctional performance. In order to overcome this limit, the paper suggests combining VSM with System Dynamics (SD) modelling.

The paper is based on a review of the literature on VSM. This review is matched with an analysis of SD modelling principles aimed at explaining the practical and theoretical contribution of this approach to operation and strategic management practices. An illustrative case study is then provided to explore the practical implications of the proposed approach.

Our results show that SD modelling provides robust methodological support to VSM and Lean Thinking due to its inner characteristics, namely: simulation, systemic view, explicit link between system structure and behaviour and effective visual representation.

This research proposes a novel approach to design VSMs aimed at fostering a strategic perspective in Lean Thinking applications. Such an approach connects two fields of research and practice – i.e. VSM and SD modelling – which have traditionally been kept separated or, at least, partially combined for specific organizational sub-systems, thereby neglecting a broader strategic view of the entire process system.

This study aims to propose a tailored Lean Six Sigma framework providing an accessible Lean Six Sigma methodology for compound feed manufacturers with the aim of mitigating rising costs and increasingly complex demands from customers.

A Lean Six Sigma framework was designed combining Lean value stream mapping and Six Sigma structured problem-solving with a case study in an Irish compound feed manufacturer.

The study found that the Lean Six Sigma implementation framework provided a simplified approach, which fitted the resource availability within compound feed manufacturing.

The study is limited by the constraints of a sole case study in providing empirical evidence of the effectiveness of the framework. Nevertheless, a conceptual Lean Six Sigma model is proposed, which will assist compound feed manufacturers implementing a continuous improvement approach.

This paper proposes a simplified approach to the implementation of Lean Six Sigma in agricultural compound feed manufacturers and in small and medium-sized organisations. This is the first such study in Ireland and will add to the body of work on Lean in agriculture and aid other agri-businesses and compound feed manufacturers in understanding how Lean Six Sigma can benefit.

The purpose of this study is to identify the perception of workers before, during and after the implementation of changes derived from the lean manufacturing (LM) technique called value stream mapping (VSM) analysis and the causes that lead to this perception.

A qualitative methodological research design was adopted, using individual transcribed and coded interviews as the primary method of data collection.

At the beginning of the VSM changes, this study found strong denial and resistance emotional responses from workers due to the uncertainty and stress generated. The main cause of this resistance was their lack of understanding of the VSM analysis process presenting technical concepts, due to their educational level and the lack of a pre-existing organisational culture oriented toward continuous improvement. However, in the last stage of change, it is found that the workers accepted the new improvement proposals without resignation, improving their productivity and work performance because they saw and understood the improvements as effective.

This study will enable those responsible for organisations to anticipate the negative reactions that may arise from the organisational changes stemming from the implementation of VSM improvements. In addition, it adds new knowledge bases to the literature on the emotional consequences for employees during LM changes through VSM.

This study provides a qualitative analysis of the perceived emotional impact on workers that participated in LM techniques, in this case, focused on VSM analysis. It is an exploratory study that serves as a foundation for future research in the quantitative field.

This study is focused to support an ongoing development project of the case company's current state and the challenges of the order-to-cash (O2C) process. The O2C process is the most visible process to the customer, and therefore, its punctual and fluent order management is vital. It is observed that the high degree of manual work in the O2C process causes mistakes, delays and rework in the process. The purpose of this article is therefore to analyze the case company's current state of the O2C process as well as to identify the areas of development in this process by deploying the means of Lean Six Sigma tools such as value stream mapping (VSM).

The study was conducted as a mix of quantitative and qualitative analysis. Based on both the quantitative and qualitative data, a workshop on VSM was organized to analyze the current state of the O2C process of a case company, engaged in the energy and environment sector in Finland.

The results found that excessive manual work was highly connected to inadequate or incorrect data in pricing and invoicing activities, which resulted in canceled invoices. Canceled invoices are visible to the customer and have a negative impact on the customer experience. This study found that by improving the performance of the O2C process activities and improving communication among the internal and external stakeholders, the whole O2C process can perform more effectively and provide better customer value.

The O2C process is the most visible process to the customer and therefore its punctual and fluent order management is vital. To ensure that the O2C process is operating as desired, suitable process performance metrics need to be aligned and followed. The results gathered from the case company's data, questionnaire interviews, and the VSM workshop are all highlighted in this study. The main practical and managerial implications were to understand the real-time O2C process performance, which is necessary to ensure strong performance and enhance continuous improvement of the O2C process that leads to operational excellence and commercial competitiveness of the studied case company.

Cardiovascular diseases are the leading cause of death worldwide. In Italy, acute myocardial infarction (AMI) is a major cause of hospitalization and healthcare costs. AMI is a myocardial necrosis event caused by an unstable ischemic syndrome. The Italian government has defined an indicator called “AMI: 30-day mortality” to assess the quality of the overall care pathway of the heart attacked patient. In order to guarantee high standards, all hospitals had to implement techniques to increase the quality of care pathway. The aim of the paper is to identify the root cause and understand the mortality rate for AMI and redesign the patient management process in order to improve it.

A Lean Six Sigma (LSS) approach was used in this study to analyze the patient flow in order to reduce 30-days mortality rate from AMI registered by Complex Operative Unit (COU) of Cardiology of an Italian hospital. Value stream mapping (VSM) and Ishikawa diagrams were implemented as tools of analysis.

Process improvement using LSS methodology made it possible to reduce the overall times from 115 minutes to 75 minutes, with a reduction of 35%. In addition, the corrective actions such as the activation of a post-discharge outpatient clinic and telephone contacts allowed the 30-day mortality rate to be lowered from 16% before the project to 8% after the project. In this way, the limit value set by the Italian government was reached.

The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

The LSS approach has brought significant benefits to the process of managing patients with AMI. Corrective actions such as the activation of an effective shared protocol or telephone interview with checklist can become the gold standard in reducing mortality. The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

LSS, applied for the first time to the management of cardiovascular diseases in Italy, is a methodology which has proved to be strategic for the improvement of healthcare process. The simple solutions implemented could serve as a guide for other hospitals to pursue the national AMI mortality target.

The novel coronavirus (SARS-CoV-2) variant of 2019 has taken more than 3.8 million lives according to the World Health Organization. To stop the spread of such a deadly and contagious disease, lockdown of varying nature was imposed worldwide. Lockdown, preventive techniques and observation of standard operating procedures (SOPs) have effectively decreased the spread of contagious diseases but have affected various businesses and industries economically. The food industry has been hit hard by different restriction parameters, due to which a disruption in food supply and demand was observed. Therefore, this study aims to study this disruption in the supply chain of processed food.

A comprehensive review was conducted on PubMed, Google Scholar, and Scopus to locate articles on processed foods, food delivery and supply chain. The selected articles were evaluated using the context analysis method.

The pandemic situation has increased the consumption and demand for processed food products from retail stores, and decreased the demand for food service products. These circumstances called for technological advancement in the field of food supply from farm to fork. This study reviews research articles, policies and secondary literature. Several advances have been made to deliver safe, nutritious and wholesome food to consumers. Block chain-based food supply chains, value stream mapping, sustainable supply chain domain and online ordering systems via mobile apps have been discussed in correspondence with information and communication technology (ICT) during COVID-19.

This study concludes that the use of advanced software and its adequate knowledge by suppliers, logistics companies and consumers have assisted in handling shocks to the global food system and provided in-time food delivery, traceability, database information and securely processed food to consumers.

This study shows the effects of COVID-19 pandemic on global food systems; disruption in food demand and supply chain is overlooked and changed; use of technological advances in food supply chain to tackle pandemic; online food ordering system gained popularity and improved technically.

1. The review highlights the effects of the COVID-19 pandemic on global food systems.

2. The disruption in food demand and supply chain is overlooked and changed.

3. The use of technological advances in the food supply chain to tackle the pandemic.

4. The online food ordering system gained popularity and improved technically.

The review highlights the effects of the COVID-19 pandemic on global food systems.

The disruption in food demand and supply chain is overlooked and changed.

The use of technological advances in the food supply chain to tackle the pandemic.

The online food ordering system gained popularity and improved technically.

The goal was to improve the quality of the hospitalization process and the management of patients, allowing the reduction of costs and the minimization of the preoperative Length of Hospital Stay (LOS).

The methodology used to improve the quality of the hospitalization process and patient management was Lean Thinking. Therefore, the Lean tools (Value stream map and Ishikawa diagram) were used to identify waste and inefficiencies, improving the process with the implementation of corrective actions. The data was collected through personal observations, patient interviews, brainstorming and from printed medical records of 151 patients undergoing oral cancer surgery in the period from 2006 to 2018.

The authors identified, through Value Stream Map, waste and inefficiencies during preoperative activities, consequently influencing preoperative LOS, considered the best performance indicator. The main causes were identified through the Ishikawa diagram, allowing reflection on possible solutions. The main corrective action was the introduction of the pre-hospitalization service. A comparative statistical analysis showed the significance of the solutions implemented. The average preoperative LOS decreased from 4.90 to 3.80 days (−22.40%) with a p-value of 0.001.

The methodology allowed to highlight the improvement of the patient hospitalization process with the introduction of the pre-hospitalization service. Therefore, by adopting the culture of continuous improvement, the flow of hospitalization was redrawn. The benefits of the solutions implemented are addressed to the patient in terms of lower LOS and greater service satisfaction and to the hospital for lower patient management costs and improved process quality. This article will be useful for those who need examples on how to apply Lean tools in healthcare.

Many healthcare organizations are looking for methods, such as Lean, to reduce their costs and increase the productivity of their professionals. The Lean method looks at every step in every process to assess if this step adds value for the customer or not. The aim of this study was to explore the value adding and non-value adding process steps in stroke patient admission in an integrated care stroke service in the Netherlands.

This study focused on discharge of stroke patients from hospital acute treatment, and they were admitted for rehabilitation. According to the Grounded Theory, value stream mapping, organized interviews and expert meetings and coded was used. A configuration analysis was used to distinguish aggregates and configurations.

The most reported issues concerned in the paper are as follows: (1) insufficient internal logistics in the hospital, (2) miscommunication about medical readiness for discharge of the patient, (3) missing or delayed medical patient information, (4) overlapping discharge interviews, (5) unsafe transfer of sensitive information and (6) waiting lists and queuing up in rehabilitation facility.

At least six main areas of waste were identified in this stroke service, and they form the target for waste reducing activities. The results give insight in possible wastes in healthcare organizations and are therefore beneficial for other healthcare organizations which are planning to reduce wastes.

The purpose of this paper is twofold: first, to describe Lean maturity in primary care using a questionnaire based on Liker’s description of Lean, complemented with observations; and second, to determine the extent to which Lean maturity is associated with quality of care measured as staff-rated satisfaction with care and adherence to national guidelines (NG). High Lean maturity indicates adoption of all Lean principles throughout the organization and by all staff.

Data were collected using a survey based on Liker’s four principles, divided into 16 items (n=298 staff in 45 units). Complementary observations (n=28 staff) were carried out at four units.

Lean maturity varied both between and within units. The highest Lean maturity was found for “adhering to routines” and the lowest for “having a change agent at the unit.” Lean maturity was positively associated with satisfaction with care and with adherence to NG to improve healthcare quality.

Quality of primary care may benefit from increasing Lean maturity. When implementing Lean, managers could benefit from measuring and adopting Lean maturity repeatedly, addressing all Liker’s principles and using the results as guidance for further development.

This is one of the first studies to evaluate Lean maturity in primary care, addressing all Liker’s principles from the perspective of quality of care. The results suggest that repeated actions based on evaluations of Lean maturity may help to improve quality of care.