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This study aims at examining the effect of Healthcare 4.0 (H4.0) implementation on healthcare costs' reduction in hospitals located in developing economies. For that, 159 middle and senior leaders from hospitals located in Brazil, India, Mexico and Argentina were surveyed regarding their adoption level of H4.0 technologies and cost reduction improvements. Responses were analysed using multivariate data analysis techniques. Our findings indicate that the adoption of H4.0 technologies, empirically grouped into two different bundles (Sensing-Communication and Processing-Actuation), is positively related to healthcare costs' reduction and that the extent of such relationship may vary according to the bundle under analysis. Our results elucidate the impact of digital integration on healthcare costs, suggesting a cost-effective path based on H4.0 implementation. The identification of this relationship in hospitals located in developing economies evidences the benefits of healthcare digital transformation despite the challenging socioeconomic conditions, which has been contradictorily reported in previous studies. [ABSTRACT FROM AUTHOR]

The lean product development (LPD) approach uses lean principles and enablers (tools, techniques and practices) to reduce waste and continuously improve the product development processes (PDP). Other than reducing product development lead time, LPD also aims at improving quality by reducing problems that might occur during the process. Several LPD enablers are proposed in the existing literature; however, there is limited knowledge on how these enablers may effectively counteract the occurrence of problems in the PDP. We empirically tested the association between 4 groups of LPD enablers and 11 groups of LPD problems in a sample of 64 companies that are undergoing lean implementation in the shop floor and administrative areas. There are two major contributions here. First, we propose an empirically validated instrument for assessing the adoption of LPD enablers and the incidence of LPD problems in companies filling an existing gap in the literature. Second, we provide understanding on how LPD enablers can mitigate the incidence of LPD problems, allowing companies undergoing lean implementation to better manage their PDP. Moreover, some results demonstrate that the association between enablers and problems may not be as suggested in the existing literature. [ABSTRACT FROM AUTHOR]

This paper aims at identifying the combination of organisational culture profiles and leadership styles that best support companies implementing lean manufacturing practices. For that, 225 leaders from manufacturing companies at various stages of lean implementation were surveyed. The analytical approach clustered respondents and their respective firms according to prevailing organisational culture, leadership style and level of implementation of lean practices, testing for frequency differences among clusters. This study states that organisational culture profiles are related to leadership styles and lean manufacturing implementation level, suggesting different-from-expected effects of this relationship on lean manufacturing implementation. The study bridges a gap in the literature by exploring how the association between organisational culture and leadership styles occurs in companies that are adopting lean practices. [ABSTRACT FROM AUTHOR]

Despite the fact that Lean Manufacturing (LM) implementation has been widely discussed in the literature, a reduced number of works focus on medium-sized enterprises (MEs). Such gap becomes more evident when searching for works exploring the dimensions of learning organisation (DLO) that surround LM implementation in MEs. This paper aims at assessing DLO maturity and the importance of human resources management (HRM) practices in MEs that are starting LM implementation. We verify the applicability of a method for assessing maturity levels of DLO and HRM practices in seven different MEs. The method was originally conceived for large enterprises well advanced in the lean implementation process; it combines concepts of HRM and organisational learning with lean implementation roadmaps. Adapting the method for application in MEs allows such companies to anticipate and minimise organisational learning problems by conducting appropriate HRM practices, leading to a more effective LM implementation. We conclude that the method is a suitable diagnostic tool for MEs, indicating which phases of the lean roadmap are better prepared to be implemented. [ABSTRACT FROM PUBLISHER]

This study examines the differences in implementation level of both Industry 4.0 (I4.0) and Lean Production (LP), whose integration is denoted here as Lean Automation (LA), between manufacturers located in emerging and developed economies. A survey-based research was carried out with a total of 249 Brazilian (emerging economy) and Italian (developed economy) companies that are implementing LP and have initiated the adoption of I4.0 technologies. Collected data was analysed through multivariate data techniques. Results indicate that the socio-economic context where companies are located does influence the extension of LA implementation. However, they also suggest that, if properly managed, a high level of LA implementation is feasible regardless the socio-economic barriers and challenges that manufacturers may face. Further, companies' characteristics that favour higher LA levels might also vary between emerging and developed economies, emphasising the importance of a clear understanding of the socio-economic specificities of the contexts. This study sheds light on how pervasive LA implementation can be in manufacturers from both socio-economic contexts. Moreover, these outcomes demystify assumptions related to management approaches that may only prevail if certain socio-economic conditions are present. This evidence is especially important for multinational companies that seek for highly competitive standards across all their sites. [ABSTRACT FROM AUTHOR]

This article aims at examining the influence of teams' characteristics on the sustainability of Continuous Improvement (CI) initiatives. To achieve that, two identical manufacturing cells undergoing CI implementation and subordinated to the same leadership were investigated through a combination of quantitative and qualitative approaches. While one team has shown a sustained and increased performance, the other could not maintain improvements and worsened its performance. As the only factor distinguishing cells is team composition, we verify which team characteristics impact on CI sustainability. Results indicate that workers' seniority in company and in team, as well as their age positively influence team behaviour regarding the sustainability of CI initiatives. Long-term sustainability of CI initiatives has been a major concern in most companies. Although previous studies have approached the subject from different and complementary perspectives, the understanding of how specific characteristics of team members may influence the sustainability of CI is still vague and imprecise. [ABSTRACT FROM AUTHOR]

The implementation of lean production systems is deemed essential for companies that wish to obtain high levels of competitiveness. There are several examples in the literature discussing the adoption of lean roadmaps; however, since such maps emphasise technical factors of lean change, the organisational learning (OL) process and human resources management (HRM) practices tend to be neglected. This article presents a method for assessing the impact of HRM practices and OL factors in a company under lean implementation. The method incorporates concepts of HRM and OL into lean implementation roadmaps, enabling a maturity analysis regarding dimensions of OL at different contextualisation levels, and allowing the proposition of improvements in HRM practices. The proposed method is illustrated in a case study from the automotive parts manufacturing sector. [ABSTRACT FROM PUBLISHER]

Value stream analysis is a very useful approach in the identification of non-value adding wastes and developing a systemic plan for achieving process improvement. However, traditional value stream mapping fails in considering the inherent variability of processes, hence reinforcing improvements that might not lead to significant results. In this sense, the uncertainties associated with value streams become an issue that can be curbed with the integration of stochastic methods. By conducting a systematic literature review, this research evaluates the level of integration of stochastic methods into value stream analysis and identifies those stochastic methods that are widely adopted to address uncertainties in the value stream analysis. Results from the review indicate that the application of the existing stochastic methods into value stream analysis is still at its infancy and is not systematically integrated. In addition, the few studies that consider stochasticity of value streams weakly examines the effect that uncertainty sources entail on each other. [ABSTRACT FROM AUTHOR]

This paper aims at examining the trends, challenges and theoretical gaps in the implementation of Healthcare 4.0 (H4.0) based on a scoping review of the literature. For that, we searched journal articles in four widely known databases and screened the retrieved articles to obtain a publications' portfolio. Our findings indicate that, despite the recency of the subject, research in H4.0 has been conducted in an interdisciplinary way with a diversified set of applications and functionalities. In terms of its implementation, H4.0 has been more commonly found in hospitals' information flows, especially the ones related to healthcare treatments. The identified implementation trends, however, neglect a more holistic approach for H4.0, which originated three main research directions for this topic. Although identified as a trending topic in the area of healthcare operations management, literature on H4.0 may be viewed as randomly conceived, lacking academic alignment and practical orientation based on a grounded theory, which we aim at providing with the present study. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to understand how lean production (LP) practices are associated with operational performance in the Brazilian automotive supply chain. A survey was carried out to identify the effect of 11 lean practices on five operational performance metrics. The sample comprised 64 companies of the Brazilian automotive supply chain. Results suggest that Brazilian companies are experiencing reduction of Lead time due to the implementation of total productive maintenance practices; and reducing inventory based on the adoption of just-in-time practices. Nevertheless, there appears to be a significant gap in the way these companies are implementing LP practices, which may hinder the achievement of better operational performance results. The survey was limited to companies from Brazil and, therefore, its findings might not be expanded to other companies or sectors. The results also provide a better understanding regarding LP practices and their individual effect on performance metrics. [ABSTRACT FROM AUTHOR]

During the last decade, there has been a demand for public services to enhance management practices and attain results comparable to those experienced in the private sector. The need for achieving higher quality standards in public services has highlighted the importance of exploring new management techniques to account for the obsolescence in those organisations’ administrative models, with particular emphasis on healthcare services. This paper reports the application of one such new management technique, named value stream mapping (VSM), in the sterilised materials unit of a public healthcare organisation. In the case study presented here, we demonstrate the benefits of analysing healthcare processes using VSM; most notably reduction of wastes, inventory levels, and production lead times. The contribution of this article is twofold. First, it adds to the existing body of knowledge on lean management by examining the validity of applying lean principles and practices in contexts other than manufacturing. Second, it provides a detailed description of VSM applied in a hospital sterilisation unit; even though lean healthcare applications have been increasingly reported in the literature, to the best of our knowledge this is the first study to address the use of VSM in such context. [ABSTRACT FROM AUTHOR]