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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.

Head and neck cancers are multi-factorial diseases that can affect many sides of people's life and are due to a lot of risk factors. According to their characteristics, the treatment can be surgical, use of radiation or chemotherapy. The use of a surgical treatment can lead to surgical infections that are a main theme in medicine. At the University hospital of Naples “Federico II”, two antibiotics were employed to tackle the issue of the infections and they are compared in this paper to find which one implies the lowest length of hospital stay (LOS) and the reduction of infections.

The Six Sigma methodology and its problem-solving strategy DMAIC (define, measure, analyse, improve, control), already employed in the healthcare sector, were used as a tool of a health technology assessment between two drugs. In this paper the DMAIC roadmap is used to compare the Ceftriaxone (administered to a group of 48 patients) and the association of Cefazolin plus Clindamycin (administered to a group of 45 patients).

The results show that the LOS of patients treated with Ceftriaxone is lower than those who were treated with the association of Cefazolin plus Clindamycin, the difference is about 41%. Moreover, a lower number of complications and infections was found in patients who received Ceftriaxone. Finally, a greater number of antibiotic shifts was needed by patients treated with Cefazolin plus Clindamycin.

While the paper enhances clearly the advantages for patients' outcomes regarding the LOS and the number of complications, it did not analyse the costs of the two antibiotics.

Employing the Ceftriaxone would allow the Department of Maxillofacial Surgery to obtain lower LOS and a limited number of complications/infections for recovered patients, consequently reducing the hospitalization costs.

There is a double value in this paper: first of all, the comparison between the two antibiotics gives an answer to one of the main issues in medicine that is the reduction of hospital-acquired infections; secondly, the Six Sigma through its DMAIC cycle can be employed also to compare two biomedical technologies as a tool of health technology assessment studies.

The purpose of this paper is to analyze important theoretical work conducted in the research streams of co-opetition and value creation. While innovation is acknowledged as a desirable and empirically verified outcome of co-opetition between firms, academic research has not systematically examined value creation outcomes of intra-firm co-opetition. This study aims to explore the nature of co-opetitive relationships within the firm. Processes of knowledge creation, differentiation and evolution are presented in the paper.

The paper examines and compares co-opetitive dynamics in different contexts, by adopting a multi-level approach to help understand and analyze the complex phenomenon of intra-organizational co-opetition. Value creation in an ecology perspective is discussed to enhance the conceptualization of the Quintuple Helix.

This paper highlights the role of knowledge differentiation as a driver of value creation. In particular, intra-firm co-opetition dynamics are investigated in relationship with knowledge evolution. A theoretical model is proposed via the Dynamics of Ultra-Organizational Co-opetition and Circuits of Knowledge (DUCCK) framework.

This paper attempts to provide new perspectives on the growing academic field of co-opetition and knowledge creation. It complements previous research in intra-organizational settings and offers an alternative knowledge-based view of organizational value creation.

The paper contributes to develop managers’ practices in understanding potential benefits of intra-organizational co-opetition. The paper also brings additional insights for knowledge management (KM) practitioners, by considering the impact of co-opetition on knowledge dynamics.

This paper explores, adds to the existing theoretical knowledge and contributes to the under-researched topic of intra-organizational co-opetition. This is the first attempt to link internal co-opetition to firm’s KM practices.

This paper explores digital transformation's impact on the work of owners in entrepreneurial firms. The interplay between working practices and technology is analyzed, taking into account the organizations' specific contexts.

A multiple case study design was applied. Eight cases of entrepreneurial firms, defined as companies that bring new products and services to the market by creating and seizing opportunities, were selected, with the goal to maximize the diversity of cases. The sample includes both small- and medium-sized firms, as well as high- tech and low- tech companies in equal number. Interviews have been used to collect both quantitative and qualitative data, which was analyzed in a structured way.

The digital transformation of entrepreneurial work, that is the daily work of entrepreneurs, is an evolutionary, practice-based phenomenon, rather than the result of rational design. The use of different digital tools is interrelated and depends on the characteristics, and dynamics of the surrounding environment.

The findings of this study are relevant to entrepreneurs interested in understanding the dynamics of their working practice, to software development firms interested in entrepreneurs as customers and to institutions interested in the education of entrepreneurs.

To the best of the authors' knowledge this is the first study which considers the interplay between digital technology and the daily activities of entrepreneurs, considered as a whole. It provides insights on how these interconnected dimensions evolve, thus contributing to understanding the work of entrepreneurs, and as a consequence the dynamics of entrepreneurial firms in the context of digital transformation of organizations.

Existing literature is limited in its ability to consider start-ups as a knowledge broker to trigger innovation in a supply chain ecosystem (SCE). In a traditional SCE, start-ups are relatively isolated, leading to structural holes that limit knowledge sharing among members. This paper aims to overcome that limitation and to build frameworks that help to illustrate the interaction between knowledge management and sharing, start-up innovation and an ecosystem from a supply chain perspective.

Following a qualitative approach, this study theorizes about the role of start-ups as knowledge brokers and the implications of knowledge management and sharing with members in an SCE concerning innovation. Conceptual analysis is used for examination, and this study uses a set of qualitative tactics to interpret and generate meaning from the existing literature.

This study develops two frameworks to provide insight into how start-ups can trigger innovation as knowledge brokers in an SCE. The first framework shows how start-ups, and their knowledge base, influence supply chain members and the overall ecosystem, highlighting the isolated function of start-ups and the issue of structural holes in a traditional SCE. The authors propose a model that illustrates how structural holes can be bridged within an SCE, thereby demonstrating how start-ups redefine the ecosystem architecture according to their knowledge broker position in the SCE.

By expanding insight into the concepts of how start-ups can trigger innovation as knowledge brokers in an SCE, this paper extends the so-far neglected area of start-ups and knowledge brokers. This study clarifies the conceptual and theoretical components and processes in an SCE and links the different roles of start-ups as knowledge brokers to the respective supply chain members to better understand the implications on the entire SCE.

This study aims to understand if and how European digital innovation hubs (DIHs) filling the role of knowledge brokers (KBs) can support the digital transformation (DX) of small and medium-sized enterprises (SMEs) by triggering open innovation (OI) practices.

After presenting a conceptual model of reference, a survey and a subsequent in-depth interview were conducted to capture evidence from Italian DIHs. These structures were selected for their growing importance, as confirmed by the National Plan for Industry 4.0.

The findings highlight that Italian DIHs act not only as KBs but also as knowledge sources that give rise to a digital imprinting process that is able to shape the DX of SMEs.

Research on knowledge sharing and OI has mainly focused on large firms. The study covers the gaps identified in the literature by considering the role of KBs in enabling SMEs to embrace DX.

Common availability of digital technologies encouraged companies in almost all industries to focus on exploring various ways of benefiting from their adoption and thus taking steps toward their digital transformation. This paper aims to describe the digital transformation of small and medium enterprises (SMEs) as a challenging opportunity and identify ways in which companies from the food industry address it.

The paper presents empirical evidence based on a case study of the Polish freeze-drying market and companies operating on it. This study adopted a single case study research method to describe the digital transformation journey of SMEs. The sample constitutes a single sectoral case study with more than one unit of analysis – sixteen companies. The undertaken approach follows an embedded case study design and allows for an extensive and multidimensional analysis of rich empirical data.

The results of this analysis allowed to identify four significant trends describing human resources involvement in the digital transformation of freeze-drying companies in Poland (i.e. visionary top-down, cooperative task-oriented, persuasive bottom-up, chaotic), a detailed catalog of outcomes of digital transformation from the perspective of food industry companies grouped in seven categories and a list of main barriers to digital transformation.

This paper contributes to expanding knowledge on the practices of food industry companies in addressing challenges posed by the development of information technology and the dynamically changing environment after the COVID-19 pandemic. It contributes further to the discussion related to context-, industry- and country-specific barriers to digital transformation, identifying time-related constraints as an essential barrier to digital transformation.