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This paper aims to analyze the influences of context and methodological differences in how universities confront, report and manage carbon neutrality in selected Andean universities, contrasted with a university in the USA.

A sequential, mixed-methods design, using quantitative and qualitative approaches was applied. The data analysis is based on a systematic literature review with bibliometric analysis to identify how carbon neutrality in universities is understood and applied. Informed by the quantitative analysis, the qualitative phase compared the assessment methodologies, opportunities and obstacles in three Andean universities – EAFIT in Colombia, EPN in Ecuador and the UC in Chile – contrasted with MIT (USA) for comparative purposes beyond the region.

The bibliometric analysis points to the evolution of carbon management and carbon neutrality in universities and indicates how universities have applied methodologies and defined opportunities and obstacles. In this comparative experience, the contextual issues are brought to the fore. The conclusions highlight the importance of context in carbon neutrality assessment and argue against crude comparative metrics. While carbon assessment protocols provide data on which actions may be taken, the phase of carbon management development and the specifics of context – based on local institutional, geographical, climatic, cultural, socioeconomic and national policy conditions – are far more relevant for identifying actions.

This study only considered four universities, and the findings are not generalizable. The argument highlights the point that contextual factors generate important differences that may complicate simple comparisons based on the university's type or size. It also highlights the differences in the carbon calculation methodologies used by the institutions.

Results build on the recent publications that document the Latin American context. The article contributes to knowledge about Andean university commitments and actions relating to climate change and carbon neutrality. This knowledge can contribute to how universities in the region seek to apply different methodologies, set targets and the timing of actions and consider their contextual opportunities and obstacles.

Comparing university carbon footprints and carbon neutrality plans is an emerging topic, presenting methodological and institutional difficulties. This paper reveals some of these difficulties by comparing parameters, actions and implementation processes against contextual factors. While there is a drive for international and national comparisons and systematization of data on university carbon performance, significant methodological gaps still need to be resolved to account for these contextual factors.

This paper aims to contextualize the process of public hospital providing services, based on the measurement of the performance of Federal University Hospitals (HUFs) of Brazil, using the technique of multivariate statistics of principal component analysis.

This research presented a descriptive and quantitative character, as well as exploratory purpose and followed the inductive logic, being empirically structured in two stages, that is, the application of principal component analysis (PCA) in four healthcare performance dimensions; subsequently, the full reapplication of principal component analysis in the most highly correlated variables, in module, with the first three main components (PC1, PC2 and PC3).

From the principal component analysis, considering mainly the component I, with twice the explanatory power of the second (PC2) and third components (PC3), it was possible to evidence the efficient or inefficient behavior of the HUFs evaluated, through the production of medical residency, by specialty area. Finally, it was observed the formation of two groups composed of seven and eight hospitals, that is, Groups II and IV, which shows that these groups reflect similarities, with respect to the scores and importance of the variables for both hospitals’ groups.

Among the main limitations, it was observed incomplete data for some HUFs, which made it impossible to search for information to explain and better contextualize certain aspects. More specifically, a limited number of hospitals with complete information was dealt with for 60% of SIMEC/REHUF performance indicators.

The use of PCA multivariate technique was of great contribution to the contextualization of the performance and productivity of homogeneous and autonomous units, represented by the hospitals. It was possible to generate a high quantity of information, to contribute with assumptions to complement the decision-making processes in these organizations.

Development of public policies, with emphasis on hospitals linked to teaching centers represented by university hospitals. The projection of improvements in the reach of the efficiency of the services of assistance to the public health, from the qualified formation of professionals, both to academy, as to clinical practice.

The originality of this paper for the scenarios, Brazilian public health sector and academic area involved the application of a consolidated performance analysis technique, that is, PCA, obtaining a rich work in relation to the extensive exploitation of techniques to support decision-making processes. In addition, the sequence and the way in which the content, formed by object of study and techniques, has been organized, generating a particular scenario for the measurement of performance in hospital organizations.

This paper aims to evaluate the measurement properties of the Employee Perception to Assess the Lean Implementation Tool (EPLIT) in the Brazilian hospital context.

A cross-sectional study was conducted in two Brazilian hospitals, adhering to COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Exploratory factor analysis (EFA) and Cronbach's alpha were used for construct validity and reliability.

The adapted tool comprises 27 items across five domains, explaining 63.3% of the variance. Cronbach's alpha ranged from 0.78 to 0.86, indicating satisfactory reliability.

Limitations include convenience sampling and exclusive use of EFA for validation. Future studies may employ Confirmatory Factor Analysis for further validation.

The tool aids healthcare managers in Brazil to systematically evaluate Lean implementation, contributing to process optimization and quality improvement.

Effective Lean implementation using the validated tool could lead to improved healthcare delivery and patient outcomes.

This is the first study to adapt and validate EPLIT for the Brazilian healthcare sector, offering a robust tool for managers and researchers.