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This study aims to fully assess the readiness for Lean Six Sigma (LSS) and Quality Performance Improvement (QPI) in an Italian Public Healthcare ecosystem.

Drawing from previously established survey development and adaptation protocols, a replication study was carried out; Lean, Six Sigma and QPI were extracted and validated through confirmatory factor analysis in an Italian Public Healthcare setting, with a sample of health professionals from the Campania region.

This study reports the adaptation of an existing scale for measuring LSS and QPI in an Italian public healthcare organisation. This analysis extracts six conceptual domains and constitutes an original adaptation of an existing scale to assess the readiness to adopt Lean, Six Sigma and Quality Performance in Italian Public Health Organizations. The constructs show strong levels of internal consistency, as demonstrated by each item factor loading and each subscale reliability.

Managers, policymakers and academics can employ the proposed tool to assess the public healthcare ecosystem’s capability to implement LSS initiatives and strategies to improve quality performance.

This is one of the first studies to assess cross-regional organisational readiness for LSS and QPI in an Italian Public Healthcare environment at this scope and level.

This research aims at investigating how business process management capabilities (BPMC) impact the effectiveness of sustainable digital transformation (ESDT). Furthermore, it delves into the mediation of dynamic decision-making (DDM) in the relationship between BPMC and ESDT.

This research employed the hypothetico-deductive technique. The statistical database was generated from sample of 712 respondents from small and medium companies (SMEs) in Vietnam, utilizing convenience and snowball sampling methods. The two-step process utilizing structural equation modeling, supported by SmartPLS version 4.1.0.9 and AMOS 28, was employed to assess the measurement model, while SmartPLS version 4.1.0.9 was used to evaluate the structural model.

The results of the analysis emphasize significant and positive correlations between the proposed constructs related to significance and effect size. The statistical results indicated that BPMC had a significant and beneficial effect on ESDT. This relationship was partially mediated by DMM.

The salient point emphasized that practitioners should prioritize enhancing focus on BPMC and DDM, as this would significantly facilitate more comprehensive solutions, enabling SMEs to achieve optimal success in sustainable digital transformation. Policymakers and government influencers are urged to concentrate on innovative attributes and ensure a conducive environment for the implementation of innovation by enacting regulations that promote the application of digital technology.

The findings of this study will broaden scholars’ understanding of the influence of BPMC on ESDT. The originality of the research is to provide research directions for advancing studies on the role of DDM in the context of sustainable digital transformation.

The paper aims to contribute to the advancement of the debate on digital innovation and entrepreneurship from a cross-generational perspective in the context of family businesses. Specifically, the paper explores the contribution provided by the young generations of entrepreneurs to the digital transformation and resilience of family businesses during the pandemic emergence of COVID-19. Focusing on the need for a major understanding of digital resilience in the context of family businesses and small and medium-sized enterprises, the paper aims to provide theoretical and empirical contributions in replying to the following research question: How did young entrepreneurs contribute to the resilience and the digital transformation of their family businesses during COVID-19?

The methodology consisted of a two-stage qualitative investigation including a focus group managed in presence with the involvement of 24 young entrepreneurs and a self-administered online survey involving the family businesses belonging to the Association of Young Entrepreneurs of Confindustria Puglia (South Italy) that has allowed to collect 47 replies, with a 32% response rate.

The paper presents evidence about the resilience of family businesses during the COVID-19 supported by the disruptive role of emerging digital technologies. Our analysis demonstrates that young entrepreneurs adopted different patterns of digital transformations, depending on the firm’s industry and the family firm’s digital maturity. Digital resilience in the context of the observed family businesses produced different benefits in terms of competitiveness, effectiveness of decision-making, visibility and communication and new opportunities for value creation; it occurred in several business areas, including production, logistics, sales and human resources management.

The study highlights the relevant role that younger generations can play in exploring innovation opportunities associated with digitalisation as well as in contributing to reinforce innovation and resilience capability of their family businesses through collaboration with external stakeholders and ecosystems.

The value of the research consists in the attempt to analyse the meaning and implication of digital innovation in the context of family business as a driver for their resilience capability. The Family Businesses Digital Readiness and Young Entrepreneurs Contributions Matrix presented into the study as an original contribution of synthesis of the evidence collected.