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This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.

This study aims to examine the effect of human resource management (HRM) in mitigating negative effects of Lean management and Six Sigma (LM&SS) on employee well-being in health care. The authors subdivide well-being into three components: happiness, trust and health.

This is a cross-sectional, multisite survey study in internal service units of hospitals. Data analyzed using multivariate regression come from a sample of 1,886 survey respondents (42 units, N = 218 supervisors, N = 1,668 employees) in eight Dutch academic hospitals that have implemented LM&SS.

The present study findings show no or weak effects of LM&SS on the happiness and health component of employee well-being. In addition, the authors found a significant but weak direct positive effect (ß = 0.07) of the LM&SS bundle on the trusting relationships component of well-being. Therefore, moderating effects of HRM practices on the relationship between LM&SS and employee well-being seem less relevant because an existing relationship between LM&SS and employee well-being is a prerequisite for moderation (Hayes, 2009). There were unexpected side effects. Inspired by research that discusses direct effects of HRM on employee well-being, the authors tested this relationship and found that HRM has a direct positive effect on trust and happiness of employees in health care. For the health component of well-being, the present results show a weak negative effect of HRM.

This study results in a cautiously optimistic view about LM&SS in health care, provided that it is applied in a targeted manner (to improve the performance of their processes) and that HRM is strategically aligned with the goals of LM&SS to improve employees’ happiness and trusting relationships.

Unique features of the study are the focus on the consequences for employees’ well-being related to LM&SS in health care, the role of HRM in regard to this relationship and the participation of all eight Dutch academic hospitals in this research.

Rooting in the literature on training and laying on Kirkpatrick model, this paper aims to explore key drivers of corporate training to identify how they can be combined into an integrated framework of learning for human capital development.

By adopting the constructivist grounded theory, this contribution analyzes the experience carried out in the last ten years by Virvelle, an Italian corporate training firm.

Results show the rise of five core categories, g1iving rise to an integrated model of Kirkpatrick. Their dynamic interplay led to a new orientation of Kirkpatrick model giving rise to a metalearning ecosystem.

Managerial implications have identified key factors on which building and implementing appropriate corporate training programmes capable of triggering co-generative processes of value creation. Particularly, the essential role of learning quality culture, digital technology and personalization are detected in integrating not only hard but furthermore soft shades of learning. Concerning theoretical implications, the emergence of key structural and systems enabling dimensions for learning, and contextual mechanisms involved in reshaping training effectiveness and achieving integrated learning outcomes are detected. The main limitation of this study lies in the need to generalize results: the conceptualized framework needs to be empirically tested.

The value of this research is built along three main points. The first is the integration among the core categories that an integrated learning system can be built on, promoting learning quality culture through positive feedback loops. The second is represented by the chance to enhance an integrated mutual knowledge development among engaged actors, thereby shaping a more holistic and multidimensional learning model. The third is related to the transversal role that digital technology plays in all phases of the training process as it integrates and enriches them.

This study explores the interplay between levels of cultures and aspects of quality management (QM), aiming to develop a conceptual framework and introduce propositions regarding managing quality in a multinational company (MNC).

A conceptual framework delineating the relationship between the levels of cultures in MNCs and various aspects of QM is proposed. Thereafter, based on a theory elaboration approach, a case study in Swedish facilities of MNCs is used to further illustrate the link between constructs of the framework, contributing to the identification of challenges and possibilities in managing quality in MNCs.

The research identifies key propositions regarding the intricate relationship between levels of cultures and their influences on aspects of QM in MNC. Proposition 1 emphasises the impact of national cultural differences on perceptions of QM principles. Proposition 2 reveals that diverse QM perceptions affect global consistency in QM practices. However, proposition 3 suggests that emphasising technical aspects in common QM practices fosters shared perceptions and a cohesive organisational culture, leading to Proposition 4, that a QM-centric organisational culture mediates national cultural differences, facilitating the management of quality globally.

This research relies on a case study from a Swedish perspective. There is a need for quantitative or mixed method approaches to validate the proposed framework.

This research yields practical insights into cross-cultural QM challenges and possibilities in MNCs.

By integrating national and organisational culture into the QM framework, this research offers a conceptual model and propositions as a foundation for future cross-cultural QM research in MNCs.

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.