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Problem‐solving teams, involving front‐line staff, are widely used to achieve continuous process improvement. Approaches such as “plan‐do‐study‐act” (PDSA) cycles, are now a core element of many health‐care improvement initiatives. This paper evaluates the use of PDSA improvement cycles within the UK National Health Service, using emergency care improvement activity as a source of research evidence. It was found that, despite an abundance of information on how to implement this type of change, many senior professionals still misinterpret how this should work. This has implications for how such methodologies are implemented. There is a long way to go in allowing greater employee involvement, moving much further away from the “management committee” style of change. Care has to be taken to ensure that empowered employees are working to consistent and appropriate objectives. It is important that senior personnel develop process understanding alongside the workforce, rather than simply providing distant support.

This chapter examines Unilever's transformation in sustainability and corporate social responsibility (CSR) over the past decade. It tracks the author's involvement with an internal team that studied Unilever's world “outside in” and “inside out” through the engagement of over 100 organizational leaders to awaken the company for change. The case reports how Unilever embraced a “vitality mission” to align its strategies and organization around sustainability and CSR and infuse social and environmental content into its corporate and product brands. Among the innovations described are certification of the sources of sustainable fish and tea, Dove's inner-beauty campaign, and several “bottom of the pyramid” efforts. Particular attention is given to the makeover of its high-growth Asian business. The transformation is examined as a “catalytic” approach to change and discussed with reference to theories of complex adaptive systems. This raises theoretical questions about the role of top-down versus more communal leadership, the importance of mission versus vision in guiding change, and the relevance of emotive and psycho-spiritual versus more programmatic interventions in the rearchitecture of an organization as it progresses on sustainability and CSR.

Three events of significance to this country took place in 1899 – the British Food Journal was launched, Australia retained the Ashes, and the Boer War hostilities commenced. If challenged on the order of their importance, cricketers and Empire‐builders may be excused their preference. However, looking at it purely from the standpoint of pro bono publico, the dispassionate observer must surely opt for the birth of a certain publication as being ultimately the most beneficial of the three.

The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals.

Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach.

Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement.

The study was conducted in one hospital setting.

Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics.

This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.

The purpose of this paper is to develop a framework to assess the lean readiness within emergency departments (EDs) and identify the key quality practices deemed essential for lean system (LS) implementation.

An extensive review of the lean healthcare literature was conducted, including LS implementation within the healthcare sector (both generally and in EDs), best ED quality practices, essential factors for LS implementation within healthcare and lean readiness assessment frameworks. The authors identified six main categories from a literature review (top management and leadership, human resources, patient relations, supplier relations, processes and continuous improvement (CI)), and validated these based on experts’ opinion.

Several factors were identified as crucial for EDs, including top management and leadership, human resources, patient relations, supplier relations, processes and CI.

The framework has not yet been tested, which prevents the author from declaring it fit for EDs.

This framework will help ED managers determine the factors that will enable/hinder the implementation of LSs within their premises.

To the author’s knowledge, this is the first lean readiness assessment framework for EDs and one of the few lean readiness assessment frameworks in the literature.

Restaurants are unique and challenging environments for accommodating food allergies. The purpose of this paper is to evaluate food allergy knowledge, attitudes and resources among restaurant employees, and identify differences based on restaurant mode of operation.

A total of 209 food-service workers were surveyed in full-service restaurants across Southern Ontario, Canada. A paper-based questionnaire was used to evaluate participants’ food allergy knowledge, attitudes toward handling food allergy requests and emergencies, and the availability of food allergen resources at the restaurant.

Most participants were knowledgeable about food allergies, and valued being able to provide safe meals. However, there was a general lack of access to important food allergy risk management resources and training. Food allergy attitudes were significantly different between restaurant modes of operation. Also, food allergy training and resources were positively correlated with employee attitudes toward food allergies.

The results of this study show that engaging employees in food allergy training can contribute to greater levels in employee awareness and confidence in protecting health and safety of restaurant patrons with food allergies. Restaurants that demonstrate a strong preparedness toward handling food allergy requests can deliver a better customer experience and increase customer loyalty.

The findings of this study underscore the need for the restaurant industry, policy makers and food safety educators to work together to develop training programs and relevant resources to support and facilitate food allergy risk management in restaurants.

Food supply chains (FSCs) are becoming increasingly complex and vulnerable to recall risks due to quality failures. Measures for supply chain risk management can minimize these recall risks. However, this responsibility must be shared by all stakeholders in the chain. This study aims to analyze the roles of different stakeholders in managing risks in the events of food recalls.

A systematic literature review was carried out, and 110 articles were explored to identify risk management actions and to link them to the role of stakeholders involved in FSC recall.

The study found that nine stakeholders were responsible for 25 hazard management actions related to food safety and traceability systems, regulatory and preventive measures, and control and response mechanisms for food recalls in the FSC.

This article contributes to the literature by proposing an explanatory map associating risk management actions to different stakeholders in food recall. The actions were grouped according to whether they were prevention actions to avoid a food recall or contention actions to limit the negative economic effects and maintain the health of the population.