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Workflow optimisation is crucial for establishing a viable acute stroke (AS) intervention programme in a large tertiary care centre. This study aims to utilise Lean Six Sigma (LSS) principles to enhance the hospital's workflow.

The Action Research methodology was used to implement the project and develop the case study. The study took place in a large tertiary care academic hospital in India. The Define-Measure-Analyse-Improve-Control approach optimised the workflow within 6 months. Lean tools such as value stream mapping (VSM), waste audits and Gemba were utilised to identify issues involving various stakeholders in the workflow. Sigma-level calculations were used to compare baseline, improvement and sustainment status. Additionally, statistical techniques were effectively employed to draw meaningful inferences.

LSS tools and techniques can be effectively utilised in large tertiary care hospitals to optimise workflow through a structured approach. Sigma ratings of the processes showed substantial improvement, resulting in a five-fold increase in clinical outcomes. Specifically, there was a 43% improvement in outcome for patients who underwent acute stroke revascularisation. However, certain sigma ratings deteriorated during the control and extended control (sustainment) phases. This indicates that ensuring the sustainability of quality control interventions in healthcare is challenging and requires continuous auditing.

The article presents a single case study deployed in a hospital in India. Thus, the generalisation of outcomes has a significant limitation. Also, the study encounters the challenge of not having a parallel control group, which is a common limitation in quality improvement studies in healthcare. Many studies in healthcare quality improvement, including this one, are limited by minimal data on long-term follow-up and the sustainability of achieved results.

This study pioneers the integration of LSS methodologies in a large Indian tertiary care hospital, specifically targeting AS intervention. It represents the first LSS case study applied in the stroke department of any hospital in India. Whilst most case studies discuss only the positive aspects, this article fills a critical gap by unearthing the challenges of applying LSS in a complex healthcare setting, offering insights into sustainable quality improvement and operational efficiency. This case study contributes to the theoretical understanding of LSS in healthcare. It showcases its real-world impact on patient outcomes and process optimisation.

Launching a new product successfully in a multi-brand portfolio is one of the major challenges a pharmaceutical marketer faces. This study aims to examine the role of detailing of new brands on physicians’ prescription behaviour as compared to established brands. Further, the study explores mediating role of detailing priority and detailing time on the relationship between detailing of new versus established brands and physician’s prescription behaviour.

This study was conducted as a real-world observational study involving field research. In total, 338 physicians, 90 PSRs and 44 field managers participated in this study. A serial mediation model (Hayes, Model 6) was used to examine the relationship. Regression analysis with bootstrapping was used to test the hypotheses.

Detailing of new versus established brands has a differential effect on physicians’ prescription behaviour. In addition, this relationship is serially mediated by detailing priority and detailing time.

Results suggest that detailing priority and detailing time positively and significantly alter the relationship between the detailing of new brands and physicians’ prescription behaviour as compared to established brands. While, in the absence of mediators, established brands generate higher prescriptions than new brands, the serial mediating effect helps new brands to generate more prescriptions as compared to established brands.

This research highlights the importance of detailing priority and detailing time for the successful launch of the new products. It presents compelling evidence for practicing managers to effectively use a “predetermined detailing plan” vis-à-vis “individualized detailing strategy” during the launch of a new brand.

To the best of the authors’ knowledge, this is the first study to evaluate the role of detailing priority and detailing time as mediators between the relationship of detailing and physicians’ prescription behaviour. This is also one of the rare studies to use real-world observational study methodology for conducting research.

The COVID-19 outbreak has severely impacted the health tourism industry. This study aims to examine the research undertaken on health tourism during COVID-19.

A bibliometric analysis was performed using 211 documents written by 645 authors between 2020 and 2024. The databases used for this analysis are SCOPUS, Web of Science and PubMed. The study was conducted using the Biblioshiny application for R software. Various analyses, including citation analysis, keyword analysis, thematic mapping and evolution and collaboration analysis, were conducted to get a comprehensive picture of the impact of COVID-19 on health tourism.

The findings suggest that medical tourism was the major area of focus for researchers during COVID-19, whereas wellness tourism was studied in the later stages of the pandemic and is considered important for coping with the negative effects of COVID-19. The thematic review indicates that pre-pandemic research focused on strategies that accelerate the growth of the health tourism sector, whereas during and post-pandemic, the focus was on studying the impact of COVID-19 on the survival and recovery of the sector. Overall, health tourism was considered instrumental in the post-pandemic revival of the tourism industry.

The bibliometric analysis is limited to only four years, as the focus was on studying health tourism during COVID-19. Hence, the study offers more precise insights into the research focus on health tourism during a pandemic. The current study offers limited insights into the post-pandemic scenario as the research is still emerging.

There is a significant opportunity for future research on post-COVID-19 recovery strategies, wherein this research will be helpful for researchers, particularly from emerging countries and countries with high dependence on health, medical and wellness tourism. The thematic analysis provides a valuable comparison of pre-, during and post-pandemic research.

The research indicates an opportunity to study the policies and strategies adopted by various countries regarding the health tourism sector in the post-COVID-19 era. The research also highlights the interwoven, intricate, interdisciplinary nature of health tourism in relation to public and mental health and the need for collaborative efforts.

The study provides critical insights and new directions for future research by highlighting the crucial role of health tourism in mitigating the impact of COVID-19.

Waste can be converted to a high-value asset if treated properly with smart solutions. The purpose of this research is to identify critical barriers hindering smart waste management (SWM) implementation in developing economies using comparative analysis and a mixed-method approach. The objective of this work is to provide exhaustive insight including the smart cities projects to discuss the deferring parameters toward IoT-enabled waste management systems.

To accomplish the objective, the present study followed mixed-method approach consisting of two phases: In the first qualitative phase, barriers in the adoption of IoT (Internet of Things) for SWM were identified using extensive literature review and discussion with selected experts. In the second phase, the quantitative analysis using the Fuzzy DEMATEL (Decision-Making Trial and Evaluation Laboratory) method was performed on the selected barriers. The fuzzy DEMATEL methodology helps in prioritizing the most significant causal barrier by separating them into the cause-effect group. The comparative analysis was used to understand two different perceptions. To provide more detailed insight on the problems faced while implementing SWM in developing economies.

The results disclose that “Lack of government strict regulatory policies,” “Lack of proper financial planning” and “Lack of benchmarking processes” are the most critical causal barriers toward IoT-enabled SWM implementation that are hindering the vision of efficient and effective waste management system. Also, “Difficulty in implementing innovative technologies” and “Absence of Dynamic Scheduling and Routing” fall under the potential causal category. The effect barriers include “Lack of awareness among the community,” “Lack of source segregation and recycling commitment” and “Lack of service provider” as concluded in results considering the comparative analysis. The results can aid the policy-makers and stakeholders to identify the significant barriers toward a sustainable circular economy and mitigate them when implementing IoT-enable waste practices. Also, it assists to proactively build programs, policies, campaigns and other measures to attain a zero-waste economy.

The research is focused on the context of India but it provides new details which can be helpful for other developing economies to relate. The research addresses the call for studies from public-sector and citizen’s perspectives to understand the acknowledgment of SWM systems and critical success factors using qualitative and exploratory method analysis.

The practical implications of the study include strict regulatory policies and guidelines for SWM acceptance, proper financial administration and benchmarking waste-recycling practices (prominent causal barriers). The practical implication of the results includes assistance in smart city projects in handling barriers proactively. The “Lack of Benchmarking processes” provides a critical application to standardized recycling practices in developing economies to improve the quality of the recyclable material/product. The comparative analysis also provides in-depth reflection toward the causal barriers from both the perspective which can help the government and stakeholders to work in a unified manner and establish an efficient waste management system. The results also conclude the need for targeted training programs and workshops for field implementation of innovative technologies to overcome the causal barrier. Moreover, policy-makers should focus to improve source segregation and recycling practices and ensure dedicated communication campaigns like Swachh Bharat Abhiyan to change the behavioral functioning of the community regarding waste. Lastly, developing economies struggle with the adequacy of resources to establish SWM systems, hence the authors conclude that proper financial planning is required at the ground level for smart city projects to overcome the spillover effects.

The social implications of the study include a reduction in pollution and efficient handling of waste resulting in a healthier and cleaner environment using IoT technology. Also, the results assist decision-makers in developing economies like India to establish smart city projects initiatives effectively to improve the quality of life. It proposes to establish standardized recycling processes for the better quality of recyclables and help in attaining a sustainable circular economy.

The research is novel as it provides comprehensive and comparative information regarding the barriers deferring SWM including the field barriers. To our consideration, the present study serves the first to address the comparative analysis of barriers in IoT-enabled waste systems and establish the relationship from both the perspective in middle-lower income economies. The study also suggests that the effect barriers can be overcome automatically by mitigating the causal barriers in the long run.

The purpose of this study is to understand the different types of risks affecting the demand for the automotive sector in India. The study is further trying to illustrate an approach for analyzing the relative intensities of these risks in the present uncertain business environment.

Risk on the overall demand is assessed by a combined Bayesian – multi-criteria decision-making approach. Data related to the different factors, affecting their product demand is collected from major automobile firms. Then, weights for these factors are evaluated by applying the analytic hierarchy process approach. Further, these weights are used in the Bayesian analysis network to evaluate the risk intensity for different subgroups, namely, political, economic, social, technological and environmental.

From the literature and experts’ opinion, total 16 risk factors have been finalized and these are further grouped into 5 categories i.e. political, economic, social, technological and environmental. It is observed that the demand for organizations functioning in the automotive sector is more vulnerable to economic risk as compared to other risks considered in the study.

Managers and decision makers of associated organizations can use the proposed framework to assess the demand risks so as to pre-evaluate their demand corresponding to future changes. Factors can be added or removed and importance could be assigned to different risk factors according to the prevailing business environment for an organization or sector. This will also help the organizations to conduct a more effective risk management in an uncertain business environment.

The study will help in better understanding of the various demand risks prevalent in the Indian auto sector. The methodology used, provides a novel approach for assessing the macroeconomic demand risks and can be used by the firms working in the automotive sector. The proposed methodology could be used for assessing supply chain risk or any other business initiative risk. The suggested approach will help managers in devising flexible management techniques so as to mitigate the risk.

This paper aims to understand the impact of smart working on employees’ quality of life. The service-dominant logic indicates that key actors, including employees, are resource integrators. This empirical study contributes to the current knowledge of transformative service by expounding on smart working practices and their relationship with self-efficacy and, ultimately, quality of life of employees.

This study contends that smart working enhances employees’ self-efficacy. The current research uses conservation of resources (COR) theory as a basis in hypothesizing that self-efficacy serves as a key resource, which can stimulate workplace creativity, job satisfaction and quality of life. An onsite survey is conducted among employees who have been involved in smart working in the travel agency context.

Smart working has a positive effect on self-efficacy, which positively influences workplace creativity, job satisfaction and quality of life. Workplace creativity enhances job satisfaction but does not influence quality of life. Job satisfaction boosts quality of life, which is important to tourism services and their employees amid various crises.

Consistent with COR theory, the immediate recommendation to managers is to invest in smart working, which can lead to employees’ creativity, job satisfaction and quality of life.

To the best of the authors’ knowledge, this empirical study is the first to assess the viability of smart working in the travel agency context. Smart working offers positive outcomes, such as convenience for employees to work independently, improving workplace creativity, job satisfaction and quality of life. Travel agencies are mainly categorized as small and medium enterprises (SMEs). In the future, SMEs may also introduce smart working that can eventually become their competitive advantage to retain talented employees.

旅行社中的智慧办公与员工的生活质量

本文旨在了解智慧办公对员工的影响.服务主导逻辑表明, 员工等关键人物是资源整合者。本文通过实证研究揭示了智慧办公实践及其与员工自我效能和生活质量的关系, 对现有转型服务知识做出贡献。

本研究认为智慧办公可以提高员工的自我效能。基于资源守恒理论(COR), 本研究假设自我效能是激发职场创造力、工作满意度和生活质量的关键因素, 对旅行社中参与智慧办公的员工进行了现场调查。

智慧办公对自我效能有正向影响, 同时自我效能对职场创造力、工作满意度和生活质量均产生正向影响。职场创造力能够提高工作满意度, 但对员工的生活质量不起作用。另外, 工作满意度有利于提升生活质量, 这对面临各种危机的旅游企业和员工具有重要意义。

根据COR理论, 即刻建议管理者投资推行智慧办公, 从而提升员工的创造力, 工作满意度和生活质量。

这一实证研究首次尝试评估旅行社中推行智慧办公的可行性。智慧办公可带来多种积极效果, 如为员工独立工作提供便利, 提升员工的职场创造力、工作满意度和生活质量等。旅行社属于中小型企业(SMEs)。未来, 中小型企业同样可尝试引入智慧办公, 这将成为其留住优秀员工的竞争优势。

关键词：智慧办公, 公平评估, 自我效能, 创造力, 自主, 生活质量

文章类型： 研究型论文

El trabajo inteligente en las agencias de viajes y la calidad de vida de los empleados

Resumen

Este artículo tiene como objetivo entender el impacto del trabajo inteligente en la calidad de vida de los empleados. Basándose en la lógica de servicio dominante, los actores clave, incluidos los empleados, son integradores de recursos. Este estudio empírico contribuye al conocimiento actual de lo que constituye un servicio transformador al exponer prácticas laborales inteligentes y su relación con la autoeficacia y, en última instancia, la calidad de vida de los empleados.

Este estudio sostiene que el trabajo inteligente mejora la autoeficacia de los empleados. Plantea la hipótesis de que la autoeficacia sirve como un recurso clave que puede estimular la creatividad en el lugar de trabajo, la satisfacción laboral y la calidad de vida utilizando la teoría de la conservación de recursos. Se ha realizado una encuesta in situ entre los empleados que han llevado a cabo trabajo inteligente en el contexto de la agencia de viajes.

El trabajo inteligente tiene un efecto positivo en la autoeficacia que influye positivamente en la creatividad en el lugar de trabajo, la satisfacción laboral y la calidad de vida. La creatividad en el lugar de trabajo mejora la satisfacción laboral, pero no influye en la calidad de vida. La satisfacción laboral mejora la calidad de vida, lo que es importante tanto para los servicios turísticos como para sus empleados durante las crisis.

De acuerdo con la teoría de la conservación de recursos, la recomendación inmediata a los gerentes es invertir en un trabajo inteligente que pueda conducir a la creatividad, la satisfacción laboral y la calidad de vida de los empleados.

Este estudio empírico es el primero del que tengamos constancia en evaluar la viabilidad del trabajo inteligente en el contexto de la agencia de viajes. El trabajo inteligente ofrece beneficios, como la posibilidad de que los empleados trabajen de forma independiente, mejorando así la creatividad profesional, la satisfacción laboral y la calidad de vida. Las agencias de viajes se incluyen principalmente en la categoría de pequeñas y medianas empresas (pymes). En el futuro, las pymes también pueden introducir el trabajo inteligente, que puede llegar a convertirse en su ventaja competitiva para retener a los empleados con talento.

Trabajo inteligente, Equidad en las valoraciones, Autoeficacia, Creatividad, Autonomía, Calidad de vida

Biofortification of staple crops is a promising strategy to alleviate micronutrient deficiencies in rural populations of the developing world. The possibility to sell biofortified crops at “a good market price” plays a vital role for the acceptance by smallholder farmers. This study is therefore focused on non-farming consumers' willingness to pay (WTP) for biofortified crops.

Specifically, we elicited non-farming consumers' WTP a premium for the improved iron content (+30% iron) in a 1kg finger millet bag using a 2nd price Vickrey auction with six auction rounds and one health- and one process-related information treatment. Due to multiple bids per subject, premiums were analyzed using a linear mixed-effects model, controlling for market feedback and auction round.

Despite more than half of the respondents being skeptical toward new crop varieties, the acceptance rate was very high (98% with a WTP above zero). The average premium amounted to 27% and could be significantly increased with the provision of health-related information. In contrast, information about the breeding method was ineffective. The WTP was significantly higher for higher income and lower for higher age, education and skepticism toward new crop varieties and increased with increasing rounds.

Our results suggest that non-farming consumers are willing to pay “a good market price” for iron-biofortified finger millet. Our analysis also confirms the importance of health-related information for raising consumers' WTP. This information supports the further development and introduction of biofortified crops to alleviate micronutrient malnutrition.

This study adds to the still limited literature on consumers' WTP for iron-biofortified crops in India, focusing on non-farming consumers to assess the price such crops can achieve on the market.