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Patient satisfaction and quality care are important indicators for the success of any health care enterprise. The critical nature of health care operations entails that some excess capacity is stored in the system to provide the necessary flexibility of response. To prepare health care organizations to deliver high quality services at lower costs, this paper aims to report a lean health care (LEAN‐HC) transformation model that integrates queuing theory and lean methodology to improve the dynamic performance of the health care system.

This paper reviews and evaluates an emergency department health care system that adopts a system dynamic model, redesigned the process using value stream mapping to eliminate non‐value‐added activities to achieve just‐in‐time (JIT) services. This study was conducted at SD Mission Hospital, India. The LEAN‐HC model includes three steps. First, the patient arrival flow is assessed and adjusted, using physicians at the front of the queue to separate patients at triage into major, medium, and minor injury classes. Second, a cross‐functional team consisting of process, information and clinical experts maps the hospital's current state to identify and eliminate wasteful non‐value‐added activities. Third, the process is continually de‐bottlenecked using a variety of lean techniques, such as 5S visual management, one‐piece‐flow to reduce service lead time, and adoption of standard operating procedures.

The authors' results reveal that a lean integration to queuing methodology frees up capacity in the health care system, providing necessary flexibility of response. The implementation of the LEAN‐HC model resulted in the following improvement. First, an improved process flow and increased capacity. Second, emergency department length of stay for all patient classes decreased. Third, value stream mapping was found to be useful in detecting opportunities to decrease patient turnaround. Fourth, the service bottleneck could be identified and shifted to where it could be most easily controlled, adhering to the principle of one piece flow. No changes in resource availability and safety or quality issues occurred during the implementation of lean methodology.

This study demonstrates how to apply lean methodology in conjunction with the queuing modeling in the health care industry, particularly with regards to the patient wait time and reduction in medical errors. The LEAN‐HC model delivers more efficient service by increasing hospital capacity while reducing non‐value‐added times and overhead costs.

The purpose of this study was to determine the rate of concordance and discordance between clinical diagnosis and post‐mortem findings in patients admitted to the hospitals of the Saskatoon Health Region.

A retrospective record review of the medical and autopsy charts was carried out for all the deceased adult in‐patients admitted during calendar years 2002, 2003 and 2004. A total of 3416 in‐patient deaths were registered during the study period. Autopsies were performed on 206 of the deceased resulting in an autopsy rate of 6 percent. In accordance with selection criteria, 158 cases were included for this study. The mean age of subjects was 66.6±15.3 years with a range of 16‐94 years. The study group consisted of 92 males (58.2 percent) and 66 females (41.8 percent) with an average length of stay at the hospital of 12.9±10.9 days.

The concordance rate between clinical and autopsy diagnosis was found to be 75.3 percent. The discordance rate was 20.9 percent and in 3.8 percent of the study population a conclusive clinical or autopsy diagnosis was not finalized.

These results suggest that despite of the technical advances in medical and diagnostic modalities, diagnostic discrepancies in the present day health care system remain prevalent.

The authors encourage residents and physicians to continue using autopsy as an important tool to extend understanding of disease processes.

Celebrity endorsement advertising is a prevailing advertising technique. Some marketers choose to utilize multiple celebrities to promote their products or brands. Nevertheless, it is surprising that so little research has focused on this phenomenon. This research discussed advantages and potential concerns of multi‐celebrity endorsement advertising and documented the actual use of multiple celebrity endorsers in the milk mustache campaign in the USA. We analyzed the content of the 50 milk mustache ads appearing on the http://www.whymilk.com Web site on a list of celebrity‐ or product‐related dimensions. Overall, we found that these milk mustache ads have matched their celebrities’ gender, age and type of milk attributes in appealing to their female/male, teen/adult consumers. The results support that fit between the endorsed product and various celebrities is a key factor for using multiple celebrity endorsers in advertising.

The purpose of this paper is to examine whether the theory of planned behavior (TPB) can be used to explain financial salespeople ' s ethical selling intentions and behaviour in developing countries. Understanding salespeople ' s ethical intentions and behaviour is important as consumers in developing countries are more at risk of ethical abuse arising from higher information asymmetry, their lower levels of financial literacy and less effective services regulation relating to ethical sales practices. Developing countries also have fewer governmental social support mechanisms, making the purchase of insurance more important for protecting consumers ' financial well-being.

The paper examines 205 Bangladeshi financial salespeople ' s ethical selling intentions and behaviour using the TPB. Structural equation modeling is used to analyze the constructs and overall model.

The findings identify that attitudes, subjective norms and perceived behaviour control (PBC) affect ethical selling intentions which, in turn, predict salespeople ' s ethical sales behaviour. However, PBC does not directly relate to ethical sales behaviour.

Understanding of the determinants of financial salespeople ' s ethical selling intentions and behaviour is important for firms in developing countries and identifies that they need to develop effective management systems and foster organisational cultures that engender ethical behaviour. This is important in developing countries where ethical abuses and lapses will result in harm to consumers who have limited financial resources.

The results identify that the TPB applies to the selling of financial services in developing countries and, thus, broadens the applications and contexts of the TPB model. It also provides some managerial guidance as to how potential ethical breaches might be limited.

The adoption of electronic health records (EHRs) and digitization of health data over the past decade is ushering in the next generation of digital health tools that leverage artificial intelligence (AI) to improve varied aspects of health system performance. The decade ahead is therefore shaping up to be one in which digital health becomes even more at the forefront of health care delivery – demanding the time, attention, and resources of health care leaders and frontline staff, and becoming inextricably linked with all dimensions of health care delivery. In this chapter, we look back and look ahead. There are substantive lessons learned from the first era of large-scale adoption of enterprise EHRs and ongoing challenges that organizations are wrestling with – particularly related to the tension between standardization and flexibility/customization of EHR systems and the processes they support. Managing this tension during efforts to implement and optimize enterprise systems is perhaps the core challenge of the past decade, and one that has impeded consistent realization of value from initial EHR investments. We describe these challenges, how they manifest, and organizational strategies to address them, with a specific focus on alignment with broader value-based care transformation. We then look ahead to the AI wave – the massive number of applications of AI to health care delivery, the expected benefits, the risks and challenges, and approaches that health systems can consider to realize the benefits while avoiding the risks.

This study aims to explore the reasons for the rise of independent, stand-alone restaurants and ascertains the benefits of outsourcing food and beverage (F&B) in luxury hotels in India from the perspectives of the strategic partners involved in such an alliance. The study also proposes different formats for F&B outsourcing in luxury hotels.

An exploratory study was carried out by collecting primary data from 16 Hotel General Managers and F&B operations experts through qualitative, semi-structured, personal and in-depth interviews. NVivo12 software was used to carry out a qualitative thematic analysis of the data. The primary data collected were triangulated with secondary data gathered through literature review of academic papers, industry reports and studies on the trends of restaurants in luxury hotels being outsourced.

The study focusses on the antecedents of the rise of stand-alone restaurants in the Indian hospitality industry. To combat the competitive disruption arising because of this trend, the study posits the business model innovation of outsourcing F&B operations in luxury hotels.

The benefits of a strategic alliance from the perspective of both parties – the luxury hotel and Michelin-star chef or branded/marquee restaurant – are elucidated. Further, three broad formats, which can be adopted for speciality restaurant outsourcing are also proposed. Practitioners, researchers and educationists in the hospitality industry would find the implications of this study useful in the context of the present customer-centric business environment where hotels are constantly striving to meet the exponentially rising bar of guest expectations in an increasingly globalised milieu.

The study proposes a preliminary road map for internationalisation of F&B operations through the business model innovation of outsourcing operations of in-house specialty restaurants by luxury hotels in the Indian context.