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In a hospital, the management of different materials (i.e. waste, drugs, equipment, etc.) is fundamental from an economical point of view and also when considering its impact on patient treatment. The purpose of this paper is to introduce by an innovative approach lean principles in the management of this supply chain.

After the contextualization of the importance of the drug management in hospitals, authors analyze the literature in particular discussing the points of weakness. They propose an innovative methodology to implement a lean principle in this particular supply chain. After a general discussion authors discuss the application of the proposed methodology in the largest Italian hospital, the Policlinico Sant’Orsola – Malpighi in Bologna.

The results are very encouraging, confirm the value of the methods and motivate the authors to do further research. The proposed methodology takes into account both a technical approach and the real behavior of a hospital including logistics knowledge and motivation for material management in ward personnel. Real results are interesting both in term of economic impact and in term of effect on patient care.

Maximizing patient care is the mission of the healthcare system; however, poor management of drugs and materials can have serious effects on the quality of service. In the last years, several excellent technological solutions have been developed, but often their application in the field was limited and ineffective due to the gap in knowledge and commitment required and available in the ward’s personnel. The new methodology developed is focused to solve this gap and was tested in an important case study.

Tutti i Paesi che svolgono una politica del turismo tendente ad aumentare l'afflusso dei viaggiatori stranieri sul proprio territorio fanno perno e leva su quelle attrattive naturali, ambientali, culturali, nelle quali sanno di eccellere. E mentre da una parte intensificano gli sforzi diretti ad accrescere e valorizzare questi elementi di maggiore interesse per i turisti provenienti dall'estero, dall'altra sviluppano una complessa attività propagandistica rivolta a divulgare nel mondo la conoscenza di tali fattori di preminenza turistica.

The purpose of this paper is to set out a methodological framework to investigate how the integration of an activity-based costing (ABC) logic into the pre-existent accounting system supports healthcare organizations in identifying the inefficiencies related to their diagnostic therapeutic pathways (DTP) and related reengineering interventions.

The BPM-ABC methodological framework has been applied to the case of a specific surgery pathway, at the Orthopaedic Division of a University Hospital in Italy.

The case-study described in the paper points out: first, how the Business Process Management (BPM)-ABC methodology is able to produce significant information about consumed resources and the costs of the activities, useful to highlight opportunities for DTPs improvement; second, the barriers related to a pre-existing accounting system based on cost centres that can hinder the implementation of the BPM-ABC model.

The case study points out the role of the ABC as a management tool for supporting decision-making processes. The ABC allows inferring information for two purposes. First, ABC supports a cost containment process as it allows highlighting the most cost-consuming activities and resources. Second, the ABC allows identifying reengineering paths, distinguishing between incremental and radical ones.

This study represents a remarkable reference raising the awareness of the pivotal role accounting systems play in the management of the organizational processes.