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This study investigates how a hospital can increase the flow of patients through its emergency department by using benchmarking and process improvement techniques borrowed from the manufacturing sector.

An in-depth case study of an Australasian public hospital utilises rigorous, multi-method data collection procedures with systems thinking to benchmark an emergency department (ED) value stream and identify the performance inhibitors.

High levels of value stream uncertainty result from inefficient processes and weak controls. Reduced patient flow arises from senior management’s commitment to simplistic government targets, clinical staff that lack basic operations management skills, and fragmented information systems. High junior/senior staff ratios aggravate the lack of inter-functional integration and poor use of time and material resources, increasing the risk of a critical patient incident.

This research is limited to a single case; hence, further research should assess value stream maturity and associated performance enablers and inhibitors in other emergency departments experiencing patient flow delays.

This study illustrates how hospital managers can use systems thinking and a context-free performance benchmarking measure to identify needed interventions and transferable best practices for achieving seamless patient flow.

This study is the first to operationalise the theoretical concept of the seamless healthcare system to acute care as defined by Parnaby and Towill (2008). It is also the first to use the uncertainty circle model in an Australasian public healthcare setting to objectively benchmark an emergency department's value stream maturity.

Delivering housing to resource-constrained communities (RCCs) is a complex process beset with difficulties. The purpose of this study is to use a complexity lens to examine the approach taken by a social enterprise (SE) in Australia to develop and manage a housebuilding supply chain for RCCs.

The research team used a longitudinal case study approach from 2017 to 2022, which used mixed methods to understand the phenomenon and gain an in-depth understanding of the complex issues and problem-solving undertaken by an SE start-up.

Balancing mission logic with commercial viability is challenging for an SE. The supply chain solution that evolved accommodated the particulars of geography and the needs of many stakeholders, including the end-user community and government sponsors. Extensive and time-consuming socialisation and customisation led to a successful technical design and sustainable supply chain operation.

Analysing supply chain intricacies via a complexity framework is valuable for scholars and practitioners, assisting in designing and developing supply chain configurations and understanding their dynamics. Meeting the housing construction needs of RCCs requires the SE to place societal focus at the centre of the supply chain rather than merely being a system output. The developed business model complements the engineering solution to empower a community-led housing construction supply chain.

This longitudinal case study contributes to knowledge by providing rich insights into the roles of SEs and how they develop and operate supply chains to fit with the needs of RCCs. Adding a contextual response dimension to an established complexity framework helped to explain how hybrid organisations balance commercial viability demands with social mission logic by amending traditional supply chain and governance practices. The case provides insights into supply chain configuration, needed changes and potential impacts when an SE as a focal actor inserts into a traditional for-profit construction supply chain.

The sudden arrival of Covid-19 severely disrupted the supply chain of personal protective equipment (PPE) in Australia. This paper aims to examine the development of a geographical cluster, which, through the application of additive manufacturing (AM), responded to the PPE supply crisis.

This longitudinal case study focuses on an AM cluster, which was developed to supply PPE in a responsive and flexible manner from 2019/2020. The study gathered data over three stages of cluster evolution: pre, during and post-peak Covid-19.

The type and nature of exchanges between organizations involved in the cluster established important insights into success factors for cluster creation and development. Using an established complexity framework, this study identifies the characteristics of establishing a cluster. The importance of cluster alignment created initially by a common PPE supply goal led to an emerging commercial and relational imperative to address the longer-term configuration after the disruption.

Clusters can be a viable option for a technology-driven sector when there is a “buzz” that drives and rapidly diffuses knowledge to support cluster formation. This research identifies the structural, socio-political and emergent dimensions, which need to be considered by stakeholders when aiming at improving competitiveness using clusters.

Covid-19 has rapidly and unexpectedly disrupted the supply chain for many industries. Responding to challenges, businesses will investigate different pathways to improve the overall resilience including on-/near-shoring. The results provide insights into how clusters are formed, grow and develop and the differentiating factors that result in successful impacts of clusters on local economies.