Maro Vlachopoulou and Vassiliki Manthou
Successful virtual working requires organizations to adopt new approaches towards managing and leading in the following key areas: managing infrastructure, people, information and…
Abstract
Successful virtual working requires organizations to adopt new approaches towards managing and leading in the following key areas: managing infrastructure, people, information and joint activities/processes. Marketing transformation and integration between the partners’ internal and external activities and relationships are the prerequisites in order to combine their core competencies creating dynamic virtual collaboration networks. In this paper several e‐partner relationship management paradigms are illustrated and categorized according to the degree of integration and e‐marketing/business transformation. The proposed integrated e‐partner relationship management solution offers a systematic process for ensuring that specific partnerships criteria are developed and managed in the most beneficial way for the involved parties in virtual environment.
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Giancarlo Giacchetta and Barbara Marchetti
A measurement campaign was carried out for assessing the waste flow in a pilot hospital of a region in central Italy, with the purpose of having a complete overview of the waste…
Abstract
Purpose
A measurement campaign was carried out for assessing the waste flow in a pilot hospital of a region in central Italy, with the purpose of having a complete overview of the waste stream and of the personnel behavior in managing and handling waste flow both internally and in outsourcing. The main aim of the work was to provide instruction for decreasing waste quantities, improving segregation and decreasing costs and environmental risks. Moreover an analysis of the effectiveness of outsourcing the waste management service in terms of cost reduction and efficiency improvements and of the limits has been performed.
Design/methodology/approach
A self‐assessment model was proposed for evaluating waste generation patterns, quantities and sources and identifying anomalies. The research team comprised the hospital administrator, the head physician and charge nurse of each hospital ward, the administrative in charge of the waste management documents, the head of the hospital pharmacy, the responsible for the external outsourcing company in charge of waste collection and disposal, and the research team of Università Politecnica delle Marche. The data were obtained through the questionnaires elaborated by the group and submitted to a selected sample of personnel; they were asked to provide information on waste management practices (generation, collection, segregation, cleaning, storage) and quantities.
Findings
Anomalous behaviors were identified in the high amount of solid waste going into the medical waste stream; corrective actions have been proposed and their effectiveness has been monitored after implementation. The measures allowed a reduction of medical waste from 13 to 15 percent in two analyzed wards with a significant reduction of waste management costs.
Originality/value
This work has been requested and supported by the management of the healthcare structure analyzed, and represents a first step in the implementation of a policy that considers waste management as one of the fundamental processes for the proper functioning of the hospital.
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Cristina Machado Guimarães, José Crespo de Carvalho and Ana Maia
Understanding how VMI benefits serve lean purposes in healthcare and why its outcomes can be difficult to achieve in healthcare settings is the main purpose of this study.
Abstract
Purpose
Understanding how VMI benefits serve lean purposes in healthcare and why its outcomes can be difficult to achieve in healthcare settings is the main purpose of this study.
Design/methodology/approach
An in‐depth case study of VMI is presented in the perspective of the downstream member, a public general multi‐site hospital, operating as a small scale consolidated service centre in terms of material management, exploring such dimensions as: VMI benefits, risks, barriers and enablers.
Findings
Despite some unawareness of VMI benefits in healthcare, it can present a waste reduction solution not only in costs but in the quality of care for freeing clinical professionals to clinical tasks, among other savings. The multiple benefits are better explored, as in any relationship building, by investing in partnership creation and overcoming the idiosyncratic barriers of the healthcare sector.
Research limitations/implications
Although findings of a single case study are difficult to generalize, the protocol and methodology presented allow replication in other units of analysis with the same inclusion criteria.
Practical implications
This paper brings the lean deployment discussion out of the organization's boundaries, showing the interconnections and pointing to the need for future work that would allow healthcare managers to build a lean supply chain.
Originality/value
By considering VMI an outsourcing alternative, this paper identifies the lean thinking intent behind such options and enhances the idiosyncratic difficulties in full deployment in the healthcare sector, a less studied setting.
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Anna Azzi, Alessandro Persona, Fabio Sgarbossa and Mauro Bonin
The purpose of the present research is to explore the current situation and future expectations on whether to self‐manage or outsource logistics operations in centralized…
Abstract
Purpose
The purpose of the present research is to explore the current situation and future expectations on whether to self‐manage or outsource logistics operations in centralized healthcare networks, and to analyse and quantify the relationships between logistics outsourcing, costs and performance.
Design/methodology/approach
The paper is based on a thorough study of a local Italian healthcare network, which evaluated the economic sustainability of logistics outsourcing. The data were collected using interviews, documentation and observations in hospital pharmacies and wards, and by referring to public information available on the internet. A system dynamic simulation followed by a sensitivity analysis was used to investigate the impact of changing key variables as well as the advice of logistics providers.
Findings
The sensitivity analysis demonstrates that logistics outsourcing is often the most economical choice.
Social implications
Performance‐oriented concepts applied to healthcare have many pros in terms of sustainable delivery of quality healthcare at affordable costs.
Originality/value
While there are numerous studies on logistics outsourcing in many industries, when it comes to the healthcare sector literature is scarce, probably due to the great changes this sector has faced in recent times: thus, the paper's quantitative findings should be seen as a first attempt to assist the “make‐or‐buy” decision process toward sustainable development of the healthcare sector.
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Gianfranco Ignone, Giorgio Mossa, Giovanni Mummolo, Rosa Pilolli and Luigi Ranieri
The aim of this paper is to support public decision‐makers in a local healthcare agency (LHA) in evaluating the effects of different de‐hospitalization strategies and the…
Abstract
Purpose
The aim of this paper is to support public decision‐makers in a local healthcare agency (LHA) in evaluating the effects of different de‐hospitalization strategies and the potential for outsourcing clinical services.
Design/methodology/approach
The approach adopted is based on the “patient pathway” perspective. Starting from the identification of specific care pathways, all the feasible care paths in a given LHA in Italy are investigated in order to evaluate the practicability of the de‐hospitalization of some phases with a particular focus on co‐ordination of hospitals and territorial services. A heuristic approach based on discrete‐event simulation modelling is proposed. The methodology and the simulation model have been validated with reference to field data derived from a full‐scale case study carried out within a LHA in southern Italy.
Findings
The results show where, in terms of care pathways, de‐hospitalization is practicable, valuable in terms of better resource utilization, and eligible for outsourcing. The outsourcing option appears to be more sustainable from a social point of view. It specifies that there would be no dismissal of employees, and that there would be recruitment of specialized workers such as nurses and doctors, employed under more flexible conditions. Savings in overheads would be achieved by means of patient de‐hospitalization.
Originality/value
The existing scientific literature, to the best of the authors' knowledge, deals with patient flow management at the hospital level. However, in the European countries, the public healthcare system is generally organized in terms of the territorially based allocation of service centres. Given the scarcity of public resources, the main difficulty seems to be a mismatch among actions needed to improve territorial and residential care for outsourcing, and the interventions needed to contain hospital costs.
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The purpose of this paper is to develop a generic framework for the assessment of VMI implementation. The framework is used for the analysis of multiple case studies in German…
Abstract
Purpose
The purpose of this paper is to develop a generic framework for the assessment of VMI implementation. The framework is used for the analysis of multiple case studies in German hospitals to discuss the feasibility of VMI in the German blood supply chain.
Design/methodology/approach
The methodology is twofold. In a first step, the literature is reviewed and a generic theoretical VMI framework is developed. In a second step, the case study methodology is applied to 13 cases to assess the feasibility of VMI in the German blood supply chain.
Findings
The paper contributes a generic framework for assessing the implementation of VMI in seven steps. The research proposed that hospitals hesitate to enter a VMI relationship for critical resources such as blood. Hospitals fear losing control over critical resources.
Research limitations/implications
The unit of analysis is hospitals in Germany and the case studies do not target the suppliers in the supply chain. The paper contributes three propositions regarding VMI in the healthcare/blood supply chain.
Practical implications
A generic framework for assessing the applicability and feasibility of VMI is provided which supports managers with the implementation of VMI in a supply chain.
Originality/value
The paper is one of the first papers targeting inventory and supply chain management in the German blood supply chain. It provides a generic framework for the assessment of the feasibility of VMI.