1,721,018 research outputs found
Managing Intellectual Capital in Italian Manufacturing SMEs
No full textThe purpose of the paper is to provide an operative framework to measure intellectual capital (IC) in SMEs and to apply it to the Italian manufacturing context. A second aim is to profile the level and the structure of IC in these firms, identifying different clusters with diverse IC profile and analysing the impact of IC on firm performance. A survey was conducted in the Italian manufacturing context. After a descriptive analysis revealing the level of IC components, cluster analysis was executed for IC profiling, while multiple linear regression models were developed to analyse the relationship between IC and firm performance. A heterogeneous IC structure emerged and three clusters were obtained and described. A positive relationship between IC components and firm performance was demonstrated. This research contributes to measuring IC in manufacturing SMEs by providing an operative integrated framework, to understand its structure and level and its effect on firm success. Managers of SMEs can draw guidelines for IC evaluation to develop internal auditing systems, to communicate adequately IC value to any stakeholders and to support decisions in managing their IC, thereby maximizing firm performance
Safety improvements from health lean management implementation: evidences from three cases
No full textPurpose - In a context where healthcare systems have to face multiple challenges, the development of a methodology that combines new managerial approaches could contribute to pursue and achieve multiple objectives. Inside the research stream that intends to combine Health Lean Management (HLM) and Clinical Risk Management (CRM), this paper aims to study the significant features that characterize HLM projects obtaining patient safety improvements (L&S projects).
Design/methodology/approach - The novelty of the research implies to adopt qualitative research methodology, analysing in-depth case studies. L&S projects at different organizational levels have been selected from the same hospital. Following a research protocol, data have been collected through semi-structured interviews and they have been triangulated studying reports and archival documentation.
Findings - Comparing the three cases, it emerges that HLM can be a support for CRM since safety improvements can be achieved solving organizational issues. Analyzing the significant features of the three cases, relevant differences have been highlighted among them. At the end, first indications useful for achieving safety improvements from lean project implementation have been grasped.
Originality/value - This research provides a preliminary contribution to a new research stream that aims to develop a synergic methodology combining HLM and CRM. The first provided indications can be followed by hospital managers who wish to learn how to implement projects achieving patient safety improvements besides efficiency enhancement. After testing and exploiting the obtained results, a new methodology should be developed moving towards a safer and more sustainable health care system
MANAGEMENT AND COMMUNICATION OF INTANGIBLE ASSETS: A MODEL TEST IN SOME ITALIAN SMEs,
No full textDuring the last decades intangible assets have become really important for firms competitiveness, not only for large companies, but also for small and medium size companies (SMEs). Despite the existence of different methods and techniques to measure firms’ intangible assets, few practical applications are described in literature, particularly in the context of SMEs. For this reason, the objective of this study has been to develop a modular, multi purposes and forward looking tool and to test it in some small firms in Italy. The results of our analysis show that the model's application in the companies has been useful to enhance the company’s awareness about intangible assets and to improve the management of them. This test allows us to put forward some improvements of the tool
Future developments in healthcare performance management
Full text linkThe paper highlights the challenges coming from performance management in healthcare, where multiple different objectives have to be pursued necessarily. Literature suggests to start from quality performance, following the sand cone theory, but considering a multidimensional concept of healthcare quality. Moreover, new managerial approaches coming from industrial context and adapted to healthcare, as lean management and risk management, can give a contribution in improving quality performance. Therefore emerges the opportunity to analyze them considering overlaps and links, in order to grasp possible synergies and to investigate the opportunity to develop an integrated methodology enabling to improve performance
Identification and development of potential synergies between health lean management and clinical risk management
No full textHealthcare systems have to afford multiple challenges especially during a crisis period where many governments have to spending review in order to comply with international agreements. Particularly for healthcare systems that are guaranteed and funded by public institutions, efficiency should be increased cutting wastes and costs. On the other hand, accreditation standards require high performance in terms of safety improvements. In a context where resources are scant and customers and ethical principles ask for high quality, new managerial solutions should be developed, in order to abandon the trade-off approach between diverging performance objectives and to take advantage of the benefits of different combined methodologies.
An increasing interest has been devoting to Health Lean Management (HLM) both in academic and in managerial literature. It has been cogitated as a managerial approach that could contribute to efficiency improvements, identifying and eliminating any wastes, attributing more value to the patient and reducing costs. Few researches have analysed the impact of this methodology on quality improvements. Another emerging managerial approach is acquiring an increasing interest and it is usually adopted in alternative to HLM. It is Clinical Risk Management (CRM), which permits to identify, analyse and treat clinical risks with the aim to enhance the healthcare quality improving in particular patient safety. Until now, the possibility to combine HLM and CRM has received scarce attention. In literature, a synergic methodology that integrates HLM and CRM is still missing whereby guidelines for implementing HLM projects with impacts on quality of care and patient safety improvements are not provided. Nevertheless, they could be helpful for hospital managers that intend to successful implement this kind of projects pursuing multiple objectives. For this reason, in this thesis after investigating the connections and overlaps between HLM and CRM in the academic literature, the characteristics of HLM projects with connections with CRM have been analysed in academic and grey literature. In the last analysis of the thesis, nine Lean & Safety projects (L&S projects), defined as HLM projects with patient safety improvements, have been studied in order to understand how it is possible to implement HLM projects with CRM benefits.
Substantially, the following research objectives have been pursued:
• Understanding whether any links exist between HLM and CRM in literature:
- Are there any connections/overlaps between HLM and CRM in hospital environment? If yes, which are the connections and the outcomes? What are the characteristics of HLM projects with CRM connections in literature?
- Can HLM support CRM in hospital environment?
• Drawing the state of the art regarding the implementation of HLM projects with connections with CRM:
- What is the state of the art of HLM in Italian context?
- What are the characteristics of the HLM projects linked to CRM in Italian context?
• Studying how it is possible to implement HLM projects with benefit to CRM:
- What are the organizational aspects of L&S projects?
- What are the phases and activities?
- What are the tools and practices?
- What are the critical factors that should be followed for a successful implementation?
The first research objective has been pursued through a systematic literature review. From this analysis, the lack of a synergic methodology that combines HLM and CRM emerged. However, connections and overlaps between the two approaches were demonstrated and it was possible to examine the features of HLM projects with connections with CRM. Those projects have been analysed also in grey literature, pursuing the second research objective. After drawing the map of the HLM experience in Italy, the characteristics about HLM projects with connections with CRM, identified in the Italian reports, have been examined and through the comparison with the results from academic literature review, interesting alignments have been found out. Focusing on L&S projects, a multiple case study has allows elaborating a framework of analysis and providing useful indications for the development of guidelines to implement successfully L&S projects. Three different clusters have been identified and characterized referring to the organizational aspects, phases and activities, tools and practices and critical factors for the implementation of L&S projects. At the end of the analysis, relevant propositions have been grasped permitting to contribute to theory building and to the definition of useful indications for developing L&S projects in hospital environment.
Thanks to this research, significant contributions to the literature of health management, health service operations management and public management have been added. In addition, a new research topic has been introduced and relevant cues for future research have been provided moving towards the realization of healthcare systems more efficient, effective, and safe.I sistemi sanitari da tempo devono affrontare sfide di diverso genere; tale situazione diventa particolarmente complicata nei periodi di crisi in cui molti stati sono costretti a revisionare le proprie spese in modo da rispettare gli impegni assunti a livello internazionale. Soprattutto nei sistemi sanitari garantiti e finanziati da istituzioni pubbliche, gli sprechi e i costi dovrebbero essere ridotti in modo da aumentare l’efficienza. Contemporaneamente a questa esigenza, gli standard di accreditamento impongono di garantire elevate prestazioni in termini di miglioramento della sicurezza. In un contesto in cui le risorse sono scarse e pazienti e principi etici obbligano a ricercare elevati livelli di qualità, nuove soluzioni manageriali dovrebbe essere sviluppate al fine di superare l’approccio di “trade-off”, che spinge a prediligere un obiettivo di prestazione rispetto ad un altro, e beneficiare, invece, dei vantaggi di diverse metodologie combinate.
Un interesse crescente è stato dedicato all’ Health Lean Management (HLM) sia nella letteratura accademica che in quella manageriale. Si tratta di un approccio manageriale che potrebbe contribuire al raggiungimento di miglioramenti di efficienza attraverso l’identificazione e l’eliminazione di tutti gli sprechi, attribuendo così un maggiore valore al paziente e riducendo i costi. Poche ricerche hanno analizzato l’impatto di questa metodologia sui miglioramenti della qualità. Esiste un altro approccio manageriale emergente che sta acquisendo particolare interesse e che spesso viene adottato in alternativa all’HLM. Si tratta del Clinical Risk Management (CRM) che consente di identificare, analizzare e trattare i rischi clinici con l’obiettivo di migliorare la qualità in sanità con particolare riferimento alla sicurezza del paziente. Finora un’attenzione davvero irrisoria è stata attribuita alla possibilità di combinare l’HLM con il CRM. Una metodologia sinergica che integri HLM e CRM risulta ancora assente per cui in letteratura non si trovano linee guida per l’implementazione di progetti di HLM con impatti sulla qualità della cura e sui miglioramenti della sicurezza del paziente. Nonostante ciò, tali indicazioni potrebbero essere di aiuto ai manager degli ospedali che intendono realizzare con successo questo tipo di progetti perseguendo una pluralità di obiettivi diversi. Per tale ragione in questa tesi, dopo aver indagato l’esistenza di connessioni e sovrapposizioni tra HLM e CRM nella letteratura accademica, si sono analizzate le caratteristiche dei progetti di HLM aventi connessioni con il CRM e presenti sia nella letteratura accademica che in quella manageriale. Nell’ultima analisi di questa tesi, nove Lean & Safety project (L&S project), definiti come progetti di HLM riportanti miglioramenti in termini di sicurezza del paziente, sono stati studiati con l’obiettivo di capire come sia possibile implementare progetti di HLM con benefici di CRM.
In sostanza, sono stati perseguiti i seguenti obiettivi di ricerca:
• Capire se in letteratura esistono legami tra HLM e CRM:
- Sono presenti connessioni/ sovrapposizioni tra HLM e CRM nel contesto ospedaliero? Se sì, quali sono queste connessioni e quali sono i relativi risultati? Quali sono le caratteristiche di progetti di HLM aventi connessioni con il CRM e presenti in letteratura?
- L’HLM può supportare il CRM in un contesto ospedaliero?
• Delineare lo stato dell’arte per quel che concerne l’implementazione di progetti di HLM aventi connessioni con il CRM:
- Qual è lo stato dell’arte dell’HLM nel contesto italiano?
- Quali sono le caratteristiche dei progetti di HLM legati al CRM nel contest italiano?
• Studiare come sia possibile implementare progetti di HLM aventi benefici in termini di CRM:
- Quali sono gli aspetti organizzativi che contraddistinguono i L&S project?
- Quali sono le fasi e le attività?
- Quali sono gli strumenti e le pratiche?
- Quali sono i fattori critici che dovrebbero essere considerati per una implementazione di successo?
Il primo obiettivo di ricerca è stato perseguito conducendo un’analisi sistematica della letteratura. Da questo studio è emersa l’assenza di una metodologia sinergica che combini HLM e CRM. In ogni caso, sono state dimostrate connessioni e sovrapposizioni tra i due approcci, per cui si è potuto procedere con l’analisi delle caratteristiche dei progetti di HLM aventi connessioni con il CRM. Questi progetti sono stati studiati anche nella letteratura manageriale, perseguendo il secondo obiettivo di ricerca. Dopo aver delineato la mappa delle esperienze di HLM in Italia, si sono esaminate le caratteristiche dei progetti di HLM aventi connessioni con il CRM, identificate nei report italiani, e attraverso la comparazione con i risultati ottenuti dall’analisi della letteratura accademica, si sono potuti scoprire allineamenti interessanti tra le due analisi. Focalizzandosi sui L&S project, la conduzione di un multiple case study ha permesso di elaborare un framework di analisi e di fornire indicazioni utili per lo sviluppo di linee guida per una realizzazione di successo di L&S project. Tre cluster ben distinti sono stati identificati e caratterizzati con riferimento agli aspetti organizzativi, alle fasi e alle attività, agli strumenti e alle pratiche, e ai fattori critici per l’implementazione di L&S project. Alla fine dell’analisi si sono definite proposizioni rilevanti che hanno contribuito al theory building e all’elaborazione di indicazioni utili per lo sviluppo di L&S project nel contesto ospedaliero.
Grazie a questa ricerca si sono potuti apportare importanti contributi alla letteratura della gestione della sanità, dell’health service operations management e della gestione pubblica. Un nuovo argomento di ricerca è stato introdotto e spunti rilevanti per lo sviluppo di ricerche future sono stati generati, progredendo verso la realizzazione di sistemi sanitari più efficienti, più efficaci e più sicuri
MAPPING LEAN EXPERIENCES AND EMERGING CONNECTIONS WITH CLINICAL RISK MANAGEMENT IN ITALIAN CONTEXT
No full textPurpose–The purpose of this paper is to describe the Italian state of art of Health Lean Management (HLM) and to analyze the Italian projects that connect this approach with clinical risk management (CRM).
Design/methodology/approach– After introducing Italian healthcare system and its main challenges, relevant Italian experiences have been searched investigating regional health plans (RHPs), managerial reports, books, workshops, conference proceedings and hospital web sites. The degree of experience of each Italian region has been first studied. Further, field of applicability, objectives, tools, practices and results of the projects with first signs of HLM and CRM integration have been analyzed.
Findings–Although interest in new managerial approaches is spreading in almost all the territory and new managerial solutions are fostered in many RHPs, HLM projects are implemented patchy in Italy. For what regards HLM projects with CRM connections, the Italian context seems aligned with the
international one, apart from few features. First indications for the implementation of HLM projects with CRM connections emerged.
Originality/value–Healthcare systems are facing multiple challenges in a context where public funds decrease but quality of care must be guaranteed. Combining different managerial approaches could solve these issues. In this research, for the first time, a map about Italian HLM adoption has been drawn, and Italian HLM projects with CRM connections have been analyzed. The results constitute one of the first contributions useful to develop guidelines for the implementation of projects pursuing efficiency, quality and safety objectives
INVESTIGATING THE CONNECTIONS BETWEEN HEALTH LEAN MANAGEMENT AND CLINICAL RISK MANAGEMENT: INSIGHTS FROM A SYSTEMATIC LITERATURE REVIEW
No full textPurpose: The purpose is to investigate connections and overlaps between Health Lean Management (HLM) and Clinical Risk Management (CRM) understanding whether and how these two approaches can be combined together to pursue efficiency and patient safety improvements simultaneously.
Method: A systematic literature review has been carried out. Searching in academic databases, papers that focus not only on health lean management, but also on clinical errors and risk reduction, were included. The general characteristics of the selected papers were analysed and a content analysis was conducted.
Findings: In most of the papers, pursing objectives of HLM and CRM and adopting tools and practices of both approaches, results of quality and, particularly, of safety improvements were obtained. A two-way arrow between HLM and CRM emerged but so far, none of the studies has been focused on the relationship between HLM and CRM.
Practical Implications: The possibility to integrate HLM and CRM, introduced and demonstrated in the paper, should foster physicians and hospital managers to develop a synergic methodology as a solution to enhance different dimensions of quality in health
Profiling the Intellectual Capital of Italian Manufacturing SMEs: An Empirical Analysis
No full textSince the early 1990s research stream of Intellectual Capital (IC) has been grown, and in the new, knowledge-intensive economies, it has become a source of competitive advantage. Scholars have tried to defined and categorized it, but still literature is not concordant and different methods of IC measurement have been developed. Some authors have emphasized the benefits of qualitative and perceptive measures that catch what the traditional systems have failed to report; furthermore, they are able to describe IC in a prospective approach.
Nevertheless, until now, little research has been devoted to analysing IC components and their interconnections and impact (directly or in conjunction) on firm performance. In particular, IC in small and medium-sized enterprises (SMEs) remains understudied.
This paper intends to provide a theoretical framework to synthesise the fragmented previous works in order to identify the appropriate IC measures and apply them to SMEs. In more detail, the objectives are: 1) to measure the level of IC and its components in Italian manufacturing SMEs, 2) to identify clusters of companies with different levels of IC and characterise them in reference to IC components and firm-specific factors and 3) to analysed the impact of IC on firm performance.
To this end, a survey has been conducted in the Italian manufacturing context and a database of 107 responses was obtained. After a descriptive analysis revealing the level of IC components, three well-distinguished groups emerged from cluster analysis and a positive relationship was identified between IC and firm performance using multiple linear regression models.
This study contributes to measuring IC, understanding its structure and level in SMEs and its effect on firm success. Managers of SMEs can draw guidelines for IC evaluation to develop internal auditing system, to communicate adequately IC value to any external stakeholders and to support decisions in managing their IC, thereby maximizing firm performance
Intangible Assets Management and Evaluation: Evidence from SMEs
No full textIn recent decades, intangible assets have become crucial
to competitiveness, not only for large companies, but also for small and medium-sized enterprises (SMEs). Despite the existence of multiple methods and techniques for measuring firms’ intangible assets, few practical applications are described in the literature, particularly in the context of SMEs. Thus, the objective of this
study is to develop a modular, multi-purpose, forward-looking tool
and test it in three small firms in Italy. The results of our analysis
show that the model’s application in the companies was useful in enhancing managers’ awareness about intangible assets and in improving the management of these assets
Simulation modelling and lean management in healthcare: first evidences and research agenda
No full textThere is a growth in the literature on simulation in healthcare that has been flourishing in
the last few years, since it allows predicting the consequences of different alternative
scenarios without the risks and the costs of real experiments. However, no literature
reviews can be found on how and in which cases simulation modelling can support
the adoption of Health Lean Management (HLM), in order to maximise the value for
patients, reducing wastes. Therefore, this research aims to supply a comprehensive
view of the state of the art about the combined application of HLM and simulation,
gaining benefits in health service delivery. Through a systematic literature review, a
database of papers has been analysed, considering the context of the application, lean
tools and practices, simulation models and software, and results obtained, in addition
to descriptive characteristics. The projects analysed in the papers regard mostly
emergency settings, outpatient care, surgery and medical laboratory, with the aim of
improving the patient flow and achieving mainly efficiency and patient safety. The
paper discusses which simulation models and software have been adopted to support
the implementation of HLM tools and practices, in relation to the specific
performance improvements achieved, triggering managerial implications and future
research directions
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