Effect of Lean Six Sigma on quality performance in Malaysian hospitals.

PURPOSE: The purpose of this paper is to investigate the effects of Lean Six Sigma (LSS) and workforce management on the quality performance of Malaysian hospitals. This paper also investigates the direct and indirect relationships between top management commitment and quality performance of the healthcare organisations in Malaysia. DESIGN/METHODOLOGY/APPROACH: This study applied stratified random sampling to collect data from 15 different hospitals in Peninsular Malaysia. The self-administered survey questionnaires were distributed among 673 hospital staff (i.e. doctors, nurses, pharmacists, and medical laboratory technologists) to obtain 335 useful responses with a 49.47 per cent valid response rate. The research data were analysed based on confirmatory factor analysis and structural equation modelling by using AMOS version 23 software. FINDINGS: The research findings indicated that LSS and workforce management have a significant impact on quality performance of the Malaysian hospitals, whereas senior management commitment was found to have an insignificant relationship with quality performance. The research findings indicate that senior management commitment has no direct significant relationship with quality performance, but it has an indirect significant relationship with quality performance through the mediating effects of LSS and workforce management. RESEARCH LIMITATIONS/IMPLICATIONS: This research focussed solely on healthcare organisations in Malaysia and thus the results might not be applicable for other countries as well as other service organisations. ORIGINALITY/VALUE: This research provides theoretical, methodological, and practical contributions for the LSS approach and the research findings are expected to provide guidelines to enhance the level of quality performance in healthcare organisations in Malaysia as well as other countries.

Going green! Factors influencing green competitive advantage of Chinese SMEs: a moderated-mediated perspective.

This research observes the impact of environmental corporate social responsibility (CSR) and green supply chain management (GSCM) on green competitive advantage in Chinese manufacturing SMEs. Top management commitment is used as a mediator between environmental CSR, GSCM, and green competitive advantage. Moreover, a pro-environmental business strategy is used as a moderator between top management commitment and green competitive advantage. A simple random sampling technique was used, and 331 questionnaires were part of the final analysis. PLS-SEM is used for hypothesis testing. The results reveal that environmental CSR does not influence green competitive advantage. GSCM, top management commitment, and pro-environmental business strategy significantly measure green competitive advantage. Top management commitment significantly mediates between environmental CSR, GSCM, and green competitive advantage. Finally, a pro-environmental business strategy significantly moderates between top management commitment and green competitive advantage. This study strives to provide insightful information for strategic managers of Chinese manufacturing SMEs to optimize green competitive advantage, including environmental CSR, GSCM, top management commitment, and pro-environmental business strategy in decision-making. This study adds value to the body of knowledge by concentrating on factors that determine green competitive advantage. This initial research integrates environmental CSR, GSCM, top management commitment, pro-environmental business strategy, and green competitive advantage in a single framework using natural resource-based view (RBV). Furthermore, the study would present various implications for managers and lines for future directions.

Greening the manufacturing firms: do green supply chain management and organizational citizenship behavior influence firm performance?

The spontaneous organizational citizenship behavior towards environment (OCBE) of employees in the workplace is crucial to businesses' green development and low-carbon transition. However, it was not considered how such behavior could be encouraged for enhanced firm performance. From the natural resource-based view theory perspective, this study tests a model that investigates how green supply chain management practices, green culture, top management commitment, and OCBE, and influences firm performance. A structural equation model (SEM) was utilized to test the hypotheses using 600 survey questionnaires collected from manufacturing firms. The results show that green supply chain management indirectly affects firm performance through green culture and top management commitment. The results reveal that green culture and top management commitment positively and significantly mediate the relationship between green supply chain management and firm performance. Furthermore, the findings show that OCBE has a direct effect on firm performance. Moreover, the results highlight that OCBE has a positive moderating effect on the association between green supply chain management and firm performance. Finally, the study's findings and implications are disclosed to be useful policy instruments for organizations, administrations, and other stakeholders.

Industry 4.0 implementation and Triple Bottom Line sustainability: An empirical study on small and medium manufacturing firms.

BACKGROUND: The current level of industrialization has generated many challenges worldwide, including ecological hazards, climate change, and the overuse of non-renewable natural resources, thereby creating an increasing demand for achieving the goal of the Triple Bottom Line (TBL). In this regard, Industry 4.0 can be used as a crunch point to contribute to the production process that can help achieve sustainable development. PURPOSE: While the Malaysian government proposed the "Industry4ward" approach to enhance technological adoption, there is scarce empirical evidence in the literature that validates SMEs for Industry 4.0. Using Dynamic Capability View (DCV), this study proposes a framework that includes core determinants like top management commitment, supply chain integration, and IT infrastructure, that can significantly influence Industry 4.0 implementation toward achieving TBL sustainability. DESIGN/METHODOLOGY/APPROACH: Employing simple random sampling, the study adopted a quantitative approach based on 199 useable respondent's feedback collected through a survey questionnaire of 900 employees from Malaysian SMEs. The statistical analysis was performed using Structural Equation Modeling (Partial Least Square, SmartPLS 3.3.2). FINDINGS: The results show that top management and IT infrastructure significantly impact Industry 4.0 implementation and sustainability. In contrast, the analysis also demonstrates that supply chain integration is insignificant to Industry 4.0 implementation in SMEs. The findings also indicate that the relationship between the determinants of Industry 4.0 and TBL sustainability can be mediated by the "effective implementation" of Industry 4.0. RECOMMENDATIONS: The study highlights the practical consequences of the role and use of the determinants in Industry 4.0 implementation. Its findings help managers and policy-makers to optimize value creation to achieve sustainable development goals. LIMITATIONS AND FUTURE RESEARCH: Focusing only on Malaysian manufacturing SMEs may restrict the generalization of the study; thus, a benchmarking analysis from other industrial settings is encouraged. The questionnaire-based survey is a further limitation of the study.

Success rate evaluation of clinical governance implementation in teaching hospitals in Kerman (Iran) based on nine steps of Karsh's model.

BACKGROUND: One of the ways to improve the quality of services in the health system is through clinical governance. This method aims to create a framework for clinical services providers to be accountable in return for continuing improvement of quality and maintaining standards of services. OBJECTIVE: To evaluate the success rate of clinical governance implementation in Kerman teaching hospitals based on 9 steps of Karsh's Model. METHODS: This cross-sectional study was conducted in 2015 on 94 people including chief executive officers (CEOs), nursing managers, clinical governance managers and experts, head nurses and nurses. The required data were collected through a researcher-made questionnaire containing 38 questions with three-point Likert Scale (good, moderate, and weak). The Karsh's Model consists of nine steps including top management commitment to change, accountability for change, creating a structured approach for change, training, pilot implementation, communication, feedback, simulation, and end-user participation. Data analysis using descriptive statistics and Mann-Whitney-Wilcoxon test was done by SPSS software version 16. RESULTS: About 81.9 % of respondents were female and 74.5 have a Bachelor of Nursing (BN) degree. In general, the status of clinical governance implementation in studied hospitals based on 9 steps of the model was 44 % (moderate). A significant relationship was observed among accountability and organizational position (p=0.0012) and field of study (p=0.000). Also, there were significant relationships between structure-based approach and organizational position (p=0.007), communication and demographic characteristics (p=0.000), and end-user participation with organizational position (p=0.03). CONCLUSION: Clinical governance should be implemented by correct needs assessment and participation of all stakeholders, to ensure its enforcement in practice, and to enhance the quality of services.