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Theory of Constraints (TOC), though a well-established process improvement methodology in manufacturing, is still a novel philosophy for healthcare and an exhaustive review of literature is needed to summarize the key findings of various researchers. Such a review can provide a direction to the researchers and academicians interested in exploring the application of TOC in the healthcare sector. This paper aims to review the existing literature of TOC tools and techniques applied to the healthcare environment, and to investigate motivating factors, benefits and key gaps for identifying directions for future research in the domain of healthcare.

In this paper, different electronic repositories were searched using multiple keywords. The current study identified 36 articles published between January 1999 to mid-2021 to conceptualize and summarize the research questions used in the study. Descriptive analysis along with pictorial representations have been used for better visualization of work.

This paper presents a thorough literature review of TOC in healthcare and identifies the evolution, current trends, tools used, nature of services chosen for application and research gaps and recommends future direction for research. A variety of motivating factors and benefits of TOC in healthcare are identified. Another key finding of this study is that almost all implementations listed in literature reported positive outcomes and substantial improvements in the performance of the healthcare unit chosen for study.

This paper provides valuable insight to researchers, practitioners and policymakers on the potential of TOC to improve quality of services, flow of patients, revenues, process efficiency and cost reduction in different health care settings. A number of findings and suggestions compiled in the paper from literature study can be used for diagnosing, learning and making substantial changes in healthcare. The methodologies used by different researchers were analysed and combined to propose a generic step by step procedure to apply TOC. This methodology will guide the practising managers about the appropriate tools of TOC for their specific need.

Good health is always the first desire of all men and women around the globe. The global aim of healthcare is to quickly cure more patients and ensure healthier population both today and in future. This article will work as a foundation for future applications of TOC in healthcare and guide upcoming applications in the booming healthcare sector. The paper will help the healthcare managers in serving a greater number of patients with limited available resources.

This paper provides original collaborative work compiled by the authors. Since no comprehensive systematic review of TOC in healthcare has been reported earlier, this study would be a valuable asset for researchers in this field. A model has been presented that links various benefits with one another and clarifies the need to focus on process improvement which naturally results in these benefits. Similarly, a model has been presented to guide the users in implementation of TOC in healthcare.

This study aims to utilize DMAIC methodology along with value stream mapping and other Lean Six Sigma tools in a major automobile light manufacturing industry to reduce defect rates and increase production capacity in their manufacturing line. The study also proposes a modified framework based on lean principles and FlexSim to identify and reduce waste in the selected industry.

A Lean Six Sigma modified framework has been deployed with DMAIC to reduce the defect rate and increase the production rate. Various tools like value stream mapping, brainstorming, Pareto charts, 5S, kanban, etc. have been used at different phases of DMAIC targeting wastes and inventory in the production line. Also, a simulation model has been utilized for the automobile light manufacturing industry to improve the machine utilization time with varying batch sizes.

The results of the study indicated a 53% reduction in defect rates. Thus, there would be an expected improvement in sigma value from 3.78 to 3.89 and a reduction in defects per million opportunities (DPMO) from 11,244 to 8,493. Additionally, simulation model using FlexSim was developed, and the optimum ordering batch size of raw material was obtained. It was also analyzed that idle time for various stations could be reduced by up to 30%.

The utilized framework helps identify defects for managers to increase production efficiency. The workers, operators and supervisors on the production line also need to be trained regularly for identifying the areas of improvement.

The modified Lean Six Sigma framework used in this study includes FlexSim simulation to make the framework robust, which has not been used with LSS tools in the literature studied. Also, the LSS finds very less application in the manufacturing domain, considering which this study tends to add value in existing literature taking a case of an automobile light manufacturing industry.

The scope of this study is to explore and summarize the pool of dimensions, models and measurement techniques of service quality used in healthcare services and to propose a comprehensive conceptual model for practitioners and researchers.

This research employs a comprehensive review of available literature by using multiple keywords on different electronic repositories using the recommendations of the PRISMA approach for the selection of articles. A critical analysis of available studies helped in compiling a list of core service quality dimensions in healthcare services.

This paper presents a comprehensive account of different dimensions and their measurement items used by various researchers to assess service quality in healthcare systems. Most of the researchers have used SERVQUAL model either in its original or modified form while the others have proposed and used totally different dimensions to assess the service quality in healthcare. Many dimensions are just an existing dimension of SERVQUAL that has undergone a name change while others are completely new. The dimensions used by many researchers have items drawn from more than one dimension of SERVQUAL model. The availability of so many dimensions and models adds to the confusion that researchers and practicing managers experience when determining the appropriate model to be used in their work. To mitigate this confusion, there is a need to develop a comprehensive model; the current work is an attempt to meet this need. Through our analysis, we identify four major service quality dimensions: clinical quality, infrastructural quality, relationship and managerial quality and propose a model named CIRMQUAL.

After exploring all available models in the domain of healthcare, this research presents the best possible areas to enhance the quality of healthcare services. It also enhances the research insights for academicians and working professionals by developing and proposing a comprehensive model for measuring healthcare service quality. The proposed model covers almost all of the service quality dimensions used by other researchers and will make the choice of dimensions/model easy for the future researchers/practitioners interested in measuring and improving the quality of services offered by their healthcare units. Such a comprehensive model has not been developed by any researcher thus far.

The purpose of this paper is to investigate the role played by service quality (SQ) in manufacturer–distributor working partnerships in the context of Indian small and medium enterprises (SMEs), and present two models which propose and validate that contributions toward SQ, made by both the manufacturing unit and distribution firm lead to satisfaction which consequently results in business-to-business (B2B) loyalty.

The research design for this study includes a combination of literature review, exploratory interviews with a focus group and a questionnaire survey conducted through interview schedule from 101 information rich and willing respondents working in SMEs of northern India.

The paper brings out scales foe measuring organizational (internal) and distributor (external) SQ. Further, two models using structural equation modeling are developed. Model-I examines the effect of organizational SQ on distributor SQ. Model-II examines the impact of distributor SQ on satisfaction and loyalty and also tests a set of four propositions related to their working relationship. The models are empirically tested and are found to be fit.

Future researchers may validate these scales, and empirically test the proposed models in alternate settings. Insights derived from this study may be transferred to other partnerships, which may exist in a manufacturing supply chain including suppliers, employees, retailers and end consumers.

This study would be of interest to SME practitioners interested in improving SQ with their distributors. The study also finds support for strengthening collaborative relationships with B2B partners to achieve a win-win situation.

There are very few empirical studies that measure SQ w.r.t. distribution function in SMEs and the concept is in nascent stage, especially in Indian setting.

The case can be used in strategic management, international business or ethics courses. In strategic management courses, students will be able to identify political relationships as sources of a firm’s competitive advantage. Students will also understand the role of ethics in the firm’s competitive advantage. In international business courses, the students will be able to analyze the role that corruption and bribery play in the analysis of a country’s institutions. Students will also understand how corruption in a host country influences a firms’ decision to internationalize. Finally, students will understand the challenges that firms face when serving customers in other countries. In ethics courses, students will understand the nature of state/business corruption, i.e. the abuse of public office for private gain and the concept of state capture, i.e. managers controlling the political system for their advantage. Students will be able to analyze the decision of whether to collaborate with unethical partners or customers.

Bell Pottinger Private (BPP) was a British public relations (PR) firm with a successful but questionable reputation of helping famous critical figures and despots improve their public image. In 2016, Lord Tim Bell and the other leaders of BPP were asked to create a PR campaign for the Gupta family. The Guptas were a group of businessmen headed by three brothers who migrated from India to South Africa in the early 1990s. By the 2010s, they had built a business empire allegedly thanks to a corrupt relationship with the President of South Africa, Jacob Zuma and his family. The press and prosecutors were increasing their investigations on these relations. The case has two parts, which address two separate challenges and can be taught as standalone cases or in a sequence in two sessions.

MBA and Executive Education.

Teaching notes are available for educators only.

CSS 5: International business.

Patients are often ill‐equipped to know which speciality to choose for their health problem. Especially in the presence of non‐specific symptoms, choosing the right specialist might not be so obvious. In such cases, misdirected self‐referrals by patients to self‐chosen specialists can sometimes lead to misdiagnosis resulting in unwarranted delays in getting the right treatment. The general physicians, on the other hand, are in a unique position to oversee the big picture of patients’ health, and are therefore better equipped to identify and sort out their individual health problems. Hence instead of a specialist if the first place of contact for patients is a general physician, they are likely to be guided along the right path of treatment for their various health problems. Such a system will minimize errors on the part of the patients by making certain that they are referred to the appropriate specialists.

Objective – This chapter assesses the extent to which previous economic and financial crises had a negative impact on health outcomes and health financing. In addition, we review evidence related to the effectiveness of different policy measures undertaken in past crises to protect access to health services, especially for the poor and vulnerable. The current global crisis is unique both in terms of its scale and origins. Unlike most previous instances, the current crisis has its origins in developed countries, initially the United States, before it spread to middle- and lower-income countries. The current crisis is now affecting almost all countries at all levels of income. This chapter addresses several key questions aimed at helping inform possible policy responses to the current crisis from the perspective of the health sector: What is the nature of the current crisis and in what ways does it differ from previous experiences? What are some of the key lessons from previous crises? How have governments responded previously to protect health from such macroeconomic shocks? How can we improve the likelihood of positive action today?

Methodology/approach – The chapter reviews the literature on the impact of financial crises on health outcomes and health expenditures and on the effectiveness of past policy efforts to protect human development during periods of economic downturn. It also presents analysis of household surveys and health expenditure data to track health seeking behavior and out-of-pocket expenditures by households during times of financial crisis.

Findings – Evidence from previous crises indicates that health-related impacts during economic downturns can occur through various channels. The impact in households experiencing reductions in employment and income could be manifest in terms of poorer nutritional outcomes and lower levels of utilization of health care when needed. Households may become impoverished, reduce needed health services, and experience reductions in consumption as a result of health shocks occurring during a time when their economic vulnerability has increased. Women, children, the poor, and informal sector workers are likely to be most at risk of experiencing negative health-related consequences in a crisis. Real government spending per capita on health care could decline due to reduced revenues, currency devaluations, and potential reductions in external aid flows. Low-income countries with weak fiscal positions are likely to be the most vulnerable.

Implications for policy – Past crises can inform policy-making aimed at protecting health outcomes and reducing financial risk from health shocks. Evidence from previous crises indicates that broad-brush strategies that maintained overall levels of government health spending tended not to be successful, failing to protect access to quality health services especially for the poor. It is particularly vital to ensure access to essential health commodities, which in many low-income countries are imported, in the face of weakening exchange rates. Focused efforts to sustain the supply of lower-level basic services, combined with targeted demand-side approaches like conditional cash transfers may be more effective than broader sectoral approaches. Low-income countries may need specific short-term measures to ensure that health outcomes do not suffer.

The case captures the origin and initial years of two restaurants Mirchi & Mime and Madeira & Mime, which exclusively employed Speech and Hearing Impaired persons (SHI) as servers (often called “waiters” in India). It documents how the restaurants were set up, captures significant incidents during this initial period and the impact of these incidents on the working of the restaurants. Further, it describes the challenge of opening a fine dining restaurant and a gastropub staffed exclusively by SHI persons as servers. The case narrates the reactions and impact on the SHIs and their families, co-workers within the outlets and the customers visiting these outlets. Finally, the case lists the recognition received by the organisation and outlines plans for the immediate future.