Maria Crema

The Identification and Characterization of Open Innovation Profiles in Italian Small and Medium‐Sized Enterprises

Open innovation () denotes a companys ability to draw on a range of external sources to meet their needs for innovation. Very few empirical analyses have been conducted on the extent to which this new paradigm is embedded in small and medium‐sized enterprises (). Thus, the present studys objective is to identify and characterize different profiles of in , considering the openness of the innovation process phases, variety and breadth of collaborations, determinants, barriers, and motivations. A survey was carried out among Italian manufacturing firms, and a database of 105 companies was obtained. With regard to data elaboration, a factorial and cluster analysis was conducted, and three different profiles emerged: selective low open, unselective open upstream, and mid‐partners integrated open. The different behaviors of the three clusters in terms of determinants, performance, contextual factors, barriers, and motivations were analyzed and discussed.

Guidelines for overcoming hospital managerial challenges: a systematic literature review

Purpose The need to respond to accreditation institutes’ and patients’ requirements and to align health care results with increased medical knowledge is focusing greater attention on quality in health care. Different tools and techniques have been adopted to measure and manage quality, but clinical errors are still too numerous, suggesting that traditional quality improvement systems are unable to deal appropriately with hospital challenges. The purpose of this paper is to grasp the current tools, practices, and guidelines adopted in health care to improve quality and patient safety and create a base for future research on this young subject. Methods A systematic literature review was carried out. A search of academic databases, including papers that focus not only on lean management, but also on clinical errors and risk reduction, yielded 47 papers. The general characteristics of the selected papers were analyzed, and a content analysis was conducted. Results A variety of managerial techniques, tools, and practices are being adopted in health care, and traditional methodologies have to be integrated with the latest ones in order to reduce errors and ensure high quality and patient safety. As it has been demonstrated, these tools are useful not only for achieving efficiency objectives, but also for providing higher quality and patient safety. Critical indications and guidelines for successful implementation of new health managerial methodologies are provided and synthesized in an operative scheme useful for extending and deepening knowledge of these issues with further studies. Conclusion This research contributes to introducing a new theme in health care literature regarding the development of successful projects with both clinical risk management and health lean management objectives, and should address solutions for improving health care even in the current context of decreasing resources.

Linking strategy with open innovation and performance in SMEs

Purpose – The purpose of this paper is to analyze the linkages between company’s strategy, open innovation and innovation performance, focusing on small and medium enterprises (SMEs). In more detail, the aim is to investigate the influence of firm strategy on the level of openness adopted and then the impact of open innovation on firm performance. Finally, the influence of context-specific variables (such as firm size, technology intensity, geographical area, experience of the company and technology turbulence) on the relations mentioned above will be verified. Design/methodology/approach – A survey has been conducted in the Italian manufacturing context and a database of 107 responses was obtained. The constructs of the research framework were created and validated using factor analysis; further, structural equation modeling was performed to verify the hypothesis about the studied relations. Findings – The obtained model confirmed most of the relations hypothesized, giving useful indications on how to de...

Linking technology innovation strategy, intellectual capital and technology innovation performance in manufacturing SMEs

ABSTRACT The research interest on Intellectual Capital (IC) has been increasing, adopting different definitions and developing diverse measurement tools. Nonetheless, little research focuses on small and medium-sized enterprises (SMEs) and the relation between IC and innovation management. The purpose of this paper is to investigate the role of technology innovation strategy on the IC development and then on innovation performance in manufacturing SMEs. After conducting a survey, measures of IC for SMEs have been performed and an integrated structural equation model has been created. Results demonstrate that technology innovation strategy affects all IC components, the internal structural capital supports the relational and human capital, and the latter two influence firm technology innovation performance. This study contributes to developing an IC measurement system in SMEs and to emphasise the importance of single IC components in improving technology innovation performance.

Investigating the connections between health lean management and clinical risk management

PURPOSE The purpose of this paper 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. DESIGN/METHODOLOGY/APPROACH A systematic literature review has been carried out. Searching in academic databases, papers that focus not only on HLM, 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. ORIGINALITY/VALUE Results highlight an emerging research stream, with many useful theoretical and practical implications and opportunities for further research.

Mapping lean experiences and emerging connections with clinical risk management in Italian context

Purpose – 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 ...

Managing Intellectual Capital in Italian Manufacturing SMEs

The 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.

First evidences from “lean & safety” projects

Purpose – The purpose of this paper is to investigate the significant features that characterize these projects: organizational aspects, phases and activities, tools, techniques, practices and key factors for successful implementation. No studies in the academic literature have yet focused on the relation between healthcare lean management (HLM) and clinical risk management (CRM) to enhance multiple aspects of performance, although the possibility of implementing “lean & safety” projects has been highlighted. Design/methodology/approach – Two significant projects have been selected from the same Italian hospital in two different fields of application. Within- and cross-case analyses have been performed to obtain useful findings. Findings – The results suggest that HLM can provide support for CRM, and an integrated methodology should be considered. The first indications concerning how this new synergistic methodology may be developed are provided and these should stimulate future research, testing and expl...

Visual management system to improve care planning and controlling: the case of intensive care unit

Abstract Health Lean Management (HLM) is usually implemented to enhance the operational performance in health care; nevertheless, scant attention is devoted to visual control and daily accountability processes. This paper aims at investigating how to adopt a visual management system to: plan and control patient journey in health care operations and perform a continuous improvement process. Conducting in-depth interviews and observations, participating in meetings and collecting documentation, the patient journey board and daily briefings of an Intensive Care Unit were studied and improved. In the patient journey board, the Plan, Do and Check phases were reported, distinguishing between actual and planned actions for the patient care. The daily meetings were organised and a continuous improvement board was also developed to solve specific issues (Act phase), by creating ad-hoc teams, involving the staff and reporting transparently on the board. Operational and sociotechnical performance, before and after the adoption of HLM, were assessed demonstrating the effectiveness and efficiency of visual management tools.

Lean Management to support Choosing Wisely in healthcare: the first evidence from a systematic literature review

Purpose Choosing Wisely (CW) is an emergent approach to identify and reduce unnecessary care, such as tests and treatments that do not add value for patients and may even cause harm. The purpose of this paper is to investigate whether and how Lean Healthcare Management (LHM) can support CW objectives, focusing on customer needs and on waste elimination. Data sources A systematic literature review has been performed in Scopus, PubMed and Web of Science. Study selection Peer reviewed articles published in English language have been selected. Papers were considered if they regarded LHM and its possible support for achieving CW objectives. Data extraction. The links between the LHM purposes of adoption and the pursued CW objectives were investigated. Moreover, LHM tools, practices and interventions to support CW were grasped. Results of data synthesis Sixteen articles were included in the analysis. Links between the identified LHM purposes of adoption and CW objectives were discovered: through process understanding, optimization, evaluation and control, LHM contributes to the reduction of overuses in healthcare, but also to the delivery of a more effective and evidence-based care (EBC). Moreover, it provides an objective approach useful for choosing the most cost-effective solution among different alternatives. Conclusions Results highlight how LHM, and with which tools and practices, can be adopted to enhance the healthcare appropriateness pursued by CW, paving the way for interesting future research about this emerging topic.