Purpose The purpose of this paper is to examine the moderating role of Industry 4.0 technologies on the relationship between lean production (LP) and operational performance improvement within Brazil, a developing economy context. Design/methodology/approach One representative from each of the 147 studied manufacturing companies filled in a survey on three internally related lean practice bundles and two Industry 4.0 technology bundles, with safety, delivery, quality, productivity and inventory as performance indicators. As this study was grounded on the contingency theory, multivariate data analyses were performed, controlling for four contingencies. Findings Industry 4.0 moderates the effect of LP practices on operational performance improvement, but in different directions. Process-related technologies negatively moderate the effect of low setup practices on performance, whereas product/service-related technologies positively moderate the effect of flow practices on performance. Originality/value With the advent of Industry 4.0, companies have been channelling their efforts to achieve superior performance by advancing levels of automation and interconnectivity. Eventually, widespread and proven manufacturing approaches, like LP, will integrate such technologies which may, in turn, impair or favour operational performance. Contrary to previous studies, the contingencies appeared to have a less extensive effect. The authors point to various options for further study across different socio-economic contexts. This study evidenced that purely technological adoption will not lead to distinguished results. LP practices help in the installation of organisational habits and mindsets that favour systemic process improvements, supporting the design and control of manufacturers’ operations management towards the fourth industrial revolution era.

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Purpose The purpose of this paper is to examine leadership behaviors associated with lean healthcare (LH) implementation and how they develop throughout the change process. Design/methodology/approach After a systematic literature review of 107 peer-reviewed articles on lean leaders’ behaviors, the authors undertook a one-year mixed-methods study of 12 leaders within a Brazilian public hospital undergoing LH implementation. Multivariate data analysis techniques were employed. Findings The literature review showed some convergence between effective lean leader behaviors in both manufacturing and healthcare work settings, implying that lean leaders’ behaviors are generalizable to other contexts than manufacturing. The empirical findings suggest that LH implementation needs leaders to demonstrate a set of task-oriented behaviors, especially if short-term results are mandatory. More mature lean leaders should also continue developing their relations-oriented behaviors. Research limitations/implications While the contingency theory assumes that contexts influence (lean) practices adoption, leadership behaviors may not be bound to the work context. The finding resembles the augmentation effect of leadership whereby more mature lean leaders adopt both task- and relations-oriented behaviors. Originality/value Longitudinal studies in this field are scarce, regardless of the industrial setting. Many manufacturing and healthcare organizations crave for knowledge about lean leader behaviors throughout the lean implementation journey in order to enhance the effectiveness of their often-struggling lean initiatives. The insights derived from this study could help organizations to adjust their expectations as well as identify behavioral gaps and needs in terms of soft skills development among their leaders.

Background: Psychological safety is a dynamic team-level phenomenon which exists when team members believe that it is safe to take interpersonal risks. In healthcare teams, the presence of psychological safety is critical to delivering safe care. Scholars have highlighted a need for alternative measures which compliment survey-based measures of psychological safety in healthcare teams. Methods: The exploratory phase of this study raised concerns about whether current survey measures could provide a sufficient understanding of psychological safety within healthcare teams to inform strategies to improve it. Thus, previously validated psychological safety surveys and a meeting observation measure were adapted for use in healthcare teams. First, two group feedback sessions were held with 22 healthcare professionals, as well as a systematic literature review. Then, the members of eleven healthcare teams in Ireland and The Netherlands (n = 135) took part in the pilot test of the adapted composite measure. Results: The final composite measure has two parts: a team meeting observation measure and an adapted survey. The observation measure has 31 observable behaviours fitting seven categories: voice, defensive voice, silence behaviours, supportive, unsupportive, learning or improvement-oriented and familiarity type behaviours. The survey part consists of 19 items in three sub-dimensions related to; the team leader, other team members and the team as a whole. Three additional items capture the perceived representativeness of the observed team meeting compared to other similar meetings. Final adaptations were made in order to integrate the observation and survey measure. Conclusions: The resulting composite measure combines the strengths of observational and survey measures and is tailored for use in healthcare teams. It is uniquely co-developed with healthcare professionals and grounded in the psychological safety and healthcare literature. This composite measure can enable longitudinal research on psychological safety and inform future research to develop and test interventions to improve psychological safety.