The paper explores the implementation of the kanban system, which is a Lean technique, within the Pharmaceutical Supply Chain (PSC). The case study provides insight to the benefits and challenges arising from the application of this technique, within a group of cooperative pharmacists, in Greece. The research questions developed from the review of the literature were tested using evidence from field-based, action research within a pharmaceutical organisation. The reported case study contributes to the longer term debate on assessing the Lean maturity level within the healthcare sector. There are two primary findings: i) that the adoption of kanban system provides a strategic benefit and improves the quality of services. ii) it also provides a basis for a strategy of operational change; it gives the opportunity to the organisation to move away from the current push delivery and logistics systems toward improved logistics strategy models.

Purpose: Healthcare organisations face significant productivity pressures and are undergoing major service transformation. This paper serves to disseminate findings from a Lean healthcare project using a NHS Single Point of Access environment as the case study. It demonstrates the relevance and extent that Lean can be applied to this type of healthcare service setting.Design/methodology/approach: Action research was applied and Lean tools used to establish current state processes, identify wastes and develop service improvement opportunities based upon defined customer values.Findings: The quality of referral information was found to be the root cause of a number of process wastes and causes of failure for the service. Understanding the relationship and the nature of interaction between the service"s customer/supplier led to more effective and sustainable service improvement opportunities and the co-creation of value. It was also recognised that not all the Lean principles could be applied to this type of healthcare setting. Practical implications:The study is useful to organisations using Lean to undertake service improvement activities. The paper outlines how extending the value stream beyond the organisation to include suppliers can lead to improved co-production and generation of service value. Originality/value:The study contributes to service productivity research by demonstrating the relevance and limitations of Lean application in a new healthcare service setting. The case study demonstrates the practical challenges of implementing Lean in reciprocal service design models and adds validity to existing contextual models.

Purpose This study aims to explore the downstream pharmaceutical supply chain (PSC) and provides insight to the delivery process of medicines and associated operational inefficiencies. Design/methodology/approach An exploratory, qualitative approach was adopted to examine PSC inefficiency within two European contexts, namely, the UK and Greece. Data was gathered through interviews and a thematic analysis conducted to analyse the data and identify challenges faced by both supply chains(SCs). Findings The medicines delivery system needs to be enhanced in terms of quality, visibility, speed and cost to perform effectively. The findings demonstrated that although the healthcare SCs in the two European contexts have different operational structures, the results are in concordance with each other. Financial, communication, waste and complexity issues were the major concerns. Research limitations/implications To the knowledge this is the first study to examine aspects of the medicines SC via a cross-case analysis in the UK and Greece and extends the body of knowledge. A broader sample of responses is warranted to further validate these findings. Practical implications The study outputs can inform pharmacies’ strategic to instigate targeted improvement interventions. The implications of which may be extrapolated further to other European healthcare organisations. Originality/value This research contributes to the academic literature by adding further theoretical insights to SC strategy development, especially those that have been characterised as highly complex. The study identifies four key areas of intervention needed within this SC (in both countries) to promote higher level efficiencies and effectiveness.

Purpose This paper aims to explore the development and application of place crowd safety management tools for areas of public assembly and major events, from a practitioner perspective. Design/methodology/approach The crowd safety risk assessment model is known as design, information, management-ingress, circulation, egress (DIM-ICE) (Still, 2009) is implemented to optimise crowd safety and potentially throughput. Three contrasting case studies represent examples of some of the world’s largest and most challenging crowd safety projects. Findings The paper provides some insight into how the DIM-ICE model can be used to aid strategic planning at major events, assess potential crowd risks and to avoid potential crowd safety issues. Practical implications It provides further clarity to what effective place management practice is. Evidence-based on the case studies demonstrates that the application of the DIM-ICE model is useful for recognising potential place crowd safety issues and identifying areas for require improvement. Originality/value Crowd science is an emerging field of research, which is primarily motivated by place crowd safety issues in congested places; the application and reporting of an evidence-based model (i.e. DIM-ICE model) add to this. The paper addresses a research gap related to the implementation of analytic tools in characterising place crowd dynamics.

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Process Management System (PMS). Such a system is often based on the Plan-Do-Check-Act philosophy (Deming, 1982) and typically consists of processes, sub-processes and procedures linked together. Performance measurement and preventive mechanisms must also be an integral part of the system. However, a question that often arises when coming to design an effective PMS is ‗what are the standards according to which one has to design and manage a Process Management System?' Eliciting, understanding and utilising the Customer Requirements that can inform a successful PMS is the key to Business Excellence (Soosay et al., 2012;Walker and Jones, 2012). This paper, therefore, investigates whether the application of QFD within a Housing Association can assist the company to translate the ‗voice' of customers into performance improvement. It also attempts to contribute to the relevant literature regarding the implementation of QFD in the service sector. The PMS used by the company was not fit for purpose as was not performing to the maximum of its ability. The company required a method to identify areas for improvement to enable it to introduce improvement projects and increase customer satisfaction. The rationale was that QFD would enable the company to correlate process functions to customer requirements and identify critical success factors.The paper is structured as follows. The literature review presents various applications of QFD and communicates the benefits and drawbacks. A number of examples of QFD application in non-The TQM Journal 4 manufacturing industries are presented, mainly to understand the reasons and need to adapt the product-oriented QFD process. The research methodology is then presented and the use of a case study approach briefly justified. Subsequent sections introduce the analysed scenario -the analysis of the processes and the customer requirements; all incorporated within three House of Qualities.The final section discusses conclusions and possible further research. The Literature review QFD definitions and aimMany authors have dwelled over which is the best approach of achieving high levels of quality (Esteban-Ferrer and Trics, 2012). Chen et al. (2015) propose that many companies are engaged in assessing ways in which their productivity, product quality, and operations can be improved.

Organizations are paying greater attention to the potential advantages that can be achieved by adopting a more strategic approach to the procurement of services. Despite services being very different from physical items in many respects, and despite their outsourcing having achieved limited gains, the procurement of services remains under-researched. To address this challenge and develop a strategic platform for new directions in future research in the area, this paper undertakes a systematic literature review of 51 articles published in 21 peer-reviewed academic journals. It reviews the applicability of supply theories to services sourcing, and compares and demonstrates the distinctiveness of services purchasing through problematizing the literature reviewed. A descriptive and thematic analysis concluded that services procurement can be classified into seven research domains: 'service production', 'governance', 'purchasing approach', 'supplier selection', 'performance management', 'the service triad' and 'specification of requirements'. We offer a comparative framework of the services procurement process and emphasize different supply practices. The provided research directions assist scholars in identifying avenues for integrating and expanding existing knowledge.

TQM: An Overview and the Role of Management 5 keep a unit in operation and in trying to emphasize excellence, just count the number of times the word 'quality' is used in the argument or presentation. Quality as a concept is quite difficult for many people to understand, and much confusion and myth surround it. In a linguistic sense, quality originates from the Latin word 'qualis' which means 'such as the thing really is'. There is an international definition of quality: 'the degree to which a set of inherent characteristics fulfils requirements' (ISO 9001 2015). However, in today's business world there is no single accepted definition of quality. Irrespective of the context in which it is used, it is usually meant to distinguish one organization, event, product, service, process, person, result, action, or communication from another. Preventing confusion and ensuring that everyone in an organization is focused on the same objectives, there should be an agreed definition of quality. For example, BetzDearborn Inc. defines quality as: 'That which gives complete customer satisfaction', and Rank Xerox (UK) as 'Providing our customers, internal and external, with products and services that fully satisfy their negotiated requirements'. North West Water Ltd use the term 'business quality' and define this as: Understanding and then satisfying customer requirements in order to improve our business results. Continuously improving our behaviour and attitudes as well as our processes, products and services. Ensuring that a customer focus is visible in all that we do.