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.