Lean Manufacturing in Public Services: Prospects for Value Creation

The purpose of this paper is to investigate the utilization of lean manufacturing systems in public service operations for poten- tial added value. A case study of lean manufacturing implementation at a UK city council was carried out using in-depth interviews with key personnel coupled with documents collection. The Organizational Commitment Questionnaire (OCQ) was administered among front-line employees. Results show that lean manufacturing systems could create signi cant added value to the business and employees. A strong relation- ship was demonstrated between the lean manufacturing implementation and the a ective commitment level of employees. This paper is one of a few studies that demonstrate the applicability of manufacturing systems in other settings and that they can generate significant added value for the service department and its employees

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The representation and attainment of students with a visual impairment in higher education

We carried out an analysis of a database of all students in higher education in the UK in 1995-96 to compare students with a visual impairment and students with no recorded disability in terms of their demographic characteristics, programmes of study and academic attainment. Students with a visual impairment constituted 0.12% of all students normally resident in the UK. Their representation varied with age, gender, ethnicity and entry qualifications and with their level, mode and subject of study. If these background variables are taken into account, a visual impairment per se appears to have surprisingly little effect on academic attainment