Modelling the Enablers of Agile Performance in Healthcare Organization: A TISM Approach

Developing an evidence-based TISM: an application for the success of COVID-19 Vaccination Drive

The study illustrates an application of evidence data for performing Total Interpretive Structural Modeling (TISM). TISM is widely used to analyze the critical success factors or inhibitors and their interlinkages. This study uses learning from evidence data, specifically social media analytics, to identify the relationship between the elements. Thus, it leads to the advancement of the TISM-P methodology with evidence-based TISM (TISM-E). This study uses Twitter as a source of evidence data. Further, 2,60,297 tweets were used to illustrate the process of TISM-E. The paper demonstrates the application of TISM-E for the success of the COVID-19 vaccination drive. The pandemic effects are long-term; therefore, the hierarchical model developed shows a sustainable approach for vaccinating maximum population. Further, the framework developed will ensure the distribution efficacy of vaccines. In addition, it will aid practitioners in developing future vaccination policies. The enhanced model provides evidence for polarity (positive/negative) of relationships and can help to build propositions for theory development. The study contributes to healthcare, modeling research, and graph-theoretic literature.

Developing structural modelling of inter-partner factors of international joint ventures performance

Purpose

The study aims to identify, analyse and develop a model for measuring the inter-relationship and interaction among the inter-partner factors. International joint ventures (IJVs) literature has scantly studied the interactions and inter-relationships among the inter-partner factors of IJVs performance. To address this gap, this research creates a hierarchical relationship framework among the inter-partner factors of IJVs performance.

Design/methodology/approach

The comprehensive literature review is used to identify the factors and possible relationships between the factors and IJVs performance. M-TISM (modified total interpretive structural modelling) methodology is used to examine the relationship among the factors of IJVs performance.

Findings

This study highlights 12 inter-partner factors that affect IJVs performance. The results suggest that size asymmetry, commitment, goal incongruency, competitive overlap, trust, control, the interdependency of resources, cooperation, economic distance, cultural distance, geographical distance and administrative distance significantly impact IJVs performance. Commitment is found to be a linkage variable as it has high dependence and driving power. Goal incongruency and competitive overlap have high driving power.

Research limitations/implications

This study gives a proposed list of critical inter-partner factors for policymakers and practitioners to consider when developing rules or recommendations to improve IJVs performance. The focus of policymakers should be on economic and geographical distance, followed by cultural distance, competitive overlap, goal incongruency, size asymmetry and administrative distance to improve inter-relationship among the partners in IJVs. The work contributes to the academician by presenting a modified TISM model that highlights the significance of ambidexterity in driving the performance of IJVs.

Originality/value

This study fills a gap in the literature by analysing the interactions among the inter-partner parameters that influence the performance of IJVs. It offers insights into the variables, such as driver dependence and the relationships between the variables.

ACP-supported redeployment in response to the COVID-19 pandemic: a service evaluation of staff experience

BACKGROUND

During the COVID-19 pandemic, healthcare organisations around the world had to optimise resources and redeploy staff to meet unprecedented demands on services. This service evaluation aims to establish the experiences of nurses redeployed to a COVID-negative Nightingale ward during the first wave of the pandemic in the UK.

METHODS

Purposive sampling using a survey was used to capture nurses' experiences. Data were extrapolated to meet the aims of the thematic line of enquiry and descriptive statistics used to analyse the data set.

RESULTS

The response rate was 34.0% (n=30). The majority of redeployees (76.7%; n=23) strongly agreed or agreed the trust induction had been beneficial. Informal learning, including from colleagues, was said to be very helpful by 50.0% (n=15) and helpful by 36.7% (n=10) of participants. Most (90.0%; n=27) agreed they were able to maintain safety, with 93.3% (n=28) satisfied with the quality of their care. Regarding giving the care they aspired to, 46.7% (n=14) strongly agreed and 40.0% (n=12) agreed they had been able to do this.

CONCLUSION

The advanced clinical practitioner role was central to successful redeployment, in preparing redeployees through induction and education. These practitioners facilitated the acquisition of the knowledge and skills to deliver competent care, ensuring staff had the capacity and capability to undertake their job. Patient safety was not compromised by redeployment.

Readiness for sustainable-resilience in healthcare organisations during Covid-19 era

Purpose

Using total interpretive structural modelling (TISM), this paper aims to “identify”, “analyse” and “categorise” the sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic.

Design/methodology/approach

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview with each respondent. To identify how the factors interact, the TISM approach was employed and the cross-impact matrix multiplication applied to a classification method was used to rank and categorise the sustainable-resilience readiness factors.

Findings

This study identified ten sustainable-resilience readiness factors for healthcare during the Covid-19 pandemic. The study states that the major factors are environmental scanning, awareness and preparedness, team empowerment and working, transparent communication system, learning culture, ability to respond and monitor, organisational culture, resilience engineering, personal and professional resources and technology capability.

Research limitations/implications

The study focused primarily on sustainable-resilience readiness characteristics for the healthcare sector.

Practical implications

This research will aid key stakeholders and academics in better understanding the factors that contribute to sustainable-resilience in healthcare.

Originality/value

This study proposes the TISM technique for healthcare, which is a novel attempt in the subject of readiness for sustainable-resilience in this sector. The paper proposes a framework including a mixture of factors for sustainability and resilience in the healthcare sector for operations.

Modeling critical success factors for sustainable LSS implementation in hospitals: an empirical study

Purpose

The objective of this paper is to investigate, assess and develop a hierarchical model to evaluate the interrelationship of critical success factors (CSFs) that influence the deployment of Sustainable LSS framework in hospitals. Further, developed model has been validated to investigate its applicability in hospitals towards sustainable LSS implementation.

Design/methodology/approach

“Interpretive Structural Modeling” (ISM) has been utilized to develop a convenient hierarchy and contextual relationship of key CSFs throughout the implementation pathway in Indian healthcare industry through systematic literature review and expert opinion, which is ensured by a taxonomy of CSFs using MICMAC (“Matrice d' Impacts Croisés-Multiplication Appliquée á un Classement”) and questionnaire-based survey to empirically validate the model through utilizing “Structural Equation Modelling” (SEM).

Findings

In this study, 17 keys CSFs to sustainable LSS implementation in healthcare industry have been investigated, and modeled. “Social and environmental responsibility,” “Financial return and project success stories,” “Top management involvement and leadership to implement Sustainable LSS,” “Availability of required resources, and their efficient utilization” are found to be the most essential CSFs for successful sustainable LSS implementation in healthcare industry. Further, classification of CSFs has been done for better interpretation of their nature using MICMAC approach. Moreover, the applicability of the proposed model has been empirically assessed utilizing SEM.

Research limitations/implications

The scrutiny of data reveals that the initial inputs from experts throughout the ISM pathway could trigger biased inputs into the study and generalization of the results into others, it might be viable that this propounded model might trigger distinct outcomes for contrasting types of healthcare organizations.

Practical implications

This model on sustainable LSS would support the decision-makers, practitioners and researchers to predict key CSFs through deployment and support the existing academic research on sustainable LSS. Accordingly, the focus on the CSFs of the sustainable LSS can be prioritized to diminish waste, and enhance patient satisfaction and safety.

Originality/value

This paper is an original contribution of analysis of CSFs in Indian healthcare industry utilizing an integrated ISM-MICMAC and SEM approach.

Modelling the resilience of start-ups during COVID-19 pandemic

Purpose

Resilience, the ability of start-ups to deal with anticipated instabilities and probable disruptions, is becoming an important success element during coronavirus disease 2019 (Covid-19). To survive in this pandemic situation, resilience is an important concept for start-ups. The present paper aims to “identify”, “analyse” and “categorize” the resilience factors for start-ups during the Covid-19 pandemic using total interpretive structural modelling (TISM).

Design/methodology/approach

The resilience elements of start-ups during Covid-19 were identified and shortlisted during the first phase, which included literature analysis and extensive interaction with experts. TISM was used in the second phase to investigate or to determine how the factors interplayed between the resilience factors of start-ups during Covid-19. The Matrice d'impacts Croises Multiplication Appliquee a un Classment (MICMAC) method is used to rank and categorize the factors. Closed-ended questionnaire with the scheduled interview was conducted to collect the data.

Findings

The first part of the study found ten resilience elements in total. The TISM digraph was constructed in the second step to show why one resilience component led to another. The MICMAC analysis divided these factors into four groups: autonomous, linkage, dependent and independent. These groups represented resilience variables based on their driving and dependent power, which assist executives and managers in proactively addressing them while using the TISM digraph as a guide.

Research limitations/implications

During the Covid-19 epidemic, this study focused primarily on resilience characteristics for Indian start-ups.

Practical implications

This study will help key stakeholders and scholars to better understand the elements that contribute to start-up's resilience.

Originality/value

The TISM method for start-up's resilience is suggested in this paper, which is a novel attempt in the field of resilience in this industry.

COVID-19 experience in Morocco: Modelling the agile capabilities of Moroccan Clinics

The COVID-19 pandemic posed multiple challenges to the healthcare sector. To be a leader under this crisis, healthcare organizations need to be agile in order to face the various challenges of the pandemic, as the treatment of COVID-19 patients, equipping hospitals with medical and protective equipment, strengthen epidemiological monitoring. Acknowledging the importance of this concept, many healthcare organizations have implemented agility on their health care system. In this context, this study uses total interpretive structural modeling (TISM) for two purposes. First, it models the agile capabilities of a Moroccan healthcare organization in a hierarchical form by differentiating between the driving capabilities and the dependent ones. Second, it interprets the interrelationship among them and ranks the capabilities based on their influence on agility. Through a literature review, different capabilities of organization agility have been identified followed by a questionnaire circulated among different healthcare professionals. Results indicate the most agile capabilities that bring agility in the healthcare organizations in order to address those challenges caused by the COVID-19 crisis.

How to make intelligent automation projects agile? Identification of success factors and an assessment approach

Purpose

Organizations are fast adopting new technologies such as automation, analytics and artificial intelligence, collectively called intelligent automation, to drive digital transformation. When adopting intelligent automation, there is a need to understand the success factors of these new technologies and adapt agile software development (ASD) practices to meet customer expectations. The purpose of this paper is to explore the success factors of intelligent automation and create a framework for managers and practitioners to meet dynamic business demands. Total interpretive structural modeling (TISM) framework is a suitable approach to integrate quantitative measurement with qualitative semi-structured interviews capturing the context of the individual organization environment.

Design/methodology/approach

This paper identified agility factors and their interrelationships using a TISM framework. TISM results were validated using a one-tailed t-test to confirm the interrelationships between factors. Furthermore, the agility index of a case project organization was assessed using a graph-theoretic approach (GTA) to identify both the triggering factors for agility success and improvement proposals.

Findings

Results showed that leadership vision, organization structure and program methodology were driving factors. The TISM model was validated statistically and the agility index of the intelligent automation case project organization was calculated to be79.5%. Here, a GTA was applied and the triggering factors for improvement of the agility index were identified.

Research limitations/implications

The limitations of the study are described along with the opportunities for future research as the field evolves through the rapid innovation of technology and products.

Practical implications

The increasing role of digital transformation in enterprise strategy and operations requires practitioners to understand how ASD practices must be planned, measured and/or improved over time through the implementation of automation, analytics and artificial intelligence programs. The TISM digraph provides a framework of hierarchical structure to organize the influencing factors, which assists in achieving organizational goals. This study highlights the driving factors which contribute to the success of intelligent automation projects and project organizations.

Originality/value

This is a first attempt to analyze the interrelationships among agility factors in intelligent automation projects (IAP) using TISM and the assessment of the agility index of a case IAP organization using a GTA.

Modeling and analysis of barriers in controlling TB: developing countries' perspective

Purpose

Tuberculosis (TB) continues to c-exist with humans despite many TB control programs and elimination strategies. This depicts that some barriers are not allowing achieving the desired results. The current study aims to focus on identification and ranking of such barriers to facilitate TB control programs in developing countries.

Design/methodology/approach

In the present study, 13 barriers that can influence success rate of TB elimination strategies have been recognized with an in-depth assessment of related literature and opinions of specialists from medical industry and academic world. The interpretive structural modeling (ISM) and decision-making trial and evaluation laboratory (DEMATEL) techniques have been employed for the ranking of barriers.

Findings

Based on driving power of barriers, the study coined that underinvestment is a major barrier followed by poor implementation of government policies and programs, poverty and poor primary health care infrastructure.

Research limitations/implications

The findings may guide healthcare service providers and researchers in analyzing the barriers and understanding the necessity of further advancements to decrease the count of already existing and incident cases.

Practical implications

Policy- and decision-makers may utilize the information on dependence and driving power of barriers for better planning and effective execution of TB control strategies.

Originality/value

Although a lot of literature is available on different barriers that are affecting success of TB strategies, the current study analyzes all the key barriers collectively for the prioritization of barriers.

A study on the influential factors of the last mile delivery projects during Covid-19 era

The Covid-19 has shifted the face of many markets including e-commerce and online business with many bottlenecks to be cleared. The last-mile delivery project has the greatest effect on all types of e-commerce companies because it has many consumer touchpoints as well as the Covid-19 pain points. Due to these interconnected issues, the delivery projects itself requires modern solutions. The purpose of this paper is to identify, analyse and categorize the major factors that affect the last mile delivery projects in e-commerce, food sector, retail sector and so on using total ınterpretive structural modelling approach during the Covid-19. Ten major factors are identified from literature review, and expert opinions are collected from multiple organizations that are involved in the last mile delivery projects. The results indicate that types of goods, achieving routing efficiency and meeting fulfilment timeline are the key factors for last mile delivery projects during the time of Covid-19. This study helps the managers to identify the key factors and to focus on these factors for the successful implementation of last mile delivery project.

S, P.K. V, Mahapatra SK, Kottayil SK. Industrial energy behaviour model: an analysis using the TISM approach

Purpose

In the realm of energy behaviour studies, very little research has been done to understand industrial energy behaviour (IEB) that influences the willingness to adopt (WTA) energy-efficient measures. Most of the studies on energy behaviour were focused on the residential and commercial sectors where the behaviour under investigation was under volitional control, that is, where people believe that they can execute the behaviour whenever they are willing to do so. The purpose of this paper is to examine the factors influencing the industry’s intentions and behaviour that leads to enhanced adoption of energy efficiency measures recommended through energy audits. In particular, this paper aims to extend the existing behaviour intention models using the total interpretive structural modelling (TISM) method and expert feedback to develop an IEB model

Design/methodology/approach

TISM technique was used to determine the relationship between different elements of the behaviour. Responses were collected from experts in the field of energy efficiency to understand the relationship between identified factors, their driving power and dependency.

Findings

The results show that values, socialisation and leadership of individuals are the key driving factors in deciding the individual energy behaviour. WTA energy-saving measures recommended by an energy auditor are found to be highly dependent on the organisational policies such as energy policy, delegation of power to energy manager and life cycle cost evaluation in purchase policy.

Research limitations/implications

This study has a few limitations that warrant consideration in future research. First, the data came from a small sample of energy experts based on a convenience sample of Indian experts. This limits the generalizability of the results. Individual and organizational behaviour analysed in this study looked into a few select characteristics, derived from the literature review and expert feedback, which may pose questions about the standard for behaviours in different industries.

Practical implications

Reasons for non-adoption of energy audit recommendations are rarely shared by the industries and the analysis of individual and organisational behaviour through structured questionnaire and surveys have serious limitations. Under this circumstance, collecting expert feedback and using the TISM method to build an IEB model can help to build strategies to enhance the adoption of energy-efficient measures.

Social implications

Various policy level interventions and regulatory measures in the energy field, adopted across the globe, are found unsuccessful in narrowing the energy-efficiency gap, reducing the greenhouse gas (GHG) emissions and global warming. Understanding the key driving factors can help develop effective intervention strategies to improve energy efficiency and reduce GHG emissions.

Originality/value

The industry energy behaviour model with driving, linking and dependent factors and factor hierarchy is a novel contribution to the theory of organisational behaviour. The model takes into consideration both the individual and organisational factors where the decision-making is not strictly under volitional control. Understanding the key driving factor of behaviour can help design an effective intervention strategy that addresses the barriers to energy efficiency improvement. The results imply that it is important to carry out post energy audit studies to understand the implementation rate of recommendations and also the individual and organisational factors that influence the WTA energy-saving measures.

Modeling the enablers of sourcing risks faced by startups in COVID-19 era

Purpose

Startups across all sectors are affected by the COVID-19 pandemic and are facing a formidable challenge in terms of marketing and operations. Most of the startups have experienced a downturn in demand and supply due to COVID-19 led disturbances in sourcing networks. This paper aims to identify, analyze and categorize the significant risks influencing sourcing operations in startups during the COVID-19 era in India, using the total interpretive structural modeling (TISM) approach.

Design/methodology/approach

Eight enablers were identified through literature review and expert opinions from various startups in India. This study adopted the TISM approach to analyze the inter-relationships between the enablers. Multiplication Applied to Classification (MICMAC) analysis was used to rank the sourcing risk enablers and classify them as autonomous, independent, linkage and dependent enablers.

Findings

The results indicate “insufficient fund” as the most critical enabler. Network issues and employee flexibility risk were among the other critical enablers that have a high driving power. Supplier risk, quality risk and demand risk were found to have highly dependent on other enablers for implementation.

Research limitations/implications

This study mainly focuses on the sourcing risks in startup operations in India. This study can be extended to many other countries.

Practical implications

This study will help startup industry managers and practitioners understand the interactions of enablers and identify critical enablers to mitigate risks in startup sourcing operations in the COVID-19 era.

Originality/value

The present study identifies the sourcing risk enablers in the COVID-19 era. It is the first attempt to analyze the interrelationship among sourcing risks in startups using the TISM approach.

Modelling enablers of efficiency and sustainability of healthcare: a m-TISM approach

Purpose

It would not be an exaggeration to say that healthcare is the most crucial one in today's perspective. The healthcare sector, in general, is engaged in working on various dimensions simultaneously like the safety, care, quality and cost of services, etc. Still, the desired outcomes from this sector are far away, and it becomes pertinent to address all such issues associated with healthcare on a priority basis for sustaining the outcomes in a long-term perspective. The present study aims to explore the healthcare sector and list out the directly associated enablers contributing to increasing the viability of the healthcare sector. Besides, the interrelationship among the enlisted enablers needs to be studied, which further helps in setting-out the priority to deal with individual enablers based on their impedance in the contribution towards viability increment.

Design/methodology/approach

The authors have done an extensive review to list out the enablers of the healthcare sector to perform efficiently and effectively. Further, the attempt has been made on the enablers to rank them by using the modified Total Interpretative Structure Modelling (m-TISM) approach. The validation of the study reveals the importance of enablers based on their position in the hierarchical structure. Further, the MICMAC analysis on the identified enabler is performed to categorize the identified enablers in the different clusters based on their driving power and dependence.

Findings

The research tries to envisage the importance of the healthcare sector and its contribution towards national development. The outcomes of the m-TISM model in the present study reveal the noteworthy contribution of the organizational structure in managing the healthcare facilities and represented it as the perspective of future growth. The well-designed organizational structure in the healthcare industry helps in establishing better employee–employer cooperation, workforce coordination and inter-department cooperation.

Research limitations/implications

Every research work has limitations. Likewise, the present research work also has limitations, i.e. input taken for developing the models are from very few experts that may not reflect the opinion of the whole sector.

Practical implications

The healthcare sector is the growing sector in the present-day scenario, and it is essential to keep the quality of treatment in check along with the quantity. The present study has laid down the practical foundations for improvement in the healthcare sector viability. Besides, the study emphasized on accountability of the healthcare sector officials to go with the enablers having the strong driving power for effective utilization of all the resources. This would further help them in customer (patients) satisfaction.

Originality/value

Despite an increase in demand for good quality healthcare facilities worldwide, the growth of this sector is bounded by the economic, demographic, cultural and environmental concerns, etc. The present study proposed a unique framework that provides a better understanding of the enablers. It would further help in playing a key role in increasing the viability of the healthcare sector. The hierarchy developed with the help of m-TISM and MICMAC analysis will help the viewers to recognize the important enablers based on their contribution to the viability improvement of the healthcare sector.

Developing a QFD model for prioritizing the CSFs of ERP based on the enablers of organizational agility

Purpose

The main purpose of this study is to develop a model for prioritizing the critical success factors (CSF) of enterprise resources planning (ERP) based on the enablers of organizational agility (OA).

Design/methodology/approach

First, the CSFs of ERP and the enablers of OA have been identified and classified using Decision-Making Trial and Evaluation Laboratory (DEMATEL), and then a three-phase quality function deployment (QFD) model has been designed to prioritize the influencing and influenced criteria. The proposed approach has been examined in the banking sector.

Findings

Major findings indicated that organizational structure, IT technology infrastructure, and commitment and support by top managers were selected as indicators with top priority.

Research limitations/implications

Research variables were limited to the enablers of OA and the CSFs of ERP; analysis was time-consuming due to the interconnected multiple QFD phases, and findings were limited to the selected branches of a bank. The bank managers were suggested to enhance their commitment and support toward ERP. Also, it was recommended to the managers to evaluate their organizational structure and empower it as much as possible toward the fulfillment of customers' requirements and customers' expected agility.

Originality/value

The development of the QFD matrices and dividing the factors of each research variables into influencing and influenced factors distinguished this study from the literature.

Environment Practices Mediating the Environmental Compliance and firm Performance: An Institutional Theory Perspective from Emerging Economies

Coercive pressure has forced firms to take up environmental measures in the last two decades in emerging economies. Under normative pressure, large firms with farsightedness take up the environmental practices as industry leaders. In a little mature emerging economy, such as India, where triple bottom line awareness is growing, the government facilitates the firms to operate in an environment-friendly ecosystem. We investigate how do environmental compliance and environmental practices influence the overall firm performance? The performance was measured in terms of financial, customer, internal business process, and learning and growth performance. A survey instrument was designed using well-established scales and administered to the middle to top-level corporate management executives to gather 240 data from the Indian firms. A rigorous statistical validity, diagnostics, and SEM were used to test the hypotheses. The environmental practices showed a full mediation effect on the effect of environmental compliance on performance. The examination of mediation relationships in an environmental context is limited in the reported literature. This paper is among the initial works that deal with complicated mediation relationships drawn from institutional theory propositions. The study established and argued that environmental practices' ecosystem would turn firms towards voluntary environmental compliance and eventually enjoy the long-term performance.

V, Kottayil SK. Is imperfect evaluation a deterrent to adoption of energy audit recommendations?

Purpose

Energy-efficiency leads to productivity gains as it can lower operating and maintenance costs, increase production yields per unit of manufacturing input and improve staff accountability. Implementation of energy-efficient technologies amongst industries, the factors influencing them and the barriers to their adoption have been the subject of several studies during the past three to four decades. Though energy-use behaviours of individuals or households are sufficiently explored, industrial energy conservation behaviour is scarcely studied. This study identifies the relationship between the different behavioural elements to open up a door for behaviourally informed intervention research.

Design/methodology/approach

Total interpretive structural modelling technique was used to determine the relationship between different elements of the behaviour of energy managers. Expert responses were collected to understand the relationship between the behavioural elements, through telephone interviews.

Findings

The study identified the relationship between the behavioural elements and found imperfect evaluation as the key element with the highest driving power to influence other elements.

Research limitations/implications

The authors postulate that a behaviourally informed intervention strategy that looks into the elements with high driving power such as imperfect evaluation, lack of focus on energy-saving measures and the lack of sharing energy-saving objectives can lead to: an increase in the adoption of energy efficiency measures and thereby a reduction in the energy efficiency gap; greater productivity gains and reduced greenhouse gas (GHG) emissions; Preparation of M&V protocol that incorporates behavioural, organisational and informational barriers.

Social implications

Various policy level interventions and regulatory measures in the energy field which did not address the behavioural barriers are found unsuccessful in narrowing the energy-efficiency gap, reducing the GHG gas emissions and global warming. Understanding the key driving factor of behaviour can help to design an effective intervention strategy to address the barriers to energy efficiency improvement.

Originality/value

Understanding the key driving factor of behaviour can help to design an effective intervention strategy to address the barriers to energy efficiency improvement. This study argues that through the systematic analysis of the imperfect evaluation of energy audit recommendations, it is possible to increase the adoption of energy efficiency measures that can lead to greater productivity gains and reduced GHG emissions.

Internal flexibility in health-care organizations: a value-laden perspective on sustainability

Purpose

This study aims to identify the constituents of internal flexibility in health-care organizations for achieving sustainability. The study incorporates resources-based theory and resource-dependence theory to illustrate how health-care organizations exhibit internal flexibility to redress environmental uncertainties and maximize organizational responsiveness.

Design/methodology/approach

This paper conducts a case study in a health-care organization to explore how health-care organizations acquire several resources for attaining internal flexibility. A survey of health-care professionals was conducted to assess the relationships using partial least squares-structural equation modeling.

Findings

In the present study, the dimensions of internal flexibility in health-care organizations are identified. This study also established internal flexibility as a higher-order factor and explained its underlying aspects as a value-laden perspective on sustainability.

Research limitations/implications

The study was conducted in the public health-care context in India. The framework needs to be tested in another context. The sample size for the study was limited to health-care experts, which could be extended to include the customer’s perspective.

Originality/value

The study contributes to the body of knowledge by identifying the specific dimensions of internal flexibility and explains as a higher-order factor. It enhances the understanding of sustainability from a flexibility perspective of the firm.

Evaluating the effect of critical failure factors associated with sustainable Lean Six Sigma framework implementation in healthcare organization

Purpose

The purpose of this study is to develop a structured hierarchical interrelationship-based model to evaluate the critical failure factors (CFFs) that affect the sustainable Lean Six Sigma (SLSS) framework implementation in a healthcare organization. Further, solution approaches have been provided that guide to eliminate them.

Design/methodology/approach

The CFFs has been identified through empirical study and clustered into six major categories for their better understanding. The interrelation among CFFs has been developed through total interpretive structural modeling (TISM) and classifies the nature using MICMAC technique. Further, prioritized the CFFs based on its driving and dependents power. The methodology enabled the decision-makers, practitioners to systematically analyze the CFFs and develop a structural model for implementing SLSS in the healthcare environment.

Findings

A total of 14 leading CFFs have been identified, and 7-level structured interrelationship-based model has been formed. The experts have provided the solution approach after careful analysis of the developed model. Based on the analysis, it was observed that the significant CFFs affect the deployment of the SLSS framework in healthcare organizations.

Research limitations/implications

The structured model and methodological approach have been tested in a healthcare organization. In the future, the approach can be applied in the different service sectors.

Practical implications

The present study has been conducted in a real-time industrial problem. The practitioners, decision-makers and academicians expressed the usefulness of methodology for understanding the CFFs interrelation and their effect on SLSS implementation. This study also guides decision-makers to systematically tackle related problems.

Originality/value

The development of a structured CFFs based model for SLSS framework implementation using the integrated TISM-MICMAC with a detailed solution approach is a unique effort in a healthcare environment.

What can we learn from previous pandemics to reduce the frequency of emerging infectious diseases like COVID-19?

The global risks report of 2020 stated, climate-related issues dominate all of the top-five long-term critical global risks burning the planet and according to the report, "as existing health risks resurge and new ones emerge, humanity's past successes in overcoming health challenges are no guarantee of future results." Over the last few decades, the world has experienced several pandemic outbreaks of various pathogens and the frequency of the emergence of novel strains of infectious organisms has increased in recent decades. As per expert opinion, rapidly mutating viruses, emergence and re-emergence of epidemics with increasing frequencies, climate-sensitive vector-borne diseases are likely to be increasing over the years and the trends will continue and intensify. Susceptible disease hosts, anthropogenic activities and environmental changes contribute and trigger the 'adaptive evolution' of infectious agents to thrive and spread into different ecological niches and to adapt to new hosts. The overarching objective of this paper is to provide insight into the human actions which should be strictly regulated to help to sustain life on earth. To identify and categorize the triggering factors that contribute to disease ecology, especially repeated emergence of disease pandemics, a theory building approach, 'Total Interpretive Structural Modeling' (TISM) was used; also the tool, 'Impact Matrix Cross-Reference Multiplication Applied to a Classification' analysis (MICMAC) was applied to rank the risk factors based on their impacts on other factors and on the interdependence among them. This mathematical modeling tool clearly explains the strength, position and interconnectedness of each anthropogenic factor that contributes to the evolution of pathogens and to the frequent emergence of pandemics which needs to be addressed with immediate priority. As we are least prepared for another pandemic outbreak, significant policy attention must be focused on the causative factors to limit emerging outbreaks like COVID 19 in the future.

Factors influencing organizational agility in higher education

Purpose

The purpose of this paper is to explore the factors that can facilitate agility in higher education and to analyze the interrelationship between the factors.

Design/methodology/approach

A structured model of factors facilitating agility in higher education was developed using total interpretive structural modeling (TISM). Cross-impact matrix multiplication (MICMAC) analysis helped in classifying the factors on the basis of their driving and dependency power.

Findings

An extensive literature review and expert opinion helped in identifying eight enablers that can promote agility in higher education. The ability to sense the environment, organizational structure, adoption of ICT, organizational learning, human resource strategies, leadership, readiness to change and collaboration with the stakeholders were the eight factors identified. The structural model revealed leadership as the most crucial enabler followed by human resource strategies and organizational structure.

Research limitations/implications

The model has incorporated and prioritized all the crucial drivers of agility that can help universities and colleges design, adopt and implement policies and practices that would facilitate agility.

Originality/value

So far, the research on agility in higher education has looked into each factor in isolation. This research provides a comprehensive list of the factors and establishes the interplay between the factors making this study new and original.

An analysis of growth-accelerating factors for the Indian automotive industry using modified TISM

Purpose

This study aims to identify and prioritize various growth-accelerating factors in the Indian automotive industry. It further develops a hierarchical model to examine the mutual interactions between the factors, their dependence and their driving power.

Design/methodology/approach

This study first identifies the growth-accelerating factors and then uses the modified total interpretive structural modeling (m-TISM) framework, which is an extended version of TISM. It further uses MICMAC analysis to analyze the mutual interrelation between the identified factors.

Findings

This study highlights the interrelation amongst the factors using m-TISM model. A hierarchical model shows the level of autonomous, dependence, linkage and independent factors considering the Indian automotive industry. This study also provides the understanding related to the interdependence of growth-accelerating factors.

Research limitations/implications

The government and practitioners could evaluate the growth-accelerating factors which have higher driving power for implementing efficient policies and strategy formulation. By implementing m-TISM model in the Indian automotive industry, auto manufacturers can become more productive and profitable. Future studies could use other methods such as expert opinion to derive the factors, and further model could be verified using structural equation modeling technique.

Originality/value

This study uses a novel m-TISM framework for the analysis of growth-accelerating factors in the context of the Indian automotive industry. It further provides a detailed theoretical and conceptual understanding relating to the philosophy and establishes an interrelation amongst these under-researched growth-accelerating factors.

Knowledge hiding in two contrasting cultural contexts

Purpose

The purpose of this study is to decipher the role of culture in determining knowledge-hiding tendencies of individuals. This study attempts to understand the different strategic factors (SFs) engendering knowledge hiding, model it and finally estimate the driving and dependency potency of these factors in two different cultural contexts – occidental and oriental.

Design/methodology/approach

The authors undertook content analysis of the pertinent literature to trace out the antecedents. These SFs engendering knowledge hiding were later modeled using total interpretive structural modeling (TISM) with the aid of R programming language and consequently subjected to Matriced’ Impacts Croise’s Multiplication Appliquée a un Classement (MICMAC) analysis to categorize these factors into: autonomous, depending, linkage and driving.

Findings

The analysis establishes personality traits as a common driving factor engendering knowledge hiding in both the cultural contexts. Emotional intelligence is a key driving factor in an occidental cultural context whereas interpersonal distrust drives knowledge hiding in an oriental cultural setting. The task in hand, its uncertainty and complexity are the other critical factors causing knowledge hiding in the oriental cultural context.

Practical implications

The study suggests organizations in the occidental setting to streamline their recruitment policy, giving due importance to the personality traits and emotional quotient of individuals. As task uncertainty and complexity are the critical driving factors in the oriental context, the organizations should undertake a delicate balancing act between reducing risk, removing uncertainty and progressing.

Originality/value

To the best of the authors’ knowledge, this is probably the first-ever attempt to apply comprehensive TISM and MICMAC on knowledge hiding, which characterizes the antecedents of knowledge hiding in two opposite cultural contexts and thereby offers to provide the required impetus for further research on the influence of culture in knowledge-hiding behavior.

A systematic literature review of healthcare supply chain and implications of future research

Purpose

This paper aims to review the healthcare supply chain (HSC) literature along various areas and to find out the gap in it.

Design/methodology/approach

In total, 143 research papers were reviewed during 1996-2017. A critical review was carried out in various dimensions such as research methodologies/data collection method (empirical, case study and literature review) and inquiry mode of research methodology (qualitative, quantitative and mixed), country-specific, targeted area, research aim and year of publication.

Findings

Supply chain (SC) operations, performance measurement, inventory management, lean and agile operation, and use of information technology were well studied and analyzed, however, employee and customer training, tracking and visibility of medicines, cold chain management, human resource practices, risk management and waste management are felt to be important areas but not much attention were made in this direction.

Research limitations/implications

Mainly drug and vaccine SC were considered in current study of HSC while SC along healthcare equipment and machine, hospitality and drug manufacturing related papers were excluded in this study.

Practical implications

This literature review has recognized and analyzed various issues relevant to HSC and shows the direction for future research to develop an efficient and effective HSC.

Originality/value

The insight of various aspects of HSC was explored in general for better and deeper understanding of it for designing of an efficient and competent HSC. The outcomes of the study may form a basis to decide direction of future research.

S, Dutta P. Modelling the readiness factors for agility in healthcare organization: a TISM approach

Purpose

The purpose of this paper is to identify and analyze the interactions among different readiness factors for implementing agility in healthcare organization. Total interpretive structural modeling (TISM) based readiness framework for agility has been developed to understand the mutual interactions among the factors and to identify the driving and dependence power of these factors.

Design/methodology/approach

The identification of factors is done by TISM approach used for analyzing the mutual interactions between factors. Cross-impact matrix multiplication applied to classification analysis is utilized to find the driving and dependent factors of agile readiness in healthcare.

Findings

This paper identifies 12 factors of readiness for change in literature review, which is followed by an expert interview to understand the interconnection of factors and to study interrelationships of factors. The study suggests that factors like environmental scanning, resource availability, innovativeness, cost effectiveness, organizational leadership, training and development are important for implementing/improving the readiness of agility in healthcare organizations.

Research limitations/implications

This research focuses mainly on readiness factors for agility in healthcare sector.

Practical implications

Top management must stress on readiness factors that have a strong driving power for efficient implementation of agility in healthcare. This study helps the managers to take quick decisions, and continuous monitoring of readiness factors would be more beneficial to improve the quality of service, which makes the organization more agile.

Originality/value

In this research, TISM-based readiness for agile framework structural model has been proposed for healthcare organizations, which is a new effort for implementation of agility in healthcare.

Analysis of government-supported health-care supply chain enablers: a case study

Purpose

The purpose of this paper is to identify, analyze and classify (i.e. driving and dependence power) the government-supported health-care supply chain enablers (GHSCEs) in rural areas of India for enhancing availability and minimizing wastage of generic medicines.

Design/methodology/approach

A methodology is proposed using interpretive structural modeling (ISM) – fuzzy matriced impacts croises multiplication appliqueeaun classement (Fuzzy MICMAC) analysis to analyze the GHSCEs on the basis of inputs collected from various stakeholders about their driving and dependence power.

Findings

The performance measurement system, employee recognition and reward, technology adoption, training cell and inbuilt analytical tool for IT system were found to be the appropriate GHSCEs where efforts and resources should be put for enhancing availability and minimizing wastage.

Research limitations/implications

The proposed approach provides a platform for the both researchers and academicians to understand the GHSCEs and their relationships. It also provides the direction to the government for optimally allocating the efforts and resources to enhance the current performance level of generic drug distribution.

Originality/value

Although many issues related to health-care supply chain have been widely researched and reported, no literature has been found for analysis of GHSCEs to choose the appropriate set of GHSCEs for supply chain performance improvement in general and developing country like India in specific.

Modeling and analysis of FMS performance variables by fuzzy TISM

Purpose

The purpose of this paper is to identify the flexible manufacturing system performance variables and analyze the interactions among these variables. Interpretive structural modeling (ISM) has been reported for this but no study has been done regarding the interaction of its variables. Therefore, fuzzy TISM (total ISM) has been applied to deduce the relationship and interactions between the variables and driving and dependence power of these variables are examined by fuzzy MICMAC.

Design/methodology/approach

Fuzzy TISM and fuzzy MICMAC analysis have been applied to deduce the relationship and interactions among the variables and driving and dependence power of these variables are examined by fuzzy MICMAC.

Findings

In total, 15 variables have been identified from the extensive literature review. The result showed that automation, use of automated material handling, an effect of tool life and rework percentage have high driving power and weak dependence power in the fuzzy TISM model and fuzzy MICMAC analysis. These are also at the lowest level in the hierarchy in the fuzzy TISM model.

Originality/value

Fuzzy TISM model has been suggested for manufacturing industries with fuzzy MICMAC analysis. This proposed approach is a novel attempt to integrate TISM approach with the fuzzy sets. The integration of TISM with fuzzy sets provides flexibility to decision-makers to further understand the level of influences of one criterion over another, which was earlier present only in the form of binary (0, 1) numbers; 0 represents no influence and 1 represents influence.

A study on the influence of factors associated with organizational readiness for change in healthcare organizations using TISM

Purpose

The purpose of this paper is to identify, analyze and develop a model to measure the interactions among different factors of organizational readiness for change in service sector specific to healthcare organization. The total interpretive structural modeling (TISM)-based readiness for change is to build a theoretical framework to understand the mutual interactions among the factors and to identify the driving and dependence power of these factors.

Design/methodology/approach

TISM is used to identify factors that contribute to analyze the readiness state before starting a change implementation process in healthcare. Matrice d’Impacts croises-multiplication applique´ a classement analysis is used to find the driving and dependent factors of change in healthcare.

Findings

This paper identified 12 factors of readiness for change from literature review followed by expert interview to understand the inner connection of factors and study inner relationships. The result says that state of affairs, recent trends in healthcare sector, technology advancement and interdependence among departments are key factors for readiness of change.

Research limitations/implications

This research mainly focused on readiness factors for change in the healthcare sector.

Practical implications

This study will be useful for researcher and practitioners to understand the readiness factors for change.

Originality/value

In this research work, TISM-based readiness for the change framework structural model has been proposed for healthcare organizations which is a new effort in the area of organizational change management in this sector.