Purpose This paper builds on the debate regarding the application of Lean strategy principles and tools in modern organizations, specifically focusing on the healthcare (HC) sector. The purpose of this paper is threefold: first, to highlight the potential role played by Lean strategy tools for strategic planning and management, particularly in reference to the Hoshin Kanri policy deployment system and the “focus, alignment, integration, and review” (FAIR) method; second, to discuss how Lean strategy can be operationalized, specifically relying on the X-Matrix reporting tool; and third, to explore how simulation techniques, in the form of role-playing (RP), may support the aforementioned operationalization of Lean strategy while at the same time promoting policymaking and knowledge sharing. Design/methodology/approach This research adopts a case study approach. Specifically, the paper relies on the use of a RP Lean strategy project developed in a HC setting. Findings The paper highlights the potential for the Hoshin Kanri policy deployment process in HC, also emphasizing the main strengths of X-Matrix reporting and the usefulness of the RP technique to support learning acquisition and decision making. Practical implications The paper demonstrates how a Lean strategy simulation project may be effectively used for strategic planning/management and to train professionals in HC. To achieve these aims, a methodology to design and implement simulation-based Lean strategy projects in HC is presented and discussed. Originality/value A review of the academic literature indicates that Lean strategy is still an emerging research topic addressed by only a limited number of articles. The paper contributes to a deeper understanding of the fundamentals of Lean strategy (particularly Hoshin Kanri and X-Matrix) with particular reference to the HC sector.

Within the extensive literature investigating the impacts of corporate disclosure in supporting the sustainable growth of an organization, few studies have included in the analysis the materiality issue referred to the information being disclosed. This article aims to address this gap, exploring the effect produced on capital markets by the publication of a recent corporate reporting tool, Integrated Report (IR). The features of this tool are that it aims to represent the multidimensional impact of the organization’s activity and assumes materiality as a guiding principle of the report drafting. Adopting the event study methodology associated with a statistical significance test for categorical data, our results verify that an organization’s release of IR is able to produce a statistically significant impact on the related share prices. Moreover, the term “integrated” assigned to the reports plays a significant role in the impact on capital markets. Our findings have beneficial implications for both researchers and practitioners, adding new evidence for the IR usefulness as a corporate disclosure tool and the effect of an organization’s decision to disclose material information.

The article explores the role of qualitative system dynamics (SD) in evaluating the information presented in corporate accounting reports. Particularly, this study focuses on a recent corporate report called integrated reporting (), and analyses the information using a specific qualitative SD technique, resource mapping, in order to visualize the key resources and their connections responsible for the performance of the organization. The study'; contribution is twofold. First, it provides insights on how to apply qualitative SD in the field of management accounting and corporate reporting. Second, it verifies the benefits of combining qualitative SD and corporate reporting tools to develop new knowledge useful to represent and face the dynamic complexity implicit in a business domain.

Purpose: The purpose of this paper is to investigate the potentials of role-playing (RP) both in training healthcare (HC) professionals to implement tools and improvement actions based on Lean principles, and in supporting group discussion and the sharing of different competencies for the development of Lean HC. Design/methodology/approach: The paper presents the case study of an RP simulation called LEAN HEALTHCARE LAB, which is used to train HC professionals at Siena University Hospital. The paper reports and discusses the results of a specific two-day simulation session and of a questionnaire that was distributed to gather feedback from the participants. Findings: The paper verifies the potentials of RP to be a powerful educational and training tool that is able to stimulate the HC participants to apply Lean thinking principles and share their competencies in collaborative decision-making processes. Research limitations/implications: The study provides data in reference to one single simulation session, although the game has already been applied several times in different HC organizations with very similar outcomes. Moreover, a more in-depth analysis of players’ perceptions and decisions could be performed using different tools in addition to the adopted questionnaire. Practical implications: RP games (RPGs) are effective training and educational tools for HC professionals. They offer benefits and learning conditions which are definitely different if compared with more conventional education programs for HC professionals. Originality/value: While previous studies have extensively discussed the potentialities of RPG and simulations in training programs, only a few articles have discussed the RP adoption for Lean thinking and even less to educate HC professionals on Lean principles and tools.

Purpose: The purpose of this paper is to explore the way in which system dynamics (SD) can enhance some key success factors of the balanced scorecard (BSC) model and support decision-makers, specifically in analyzing and evaluating the results of hypothetical scenarios. Moreover, the paper aims to emphasize the role played by statistics not only in validating the SD-based BSC, but also in increasing managers’ confidence in the model reliability. Design/methodology/approach: The paper presents a case study, developed according to an action research perspective, in which a three-step approach to the BSC implementation was followed. Specifically, the first step requires the development and implementation of a “traditional” BSC, which is refined and transformed into a simulation SD model in the second step. Last, the SD-based BSC is combined with statistics to develop policy making and scenario analysis. Findings: The integration of BSC and SD modeling enables the development of a comprehensive approach to strategy formulation and implementation and, more importantly, provides a more reliable basis upon which to build and test sound cause-and-effect relationships, within a specific BSC. This paper exemplifies how an SD-based BSC can be used – and perceived reliable – to evaluate different scenarios and mutually exclusive policy effects in a multidimensional approach. In particular, this study illustrates how to forecast and depict trends for financial and non-financial indicators over the simulation period, with reference to three different scenarios. Originality/value: This paper contributes to the ongoing debate on the BSC by exploring whether a combination of SD and statistics may enhance the BSC system’s advantages and facilitate its implementation process and use for decision-making and scenario analysis.

Purpose: This paper aims to stimulate interest in the potentials of serious games within organizations. Through the examination of a case study, emphasis is given to serious games designed for health care (HC) organizations that are adopting lean thinking principles and tools. Design/methodology/approach: The paper discusses how serious games can be designed and implemented in practice by describing a case study based on a HC organization. The program, now in its second year, has been used extensively to train HC professionals. Findings: The article is based on the authors’ firsthand experience with serious games and the outcome of several projects carried out in the HC setting under analysis. Serious games were found to be powerful training and management development tools as well as engaging environments for professionals. Specifically, The Lean Healthcare Lab supported professionals in their use and implementation of several Lean principles and techniques. Research limitations/implications: The article suggests the opportunity to evaluate the effectiveness of serious games also to improve team performance and develop leadership skills. Practical implications: Serious games have an enormous potential in sustaining processes of both individual and organizational learning, as well as facilitating improved teamwork. Moreover, serious games are very effective educational tools when compared to more conventional programs. Originality/value: The approach described in this study can be used to design and implement serious games in any type of organization, in particular, those employing highly skilled professionals. Additionally, this article highlights how serious games can provide learners with a simulated close-to-reality environment where they are challenged to develop policies and use a variety of Lean and management tools.