Purpose: – The purpose of this paper is to present management techniques in the healthcare sector through lean office. Design/methodology/approach: – A case study approach is adopted, with data collected in the Brazilian military organization. Findings: – The findings identify several ways to apply lean concepts outside manufacturing. From this, a future lean office health state design will be proposed. Research limitations/implications: – The lean office health proposal has to be tested in other organizations to confirm this case study. While this may limit the generalization of the findings, there is value in demonstrating the benefits modern lean office techniques can bring to the developing world healthcare. Practical implications: – The paper shows that lean office health techniques can provide benefits to healthcare in developing countries' hospitals and others. Originality/value: – The value of the paper arises from providing a detailed analysis of a healthcare lean office in the developing world. There have been only a small number of other studies published in the literature about lean office health.

Complex relationships and dynamic environments challenge the management of global supply chains. This paper first reviews conceptual frameworks for managing relationships along supply chains and concepts for the coordination of planning and scheduling processes. On the sequence, the integrated production and transportation scheduling problem for an original equipment manufacturer is formulated as a mixed integer program. The program combines an open flow shop problem and vehicle routing problem. The subsequent computational analysis shows that the formulated program supports the sustainable alignment between production and transportation systems and that heuristics are needed for suitably dealing with this kind of complex problem.

The temperature of refrigerated products along the distribution process must be kept within close limits to ensure optimum food safety levels and high product quality. The variation of product temperature along the vehicle routing sequence is represented by non-linear functions. The temperature variability is also correlated with the time required for the refrigerated unit to recover after cargo unloading, due to the cargo discharging process. The vehicle routing optimization methods employed in traditional cargo distribution problems are generally based on the Travelling Salesman Problem with the objective of minimizing travelled distance or time. The thermal quality of routing alternatives is evaluated in this analysis with Process Capability Indices (PCI). Since temperature does not vary linearly with time, a Simulated Annealing algorithm was developed to get the optimal solution in which the minimum vehicle traveling distance is searched, but respecting the quality level expressed by a required minimum PCI value.

A new Lean Six Sigma framework for improving competitiveness