Due to the changing technological possibilities of services, the demands that society places on the level of service provided by the Dutch Central Government (DCG) are changing rapidly. To accommodate this, the Dutch government is improving its processes in such a way that they become more agile and are continuously improved. However, the DCG struggles with the implementation of improvement tools that can support this. The research described in this paper aims to deliver key factors that influence the adoption of tools that improve the agile way of working and continuous improvement at the DCG. Therefore, a literature review has been conducted, from which 24 factors have been derived. Subsequently, 9 semi structured interviews have been conducted to emphasize the perspective of employees at the DCG. In total, 7 key factors have been derived from the interviews. The interviewees consisted of both employees from departments who already worked with tools to improve agile working and continuous improvement as well as employees from departments who haven’t used such tools yet. An important insight based on this research is that the aims, way of working and scope of the improvement tools must be clear for all the involved co-workers
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In pursuit of competitive advantage in an increasingly globalized and complex environment, organizations are turning to continuous improvement and digitalization to achieve operational excellence. Viewed through the lens of Dynamic Capabilities Theory, the similarities complementarities, and synergies of continuous improvement capability and data analytic capability are examined. Bridging the gap between theory and practice, continuous improvement routines and practices that can be harnessed to accelerate the implementation of data analytical capability are identified. These include Hoshin Kanri to link digitalization projects to organizational strategic, training to develop organizational knowledge of digitalization, problem solving teams to break knowledge silos, and the use of PDCA-type processes for adopting and monitoring the performance of digital technologies.
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Purpose: To deal with an increasingly competitive environment, organizations are combining continuous improvement (CI) practices with digitalization to accrue their benefits on operational performance and achieve operational excellence. The purpose of this study was to identify the enablers and inhibitors of digitalization as part of CI projects. Design/methodology/approach: A mixed-methods sequential explanatory research design consisting of an online survey and semi-structured interviews was used to examine how digitalization technologies have been incorporated by organizations in their CI projects. Findings: Key enablers of digitalization were found to be leadership capabilities, strategic direction, stakeholder involvement, system compatibility, data quality and giving employees room to experiment. Knowledge of digitalization was found to affect all these enablers. Research limitations/implications: The empirical findings are based on a nonprobability sample of Dutch CI practitioners, limiting their generalizability. Practical implications: The empirical findings highlight the need for organizations to adopt a structured approach to implementing digitalization as part of their CI projects, starting by ensuring that the necessary knowledge and skills are either present or accessible to the organization. Originality/value: The empirical findings show that enablers of digitalization in the context of CI are strongly interlinked, and thus require a holistic approach.
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To deal with an increasingly competitive environment, organizations are combining continuous improvement (CI) practices with digitalization to accrue their benefits on operational performance and achieve operational excellence. Using a mixed-methods approach consisting of an online survey and semi-structured interviews, we examined how digitalization technologies have been incorporated in CI projects by organizations. Besides significant relationships between the nature of CI initiative and the use of digitalization tools, we found key enablers for organizations to be system compatibility, room to experiment, data-driven decision-making and step-by-step introduction with involvement of stakeholders. These enablers were found to be interlinked through knowledge of digitalization.
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Experts like Jouslin de Noray, Shiba and Hardjono discern three paradigms in quality management: control, continuous improvement and breakthrough. Van Kemenade argues that before being able to reach breakthrough you need another paradigm: commitment.
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Background: In 2009, the Steering Committee for Pregnancy and Childbirth in the Netherlands recommended the implementation of continuous care during labor in order to improve perinatal outcomes. However, in current care, routine maternity caregivers are unable to provide this type of care, resulting in an implementation rate of less than 30%. Maternity care assistants (MCAs), who already play a nursing role in low risk births in the second stage of labor and in homecare during the postnatal period, might be able to fill this gap. In this study, we aim to explore the (cost) effectiveness of adding MCAs to routine first- and second-line maternity care, with the idea that these MCAs would offer continuous care to women during labor. Methods: A randomized controlled trial (RCT) will be performed comparing continuous care (CC) with care-as-usual (CAU). All women intending to have a vaginal birth, who have an understanding of the Dutch language and are > 18 years of age, will be eligible for inclusion. The intervention consists of the provision of continuous care by a trained MCA from the moment the supervising maternity caregiver establishes that labor has started. The primary outcome will be use of epidural analgesia (EA). Our secondary outcomes will be referrals from primary care to secondary care, caesarean delivery, instrumental delivery, adverse outcomes associated with epidural (fever, augmentation of labor, prolonged labor, postpartum hemorrhage, duration of postpartum stay in hospital for mother and/or newborn), women’s satisfaction with the birth experience, cost-effectiveness, and a budget impact analysis. Cost effectiveness will be calculated by QALY per prevented EA based on the utility index from the EQ-5D and the usage of healthcare services. A standardized sensitivity analysis will be carried out to quantify the outcome in addition to a budget impact analysis. In order to show a reduction from 25 to 17% in the primary outcome (alpha 0.05 and bèta 0.20), taking into account an extra 10% sample size for multi-level analysis and an attrition rate of 10%, 2 × 496 women will be needed (n = 992). Discussion: We expect that adding MCAs to the routine maternity care team will result in a decrease in the use of epidural analgesia and subsequent costs without a reduction in patient satisfaction. It will therefore be a costeffective intervention. Trial registration: Trial Registration: Netherlands Trial Register, NL8065. Registered 3 October 2019 - Retrospectively registered.
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