{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T01:35:13Z","timestamp":1773970513252,"version":"3.50.1"},"reference-count":79,"publisher":"Emerald","issue":"1","license":[{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BPMJ"],"published-print":{"date-parts":[[2021,1,25]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title><jats:p>The purpose of this paper is to systematically investigate the patient flow and waiting time problems in hospital emergency departments (EDs) from an integrated voice of customer (VOC) and voice of process (VOP) perspective and to propose a new lean framework for ED process.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title><jats:p>A survey was conducted to better understand patients' perceptions of ED services, lean tools such as process mapping and A3 problem-solving sheets were used to identify hidden process wastes and root-cause analysis was performed to determine the reasons of long waiting time in ED.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Findings<\/jats:title><jats:p>The results indicate that long waiting times in ED are major concerns for patients and affect the quality of ED services. It was revealed that limited bed capacity, unavailability of necessary staff, layout of ED, lack of understanding among patients about the nature of emergency services are main causes of delay. Addressing these issues using lean tools, integrated with the VOC and VOP perspectives can lead to improved patient flow, higher patient satisfaction and improvement in ED capacity. A future value stream map is proposed to streamline the ED activities and minimize waiting times.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Research limitations\/implications<\/jats:title><jats:p>The research involves a relatively small sample from a single case study. The proposed approach will enable the ED administrators to avoid the ED overcrowding and streamline the entire ED process.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title><jats:p>This research identified ED quality issues from the integration of VOC and VOP perspective and suggested appropriate lean tools to overcome these problems. This process improvement approach will enable the ED administrators to improve productivity and performance of hospitals.<\/jats:p><\/jats:sec>","DOI":"10.1108\/bpmj-11-2019-0457","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T10:13:15Z","timestamp":1595585595000},"page":"75-105","source":"Crossref","is-referenced-by-count":32,"title":["Enhancing patient flow in emergency department (ED) using lean strategies\u2013an integrated voice of customer and voice of process perspective"],"prefix":"10.1108","volume":"27","author":[{"given":"Ali","family":"Alowad","sequence":"first","affiliation":[]},{"given":"Premaratne","family":"Samaranayake","sequence":"additional","affiliation":[]},{"given":"Kazi","family":"Ahsan","sequence":"additional","affiliation":[]},{"given":"Hisham","family":"Alidrisi","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9074-0384","authenticated-orcid":false,"given":"Azharul","family":"Karim","sequence":"additional","affiliation":[]}],"member":"140","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"key2022092113481677300_ref001","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s40092-019-00335-x","article-title":"Emergency department resource optimisation for improved performance: a review","volume":"15","year":"2019","journal-title":"Journal of Industrial Engineering International"},{"key":"key2022092113481677300_ref002","first-page":"1893","article-title":"Integrated Lean Six Sigma approach for patient flow improvement in hospital emergency department","volume":"834","year":"2014","journal-title":"Advanced Materials Research"},{"issue":"13","key":"key2022092113481677300_ref080","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1080\/09537287.2018.1511870","article-title":"An integrated lean methodology for improving patient flow in an emergency department\u2013case study of a Saudi Arabian hospital","volume":"29","year":"2018","journal-title":"Production Planning and Control"},{"issue":"4","key":"key2022092113481677300_ref003","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1080\/00207543.2012.693639","article-title":"A time-based quantitative approach for selecting lean strategies for manufacturing organisations","volume":"51","year":"2013","journal-title":"International Journal of Production Research"},{"issue":"2","key":"key2022092113481677300_ref004","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1177\/0951484818770411","article-title":"The use of process mapping in healthcare quality improvement projects","volume":"31","year":"2018","journal-title":"Health Services Management Research"},{"key":"key2022092113481677300_ref005","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.aei.2016.11.004","article-title":"Extracting failure time data from industrial maintenance records using text mining","volume":"33","year":"2017","journal-title":"Advanced Engineering Informatics"},{"issue":"3","key":"key2022092113481677300_ref006","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1080\/20479700.2017.1304323","article-title":"Using value stream mapping and discrete event simulation to improve efficiency of emergency departments","volume":"10","year":"2017","journal-title":"International Journal of Healthcare Management"},{"issue":"4","key":"key2022092113481677300_ref007","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.surg.2008.06.012","article-title":"The devil is in the details: maximizing revenue for daily trauma care","volume":"144","year":"2008","journal-title":"Surgery"},{"key":"key2022092113481677300_ref008","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ijmedinf.2017.08.005","article-title":"Identifying and eliminating inefficiencies in information system usage: a lean perspective","volume":"107","year":"2017","journal-title":"International Journal of Medical Informatics"},{"key":"key2022092113481677300_ref009","first-page":"1","article-title":"Value stream mapping as lean healthcare's tool to see wastes and improvement points","volume":"2","year":"2019","journal-title":"Journal of Innovation and Healthcare Management"},{"issue":"3","key":"key2022092113481677300_ref010","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1108\/14777271211251309","article-title":"Lean and queuing integration for the transformation of health care processes: a lean health care model","volume":"17","year":"2012","journal-title":"Clinical Governance: An International Journal"},{"key":"key2022092113481677300_ref011","article-title":"Designing and conducting mixed methods research","year":"2007"},{"issue":"1","key":"key2022092113481677300_ref012","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1370\/afm.104","article-title":"Designing a mixed methods study in primary care","volume":"2","year":"2004","journal-title":"The Annals of Family Medicine"},{"issue":"9","key":"key2022092113481677300_ref013","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/j.healthpol.2015.02.002","article-title":"Lean in healthcare: a comprehensive review","volume":"119","year":"2015","journal-title":"Health Policy"},{"key":"key2022092113481677300_ref014","doi-asserted-by":"crossref","first-page":"168","DOI":"10.4018\/978-1-4666-5202-6.ch017","article-title":"Applying process mining to the emergency department","volume-title":"Encyclopedia of Business Analytics and Optimization","year":"2014"},{"issue":"4","key":"key2022092113481677300_ref015","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.annemergmed.2009.03.024","article-title":"Use of lean in the emergency department: a case series of 4 hospitals","volume":"54","year":"2009","journal-title":"Annals of Emergency Medicine"},{"issue":"1-2","key":"key2022092113481677300_ref016","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1080\/14783363.2014.945312","article-title":"Lean production in healthcare: a simulation-based value stream mapping in the physical therapy and rehabilitation department of a public hospital","volume":"27","year":"2016","journal-title":"Total Quality Management and Business Excellence"},{"issue":"4","key":"key2022092113481677300_ref017","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1080\/18756891.2016.1204117","article-title":"An application of value analysis for lean healthcare management in an emergency department","volume":"9","year":"2016","journal-title":"International Journal of Computational Intelligence Systems"},{"key":"key2022092113481677300_ref018","first-page":"125","article-title":"Process mining for healthcare process analytics","year":"2016"},{"issue":"6","key":"key2022092113481677300_ref019","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1108\/IJQRM-02-2017-0031","article-title":"Hospital healthcare service quality, patient satisfaction and loyalty: an investigation in context of private healthcare systems","volume":"35","year":"2018","journal-title":"International Journal of Quality and Reliability Management"},{"issue":"2","key":"key2022092113481677300_ref020","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1108\/BPMJ-06-2016-0115","article-title":"The promotion of BPM and lean in the health sector: main results","volume":"24","year":"2018","journal-title":"Business Process Management Journal"},{"issue":"1","key":"key2022092113481677300_ref021","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1037\/a0039139","article-title":"Developing and investigating the use of single-item measures in organizational research","volume":"21","year":"2016","journal-title":"Journal of Occupational Health Psychology"},{"issue":"5","key":"key2022092113481677300_ref022","first-page":"1066","article-title":"Evaluating the patient experience of an emergency burns assessment service in a UK burn unit using a service user evaluation questionnaire and process mapping","volume":"46","year":"2019","journal-title":"Burns"},{"issue":"3","key":"key2022092113481677300_ref023","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1080\/08982112.2018.1464657","article-title":"Applying Lean Six Sigma methods to reduce length of stay in a hospital's emergency department","volume":"30","year":"2018","journal-title":"Quality Engineering"},{"key":"key2022092113481677300_ref024","volume-title":"Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement","year":"2016"},{"key":"key2022092113481677300_ref025","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.ijpe.2015.05.029","article-title":"Applying lean principles to the design of healthcare facilities","volume":"170","year":"2015","journal-title":"International Journal of Production Economics"},{"issue":"12","key":"key2022092113481677300_ref026","article-title":"Process mapping evaluation of medication reconciliation in academic teaching hospitals: a critical step in quality improvement","volume":"6","year":"2016","journal-title":"BMJ open"},{"issue":"3","key":"key2022092113481677300_ref027","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.annemergmed.2010.08.001","article-title":"Lean thinking in emergency departments: a critical review","volume":"57","year":"2011","journal-title":"Annals of Emergency Medicine"},{"issue":"3","key":"key2022092113481677300_ref028","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1108\/BPMJ-08-2014-0074","article-title":"AHP framework to assist lean deployment in Abu Dhabi public healthcare delivery system","volume":"22","year":"2016","journal-title":"Business Process Management Journal"},{"issue":"1","key":"key2022092113481677300_ref029","doi-asserted-by":"crossref","first-page":"p43","DOI":"10.1108\/02656711111097544","article-title":"Manufacturing practices and performance: comparison among small-medium and large industries","volume":"28","year":"2011","journal-title":"International Journal of Quality and Reliability Management"},{"issue":"4","key":"key2022092113481677300_ref030","first-page":"p628","article-title":"Quality certification and company performance - the newly developed country experience","volume":"17","year":"2016","journal-title":"Journal of Business Economics and Management"},{"issue":"12","key":"key2022092113481677300_ref031","first-page":"1","article-title":"Do sustainable procurement practices improve organisational performance?","volume":"9","year":"2017","journal-title":"Sustainability"},{"issue":"7","key":"key2022092113481677300_ref032","first-page":"14","article-title":"Mixed method research: a research paradigm whose time has come","volume":"33","year":"2004","journal-title":"Journal of Educational Research"},{"issue":"8","key":"key2022092113481677300_ref033","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1108\/IJQRM-08-2015-0121","article-title":"Perceptions of care quality and the effect on patient satisfaction","volume":"33","year":"2016","journal-title":"International Journal of Quality and Reliability Management"},{"issue":"1","key":"key2022092113481677300_ref034","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1108\/14637151311294912","article-title":"A methodology for effective implementation of lean strategies and its performance evaluation in manufacturing organizations","volume":"19","year":"2013","journal-title":"Business Process Management Journal"},{"key":"key2022092113481677300_ref035","first-page":"526","article-title":"Manufacturing yield improvement by clustering","year":"2006"},{"key":"key2022092113481677300_ref081","first-page":"250","article-title":"Implementation of lean manufacturing in Saudi manufacturing organisations: an empirical study","volume-title":"Advanced Materials Research","year":"2011"},{"issue":"13","key":"key2022092113481677300_ref036","doi-asserted-by":"crossref","first-page":"3583","DOI":"10.1080\/00207540601164201","article-title":"Empirical relationships between some manufacturing practices and performance","volume":"46","year":"2008","journal-title":"International Journal of Production Research"},{"issue":"2","key":"key2022092113481677300_ref037","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.ijpe.2007.07.005","article-title":"A comparative study of manufacturing practices and performance variables","volume":"112","year":"2008","journal-title":"International Journal of Production Economics"},{"key":"key2022092113481677300_ref038","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.ijpe.2007.07.005","article-title":"A comparative study of manufacturing practices and performance variables","volume":"112","year":"2008","journal-title":"International Journal of Production Economics"},{"issue":"8","key":"key2022092113481677300_ref039","doi-asserted-by":"crossref","first-page":"2373","DOI":"10.1080\/00207540802642245","article-title":"An on-time delivery improvement model for manufacturing organisations","volume":"48","year":"2010","journal-title":"International Journal of Production Research"},{"issue":"1","key":"key2022092113481677300_ref040","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1080\/0958519042000295939","article-title":"Strategic global human resource management research in the twenty-first century: an endorsement of the mixed-method research methodology","volume":"16","year":"2005","journal-title":"The International Journal of Human Resource Management"},{"issue":"4","key":"key2022092113481677300_ref041","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/j.1742-6723.2006.00872.x","article-title":"Redesigning emergency department patient flows: application of Lean Thinking to health care","volume":"18","year":"2006","journal-title":"Emergency Medicine Australasia"},{"issue":"1","key":"key2022092113481677300_ref042","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s12875-015-0388-5","article-title":"Development of the competency scale for primary care managers in Thailand: scale development","volume":"16","year":"2015","journal-title":"BMC Family Practice"},{"issue":"2","key":"key2022092113481677300_ref043","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1108\/09526861011017120","article-title":"Quality of care and patient satisfaction: a new theoretical and methodological approach","volume":"23","year":"2010","journal-title":"International Journal of Health Care Quality Assurance"},{"issue":"7","key":"key2022092113481677300_ref044","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1080\/21681015.2017.1367728","article-title":"Utilizing six sigma to improve the processing time: a simulation study at an emergency department","volume":"34","year":"2017","journal-title":"Journal of Industrial and Production Engineering"},{"key":"key2022092113481677300_ref045","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/978-3-319-16071-9_3","volume-title":"Process Mining in Healthcare: Evaluating and Exploiting Operational Healthcare Processes","year":"2015"},{"issue":"6","key":"key2022092113481677300_ref046","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1108\/SCM-10-2016-0350","article-title":"The moderating effect of Lean supply chain management on the impact of Lean shop floor practices on quality and inventory","volume":"22","year":"2017","journal-title":"Supply Chain Management: An International Journal"},{"issue":"1","key":"key2022092113481677300_ref047","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/0033-0124.00143","article-title":"Multi\u2010method research: an introduction to its application in population geography","volume":"51","year":"1999","journal-title":"The Professional Geographer"},{"issue":"2","key":"key2022092113481677300_ref048","first-page":"193","article-title":"Perspectives on the recruitment and retention of culturally and linguistically diverse police","volume":"17","year":"2008","journal-title":"Cross Cultural Management: An International Journal"},{"issue":"2","key":"key2022092113481677300_ref049","doi-asserted-by":"crossref","first-page":"p193","DOI":"10.1108\/13527601011038741","article-title":"Perspectives on the recruitment and retention of culturally and linguistically diverse police","volume":"17","year":"2010","journal-title":"Cross Cultural Management: An International Journal"},{"issue":"14","key":"key2022092113481677300_ref050","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1001\/jama.2018.21812","article-title":"Reducing emergency department length of stay","volume":"321","year":"2019","journal-title":"Jama"},{"key":"key2022092113481677300_ref051","volume-title":"Perfecting Patient Bed Flow in the Emergency Department","year":"2017"},{"issue":"1","key":"key2022092113481677300_ref052","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1017\/S1481803500012021","article-title":"Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department","volume":"12","year":"2010","journal-title":"Canadian Journal of Emergency Medicine"},{"issue":"2","key":"key2022092113481677300_ref053","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/QMH.0b013e318213e75c","article-title":"Generic project definitions for improvement of health care delivery: a case-based approach","volume":"20","year":"2011","journal-title":"Quality Management in Health Care"},{"issue":"10","key":"key2022092113481677300_ref054","doi-asserted-by":"crossref","first-page":"2328","DOI":"10.1108\/IJQRM-03-2018-0073","article-title":"A customer journey perspective on service delivery system design: insights from healthcare","volume":"35","year":"2018","journal-title":"International Journal of Quality and Reliability Management"},{"issue":"2","key":"key2022092113481677300_ref055","first-page":"p126","article-title":"Application of lean production to reducing operational waste in a tile manufacturing process","volume":"8","year":"2013","journal-title":"International Journal of Management Science and Engineering Management"},{"issue":"1","key":"key2022092113481677300_ref056","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1309\/AJCPD1MSTIVZI0PZ","article-title":"Application of the Toyota Production System improves core laboratory operations","volume":"133","year":"2010","journal-title":"American Journal of Clinical Pathology"},{"issue":"2","key":"key2022092113481677300_ref057","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1080\/19488300.2015.1017676","article-title":"Operations research\/management contributions to emergency department patient flow optimization: review and research prospects","volume":"5","year":"2015","journal-title":"IIE Transactions on Healthcare Systems Engineering"},{"issue":"1","key":"key2022092113481677300_ref058","doi-asserted-by":"crossref","first-page":"p46","DOI":"10.5130\/AJCEB.v17i1.5098","article-title":"Lean construction implementation in the Saudi Arabian construction industry","volume":"17","year":"2017","journal-title":"Construction Economics and Building"},{"issue":"2","key":"key2022092113481677300_ref059","doi-asserted-by":"crossref","first-page":"p246","DOI":"10.1108\/CI-04-2017-0033","article-title":"Barriers to implementing lean construction practices in the Kingdom of Saudi Arabia (KSA) construction industry","volume":"18","year":"2018","journal-title":"Construction Innovation"},{"issue":"1","key":"key2022092113481677300_ref060","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1108\/ECAM-03-2018-0136","article-title":"Framework for the implementation of lean construction strategies using the interpretive structural modelling (ISM) technique: a case of the Saudi construction industry","volume":"27","year":"2019","journal-title":"Engineering, Construction and Architectural Management"},{"issue":"2","key":"key2022092113481677300_ref061","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.jemermed.2015.06.068","article-title":"Emergency department expansion versus patient flow improvement: impact on patient experience of care","volume":"50","year":"2016","journal-title":"Journal of Emergency Medicine"},{"issue":"2","key":"key2022092113481677300_ref062","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1108\/IJQRM-05-2015-0066","article-title":"Portuguese primary healthcare\u2013sustainability through quality management","volume":"34","year":"2017","journal-title":"International Journal of Quality and Reliability Management"},{"issue":"3","key":"key2022092113481677300_ref063","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/ACM.0b013e3181ccb628","article-title":"The future of emergency medicine: an evolutionary perspective","volume":"85","year":"2010","journal-title":"Academic Medicine"},{"issue":"4","key":"key2022092113481677300_ref064","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1080\/09537287.2017.1418455","article-title":"Lean implementation in a service factory: views from the front-line","volume":"29","year":"2018","journal-title":"Production Planning and Control"},{"issue":"4","key":"key2022092113481677300_ref065","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.sapharm.2018.06.003","article-title":"Workflow process mapping to characterize office-based primary care medication use and safety: a conceptual approach","volume":"15","year":"2019","journal-title":"Research in Social and Administrative Pharmacy"},{"issue":"2","key":"key2022092113481677300_ref066","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1108\/JBIM-05-2014-0094","article-title":"Framing stakeholder considerations and business sustainability efforts: a construct, its dimensions and items","volume":"31","year":"2016","journal-title":"Journal of Business and Industrial Marketing"},{"key":"key2022092113481677300_ref067","volume-title":"Value Stream Management for the Lean Office-Eight Steps to Planning and Sustaining Lean Improvements in Administrative Areas","year":"2003"},{"issue":"1","key":"key2022092113481677300_ref068","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1016\/j.ejrad.2010.12.045","article-title":"Applying value stream mapping techniques to eliminate non-value-added waste for the procurement of endovascular stents","volume":"81","year":"2012","journal-title":"European Journal of Radiology"},{"issue":"1","key":"key2022092113481677300_ref069","first-page":"126","article-title":"Application of lean six sigma to improve inventory management in an emergency department","volume":"9","year":"2016","journal-title":"Journal of Management and Engineering Integration"},{"issue":"11","key":"key2022092113481677300_ref070","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1080\/09585192.2012.723019","article-title":"Exploring the factors associated with employees' perceived appraisal accuracy: a study of Chinese state-owned enterprises","volume":"24","year":"2013","journal-title":"The International Journal of Human Resource Management"},{"issue":"2","key":"key2022092113481677300_ref071","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1057\/s41273-016-0004-2","article-title":"Modelling patient flow in an emergency department to better understand demand management strategies","volume":"11","year":"2017","journal-title":"Journal of Simulation"},{"issue":"7","key":"key2022092113481677300_ref072","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1080\/09537287.2010.546980","article-title":"Implementing lean sigma framework in an Indian automotive valves manufacturing organisation: a case study","volume":"22","year":"2011","journal-title":"Production Planning and Control"},{"key":"key2022092113481677300_ref073","volume-title":"Going Lean in Health Care","year":"2005"},{"key":"key2022092113481677300_ref074","article-title":"Case study research design and methods","volume-title":"Applied Social Research Methods Series","year":"2003","edition":"3rd ed."},{"key":"key2022092113481677300_ref075","volume-title":"Case Study Research: Design and Methods (Fifth)","year":"2014"},{"key":"key2022092113481677300_ref076","volume-title":"Three Studies on Lean Implementation in US Hospitals","year":"2017"},{"issue":"1","key":"key2022092113481677300_ref077","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1108\/09526860610642609","article-title":"The quality of health care and patient satisfaction: an exploratory investigation of the 5Qs model at some Egyptian and Jordanian medical clinics","volume":"19","year":"2006","journal-title":"International Journal of Health Care Quality Assurance"}],"container-title":["Business Process Management Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/BPMJ-11-2019-0457\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/BPMJ-11-2019-0457\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T23:16:30Z","timestamp":1753398990000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/bpmj\/article\/27\/1\/75-105\/258582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,24]]},"references-count":79,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,7,24]]},"published-print":{"date-parts":[[2021,1,25]]}},"alternative-id":["10.1108\/BPMJ-11-2019-0457"],"URL":"https:\/\/doi.org\/10.1108\/bpmj-11-2019-0457","relation":{},"ISSN":["1463-7154"],"issn-type":[{"value":"1463-7154","type":"print"}],"subject":[],"published":{"date-parts":[[2020,7,24]]}}}