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The impact of the COVID-19 pandemic on healthcare operations has raised questions about the applicability and capacity of the lean approach to respond to critical events. Thus, with a dearth of studies addressing this issue, this study aims to understand the role of lean in healthcare operations under the disruptive impact of the COVID-19 pandemic.

Drawing on a case study carried out in an emergency department in Brazil during the COVID-19 outbreak, the author presents results from semi-structured interviews and document analysis.

The results show three prominent themes that respond to this study's purpose: lean applicability during the pandemic, lean challenges during the pandemic and the pandemic impact on the lean processes. Furthermore, the study underscores that lean is not the panacea to operational problems caused by the pandemic in healthcare organisations, but it eases the impact on their operations. Finally, this study contributes to the discipline of operations management and highlights the need to rethink lean applications during disruptive events, focusing on flexibility, adaptability and patients' needs.

The literature addressing the pandemic impact on healthcare operations is still new and emerging; therefore, it is possible that some of the studies that are under review and could contribute to this study were not considered.

The study provides a better understanding of the lessons learned from the real-world experiences gained during the pandemic, helping managers to make informed decisions when developing contingency plans to improve healthcare readiness and responsiveness under crisis conditions (e.g. untenable demand and constrained capacity).

Given the contemporary nature of this pandemic, only few emerging studies addressing the impact of the pandemic on lean healthcare operations are available and scholars are calling for more empirical studies. Furthermore, there is an increasing criticism and scepticism about the applicability of lean in healthcare during a pandemic. Thus, this research both provides original contributions by responding to scholars' calls for novel research in this area and further contributes towards filling the void in the literature.

The COVID-19 pandemic is considered a major disruptive event of this decade, raising unforeseen socio-economic implications worldwide. This novel virus has increased the influx of patients in hospitals, and healthcare organisations are facing unprecedented constraints in their operations to deal with increased demand and pressed capacity. Thus, this article evaluates the impact of the COVID-19 pandemic on healthcare systems' demand, resources and capacity and provides research directions.

This is a viewpoint article and uses timely information on healthcare operations from both scholars and managers, published by diverse sources during the COVID-19 outbreak.

The authors discuss the focus on “flattening the curve of infection” as a measure to protect healthcare, delay the impact of increased demand and reorientate healthcare supply chain practices. Furthermore, the authors evaluate the role of lean practices on managing demand and capacity and improving quality across healthcare operations and supply chain. Finally, the authors suggest research directions on modern operational issues that emerged during this pandemic, such as discussions around the sustainability of lean post-pandemic, “just in time” practices, inventory trade-offs and lack of organisational responsiveness during untenable events.

In this article, the authors provide a contemporary assessment of the implications of the COVID-19 pandemic on healthcare operations, underscoring main economic and operational elements that can be affected, such as unforeseen demand, resources and capacity shortage. Therefore, the authors assess that healthcare organisations, practitioners and governments have to anticipate operational and economic impacts and, ultimately, to reassess their plans to deal with such adverse events.

This paper aims to discuss the strategic role of telehealth technologies in managing the COVID-19 pandemic.

This is a viewpoint paper, based on opportune information published and discussed by scholars and managers from different sources; the authors gathered this information to discuss the implications of telehealth during the outbreak.

Based on examples and benchmarking, the authors found that it is possible to lean on telehealth technologies as a frontline ally to avoid the spread of the virus by tracking, testing and treating (3T’s model).

Together with information published on COVID-19, the authors present their critical observations on the use of telehealth. However, the authors acknowledge that there are restrictions on the use of new technologies in health-care practices that were not addressed by this paper, and they suggest further research to address this limitation.

Governments, health-care organizations and managers are encouraged to take advantage of the information published in this paper. One of the benefits of telehealth is the possibility of bringing patients and physicians together virtually, without the need for physical contact. Henceforth, the authors suggest a more comprehensive implementation of best practices from telehealth to relieve congested health-care facilities and to avoid the risk of further infection.

The economic and social impacts of the virus are considered unprecedented by governments worldwide. Therefore, the authors advocate that telehealth practices embedded in health-care practices relieve the pressure that naturally arise during this type of critical event.

In this timely paper, the authors provide invaluable information related to the impact of telehealth technologies on flattening the infection curve of COVID-19.

Globally, the presence of non-urgent patients in emergency departments (EDs) is considered one of the main reasons for creating excessive waiting times and overcrowding in units. This paper aims to understand the impact of non-urgent patients in EDs' operations.

This study is based on qualitative case studies conducted within two Brazilian EDs, and uses interviews and observations to access the data.

From a thematic analysis, three key themes emerged: characteristics of non-urgent demands in EDs, negative aspects of non-urgent patients in EDs, and the impact of the healthcare system model on EDs. These themes bring to light the impact that non-urgent patients have in EDs' operations, and provide theoretical and practical implications.

The limitation of this work is bound by the understanding of the non-urgent demands in EDs. Therefore, a benchmarking approach (investigating state-of-the-art practices to avoid such impact) was not applied but was suggested for future research instead.

The research provides significant contributions to practitioners and policymakers, aiding future discussions to improve healthcare coverage and performance.

The research provides significant contributions for managers and policymakers, aiding future discussions to improve healthcare. For instance, the use of well-known techniques (e.g. lean, six sigma) are discussed and suggested to enhance healthcare capacity and performance. Furthermore, the policymakers are called upon to evaluate the healthcare access and provide regulations that involve innovative approaches to widen healthcare access.

Based upon empirical data, this research extends the discussions related to non-urgent patient in EDs and is not limited merely to descriptive analysis, but by providing practical propositions and discussions related to the impact of these patients' presence in EDs' operations. Finally, the research provides a range of suggestions for future research related to the EDs' operational performance.

Public service organizations (PSOs) face a critical dilemma: how to generate more value for society but with a much-reduced resource base. The article advances the strategy axis of entrepreneurial orientation (EO) research by examining EO and proactive market orientation (PMO) as joint-strategic approaches to this end, and how the characteristics of public managers may moderate the paths to value creation.

The article draws on a unique survey-based dataset developed from Brazilian PSOs and employs structural equation modelling for hypotheses testing. Post-hoc analysis, by way of analysis of variance, demonstrates the joint impact of the two strategic approaches on public service performance level.

Entrepreneurial and PMOs are revealed as routes to enhanced service performance, but managers’ domain expertise negatively moderates these relationships. Post-hoc analysis reveals how organizations displaying higher levels of both orientations realize superior performance, relative to those favouring either/or.

The study contributes new evidence for EO model specificity by examining a narrowly bounded sample of PSOs; addresses the neglect of other outcome variables beyond traditional performance, showing the value of EO for society and offers new insights to the managerial conditions that moderate the positive synergies between EO, PMO and service performance.

The healthcare system has been under pressure to provide timely and quality healthcare. The influx of patients in the emergency departments (EDs) is testing the capacity of the system to its limit. In order to increase EDs' capacity and performance, healthcare managers and practitioners are adopting process improvement (PI) approaches in their operations. Thus, this study aims to identify the main PI approaches implemented in EDs, as well as the benefits and barriers to implement these approaches.

The study is based on a rigorous systematic literature review of 115 papers. Furthermore, under the lens of thematic analysis, the authors present the descriptive and prescriptive findings.

The descriptive analysis found copious information related to PI approaches implemented in EDs, such as main PIs used in EDs, type of methodological procedures applied, as well as a set of barriers and benefits. Aiming to provide an in-depth analysis and prescriptive results, the authors carried out a thematic analysis that found underlying barriers (e.g. organisational, technical and behavioural) and benefits (e.g. for patients, the organisation and processes) of PI implementation in EDs.

The authors contribute to knowledge by providing a comprehensive review of the main PI methodologies applied in EDs, underscoring the most prominent ones. This study goes beyond descriptive studies that identify lists of barriers and benefits, and instead the authors categorize prescriptive elements that influence these barriers and benefits. Finally, this study raises discussions about the behavioural influence of patients and medical staff on the implementation of PI approaches.