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Operational inefficiency and perceived quality in a paediatric day hospital: a lean-informed study of patient flow, caregiver and staff perceptions

Background: Lean management is widely promoted in healthcare to improve efficiency; however, evidence is sparse concerning how Lean-informed organisational settings directly influence patient experience and frontline staff perceptions of Lean processes, particularly in paediatric day hospital (DH) environments where clinical complexity and family-centred care create inherent conflicts between standardisation and adaptability. Methods: We conducted an observational cross-sectional study using ...

The recovery and resilience facility as a transition stabiliser: recovery agendas across government transitions

The European Union’s (EU) Recovery and Resilience Facility (RRF) has profoundly transformed EU economic governance, yet we know less about how its performance-based architecture operates when Member State governments change during implementation. This article introduces a temporal perspective by conceptualising the RRF as a ‘transition stabiliser’ anchoring reform and investment trajectories over a six-year horizon, raising the political and financial costs of reversals, and allowing fo...

‘Having Your (Digital) Cake and Eating It’: Reconciling Strategic Narratives on Connectivity and Autonomy

This article examines the EU's evolving narratives concerning the governance of digital technologies, focusing on the intersection of geopolitical challenges and internal policymaking through the lens of the strategic narratives approach. This compares two key EU narratives relating to digital policy: on the one hand, the narrative on ‘digital connectivity’ which advocates collaboration, engagement and market inclusion, and on the other hand, the more recent development of a defensive ‘digita...

Governing Alternative Marine-Fuel Releases Under International Maritime and Environmental Law

The decarbonisation of shipping is accelerating the uptake of alternative marine fuels, but the legal architecture governing ship-source incidents re- mains largely calibrated to oil. This article argues that the resulting mis- match is not merely technical: it exposes a structural deficit in accountability for non-oil bunker releases. Examining the IMO liability, compensation, preparedness and pollution-prevention regimes alongside UNCLOS Part XII, the article shows why current instrume...

Applying the multi-level perspective to climate geoengineering: Sociotechnical bottlenecks for negative emissions and cloud seeding technologies

Carbon dioxide removal and negative emissions technologies, such as bioenergy with carbon capture (BECCS) and direct air capture with carbon storage (DACCS), may have an important role to play in reducing greenhouse gas emissions (GHGs). Cloud seeding (CS), a controversial form of weather modification, might also help to reduce the severity and intensity of storms and address widespread drought from climate change. Nevertheless, costs, technical complexity, social acceptance, and other unknow...

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