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The purpose of this study is to develop and validate a measurement model that evaluates the Brazilian hospital accreditation methodology (ONA), based on a multivariate model using structural equation modeling (SEM). The information used to develop the model was obtained from a questionnaire sent to all organizations accredited by the ONA methodology. A model was built based on the data obtained and tested through a structural equation modeling (SEM) technique using the LISREL® software (Scientific Software International, Inc., Skokie, IL, USA). Four different tests were performed: Initial, calibrated, simulated, and cross-validation models. By analyzing and validating the proposed measurement model, it can be verified that the selected factors satisfy the required criteria for the development of a structural model. The results show that leadership action is one of the most important factors in the process of health services accredited by ONA. Although, leadership, staff management, quality management, organizational culture, process orientation, and safety are strongly linked to the development of health organizations, and directly influence the accreditation process.

As the lean product development (LPD) process is responsible for maximizing the value/waste relation by encouraging different types of innovation, it needs a clear understanding of end customer value. Moreover, lean systems engineering is related to the application of lean thinking (LT) in systems engineering to improve the delivery of value to all stakeholders of the system. Then, faced with this scenario, this research aims to propose a value-adding conceptual model for incremental product innovations in LPD. A systematic review of the literature from the LT perspective was performed and the conceptions of value were identified and then analyzed and contrasted with the concepts and characteristics of the areas of product development, marketing, and consumer psychology, which made possible the proposition of a conceptual model. The results show that customer value is multidimensional, and it was possible to identify the importance and the need for prioritization of certain dimensions of value for specific markets and customers. The conceptual model named VA2I presented in this study is generic and can be adapted and applied in any type of organization. K E Y W O R D Scustomer value, industrial application, lean thinking, lean systems engineering, manufactured products, product development 1 or service meets customer expectations, rather than its actual performance attributes. 5,9,13 In this sense, if the concept of value is indefinite or intangible, the definition of waste will become even more incomprehensible-since the concept of waste is given as any activity that consumes resources but does not create value for the customer. 7, [14][15][16] Haque and James-Moore 4 state that from an implementation point of view, although there is a large amount of studies on LT, most of them Systems Engineering. 2020;23:281-293. c

This work aims to implement and analyze the effect of the Single Minute Exchange of Die (SMED) implementation in the bean packaging operation in a company in east Minas Gerais, Brazil. Design/Methodology/Approach: The research methodology used was action research. Two cycles of action research were conducted; the first to carry out phase one of SMED, and the second to execute phases two and three. Originality/Research gap: There are few studies on the application of Lean Manufacturing tools in agroindustry. Some works present case studies, mainly in the food supply chain aiming to fill this gap. Regarding SMED applied in agribusiness, no work was found. Key statistical results: The implementation of this methodology allowed the reduction of setup time by around 58%, the distance travelled by operators in the process by approximately 50%, in addition to gains in a production capacity of 14%. Practical Implications: It is concluded that the application of the methodology caused an increase in the company’s productivity, as it was possible to obtain gains in productive capacity without changing the amount of hours worked or the number of employees involved in the production process. Limitations of the investigation: This methodology was applied only once and the challenges encountered were not documented.

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