Purpose -The objective of this exploratory paper is to find out what is important to consider when developing a supply chain in health care, what is required in order to establish a supply chain orientation and how lean and agile can be used as process strategies in order to improve supply chain performance. Design/methodology/approach -In order to build an empirical framework for using both lean and agile strategies in health care supply chain management illustrative examples are provided from a Swedish health care setting describing the patient flow and planning processes. Findings -Supply chain management has potential to work well as a philosophy for patient flow in the health care sector. However, it should not only be about the use of the concept of lean in health care, as in fact is the case in practice today. It is rather about organizing for quick response and flexibility in a hybrid strategy through combining lean and agile process strategies. This can only be done if a systems approach is applied together with a strategic orientation, where cooperative efforts by the supply chain members should synchronize and converge operational as well as strategic capabilities into a unified whole. Practical implications -The analysis in the paper underlines the importance of focusing on both agility and leanness combined. Hospitals or health care systems that introduce such an approach, as opposed to only relying on lean strategies, could gain both competitive advantages and improved performance. Originality/value -In health care, even more so than in the manufacturing industry, containment of costs without sacrificing quality is important. This paper applies SCM techniques, tools and concepts that have not been used previously for patient flow in a health care setting, combining lean and agile in one and the same analysis.

In response to increasing demands on improved environmental performance, companies need to develop their capabilities in assessing the environmental performance of their operations. Knowledge among practitioners as well as solid research results in this area lacks. This paper aims to present a framework of dimensions important to consider regarding environmental measurement in supply chain management. The paper also aims to present a practical example on how environmental performance measurements can be a success by applying these dimensions. Design/methodology/approach Literature regarding logistics management and performance measurement is coupled with theories regarding environmental logistics and green supply chain management. A framework is developed. A case study based on four actors in a reverse supply chain is used to illustrate the framework. Findings The paper outlines important aspects to consider in the design of environmental performance measurements in supply chain management and identifies shortcomings in existing research. The case presents successful examples of how environmental performance measurements can be applied across managerial levels as well as company borders in a supply chain. Practical implications The literature review shows shortcomings in the measuring tools applied today. The case provides examples of how these shortcomings can be addressed. Originality/value This paper addresses the intersection between environmental logistics and performance measurements. The case shows how environmental performance measurements can be applied over a single company's borders by including four different actors in the supply chain.

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Although urban consolidation centres (UCC) worldwide have improved urban freight distribution and reduced externalities, other UCC initiatives have not materialised due to, e.g., business model limitations. All the same, researchers have rarely described business model components relevant to city logistics. In response, the purpose with this article is to analyse critical factors for viable business models of city logistics initiatives involving UCCs. Following an extensive literature review and multiple-case study of five initiatives with UCCs, we identified seven critical factors of viable city logistics business models: the ability to scale up and down the UCC solution; an ability to continuously develop and adapt to a dynamic environment; the important entrepreneurial role of the initiator as well; the acknowledgment of society; ability to innovate new services; logistics and supply chain management competence; and the ability to take full advantage of advanced IT. All seven factors describe continuously redeveloped business models seeking to seize new and unexpected opportunities, yet also indicate that city logistics systems require local authorities and municipalities to act as initiators, enablers, and customers. The models also underscore differences between purely commercial and purely municipal city logistics initiatives.

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