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Purpose This study aims to investigate the interactions between lean production, internal green practices, green product innovation and sustainable performance metrics. The study further looks at the mediation effect of internal green practices and green product innovation between lean production and sustainable performance dimensions. Design/methodology/approach The questionnaire was used to glean data from 209 manufacturing firms. All the hypothesized relationships were processed by using partial least square-structural equation modelling. Findings The results suggest that lean production significantly leads to the implementation of internal green practices and the production of quality products with eco-oriented features that meet customers’ needs. Further, while lean production and internal green practices were found to significantly influence sustainability performance, green product innovation significantly influences only financial performance. Besides, the mediation analysis shows that internal green practices mediate the relationship between lean production and sustainable performance dimensions but green product innovation mediates the relationship between lean production and financial performance only. Research limitations/implications The study is limited to firms from Ghana, a developing country; hence, the results cannot be imported to reflect other geographical contexts. Practical implications The results of the study provide sufficient justifications for managers, (especially Ghanaian managers and those from other similar environs) to commit their financial resources towards implementing lean production and internal green practices so as to achieve sustainability excellence. Originality/value This study magnifies and provides new insight on lean and green literature by developing a comprehensive research model that concurrently tests the direct and indirect effects between lean production, internal green practices, green product innovation and sustainable performance dimensions.

Battlefield internal medicine aims at the treatment of combatants and noncombatants with various internal diseases on the battlefield. The military medical research on battlefield internal diseases focuses on the pathogenesis, clinical management, and prevention of internal diseases under military war conditions. In both wartime and peacetime, the soldiers suffer from more internal diseases than surgical wounds. With the introduction of high-tech weapons, including chemical, physical, and biological agents, a large number of special internal illnesses and casualties will appear in future wars. The battles often occur in special environments, such as high or low temperatures, plateau or polar areas, and micro- or hyper-gravity. The current theories of battlefield internal medicine are mainly derived from wars decades ago and cannot meet the needs of military medical support under the conditions of modern warfare. Therefore, the military medical research on battlefield internal medicine should be based on contemporary military situations, focus on the purpose of treating battlefield internal diseases, and adhere to the actual needs of the troops in peacetime and wartime. We should investigate the pathogenesis of battlefield internal diseases and explore the threats that may arise in future wars to ensure the advancement of battlefield internal medicine. This review highlights new concepts, demands, challenges, and opportunities for the further development of military medical research on battlefield internal medicine.

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