Email stress: what are its causes? how is it measured? can it be solved? The literature review revealed that, despite the term being well used and recognised, discussions surrounding the root cause of email stress had reached little consensus and the concept was not well understood. By its very nature, email stress theory had fallen victim to the academic debate between psychological vs. physiological interpretations of stress which, as a result of either choice, limited more progressive research. Likewise an array of email management strategies had been identified however, whilst some generated quick successes, they appeared to suffer longevity issues and were not maintained a few months after implementation in the workplace. The purpose of this research was to determine whether email communication causes employees psychological and physiological stress and investigate the impact of email management strategies in the workplace. A pragmatic philosophy placed the research problem as central and valued the differences between paradigms to promote a mixed-method approach to research. The decision to pair both case studies and action research methods ensured a framework for presenting results and an actionable solution was achieved. In direct response to the research aims an original email stress measuring methodology was devised that combined various data collection tools to measure and investigate email stress. This research design was applied and evaluated 'email free time' and email filing. Results of the study showed an increased stress response to occur during email use, i.e. caused employees' increased blood pressure, heart rate, cortisol and perceived stress, and a number of adverse effects such as managing staff via email, social detachment, blame and cover-your-back culture were identified. Findings revealed 'email free time' was not a desirable strategy to manage email stress and related stressors, whereas email filing was found more beneficial to workers well-being. Consolidation of the data gathered from the literature review and research findings were used to develop an initial conceptualisation of email stress in the form of two models, i.e. explanatory and action. A focus group was conducted to validate the proposed models and a further investigation at the ? was carried out to critique the use of an email training intervention. The results showed some improvements to employees' behaviour after the training, e.g. improved writing style, email checked on fewer occasions each day and fewer sufferers of email addiction. The initial models devised, alongside the latter findings, were synthesised to create a single integrative multidimensional model of email stress and management strategies. The model made an original contribution to knowledge in terms of theory, i.e. to conceptualise email stress, and practice, i.e. to offer practical solutions to the email worker.

The medical technology sector in Germany is considered an innovative, fast-growing and promising industry, being third behind the USA and Japan as the biggest market in the world, worth 17.1 billion euros. Consequently, supply chain success is of high importance. This research identified the Critical Success Factors (CSFs) for Original Equipment Manufacturers that are involved within medical technology supply chains in Germany. This thesis begins with a full literature review on Supply Chain Management (SCM) in the medical technology sector and presents the current state of academic discussion on CSFs in this context. The literary analysis identified that most academic research focuses on developing theory based on supply chains of the manufacturing sector with the consumer market as their primary concern, with limited insights into Medical Technology Supply Chains (MTSCs). This was a main driver for the exploration of the drivers and barriers extant in this sector. Two studies were designed to address the identified research gaps. The first study was a qualitative research using multiple case studies and was divided in two phases. Phase A involved 15 German manufacturers of medical technology products and focused on identifying the CSFs in this sector. Phase B involved 14 German manufacturers and uncovered issues and weaknesses of their current SCM strategies by means of an assessment tool developed specially for this study. The second study consisted of an action research project, using interviews and participative workshops to develop an understanding on how organisations in this sector can improve operations using the CSFs concept while offering insights into the actual implementation of SCM strategies and the behavioural aspects of change management in this context. The findings extend theory and provide insights into real-world practitioner challenges and priorities. The outcomes of this study propose that the prioritised combination of the identified CSFs leads to better performance of OEMs in the German MTSC sector, which shifts our understanding of how practitioners prioritise CSFs. Furthermore, this thesis addresses the qualitative knowledge gap around the relational aspects of implementing SCM practices within this sector, while exploring relationships between stakeholders during the process of introducing these changes. These findings challenge existing generic assumptions about supply chain CSFs, as well as adding to SCM, CSF, and medical technology research and knowledge.

This dissertation investigated the development, implementation, and evaluation of a management methodology founded on the alignment among the strategy, performance, and customer to bring value to any organization. A case study/action research in a service organization, called Institution "Z," provided the opportunity to assess the effects of the proposed Six Sigma Scorecard (SSS) methodology in the productivity indicators (measured by cycle time, line capacity, and number of errors). The Case study/action research was conducted in three phases: Model and Concepts Design, Data Collection, and Findings. During the research, validity was pursued by using triangulation and theory to help maintain the case under research control. The observation of the SSS methodology in a real organization allowed the researcher to describe the merging process between Balanced Scorecard and Six Sigma methodology and their relationships to each other. The SSS methodology allowed identification of improvement projects that contribute to organizational strategy, implementation of strategies and provide feedback to the top level of management establishing alignment at three organizational levels - corporate, business, and functional. The results of the implementation of the SSS methodology in Institution Z showed a 40% improvement of the cycle time of the auto credit process, a 500% increase in the capacity of the process, and 65% decrease in the number of non-added value activities. During the same period of time, the BSC indicators showed a positive impact, specifically one financial indicator known as Level of Intermediation or GIC grew from 30% to 42% as it was expected by the end of the SSS implementation. The demonstration of the SSS framework in a Case study justifies the need for a combined methodology that aligns strategy, performance improvement and organizational outputs in a feedback loop. More research in this area is needed, especially investigations that include assessment studies where different management approaches are used alone and combined with strategic tools, and investigations that measure the relationship between level of coherence in the three merging points of the SSS and the results reached at the performance of the organization.

Infrastructure is presenting significant national and global challenges. Whilst often seen as performing well, infrastructure tends to do so against only limited terms of reference and short-term objectives. Given that the world is facing a new infrastructure bill of ~£40T, improving the benefits delivered by existing infrastructure is vital (Dobbs et al., 2013). This thesis investigates strategic intent and the management of infrastructure systems; how factors such as organisational structure and business practice affect outcomes and the ways in which those systems — not projects — are managed. To date, performance has largely been approached from the perspective of project investment and/or delivery, or the assessment of latent failures arising from specific shocks or disruptive events (e.g. natural disaster, infrastructure failures, climate change). By contrast, the delivery of system-level services and outcomes across the infrastructure system has been rarely examined. This is where infrastructure forms an enduring system of services, assets, projects, and networks each at different stages of their lifecycle, and affecting one another as they develop, then age. Yet system performance, which also includes societal, organisational, administrative and technical factors, is arguably the level relevant to, and the reality of, day-to-day public infrastructure management. This research firstly investigated industry perceptions in order to test and confirm the problem: the nub of which was the inability to fully deliver appropriate and relevant infrastructure outcomes over the long term. Three detailed studies then explored the reasons for this problem through different lenses; thereby providing an evidence-base for a range of issues that are shared by the wider infrastructure industry. In confirming its hypothesis that “the strategic intent and the day-to-day management of infrastructure systems are often misaligned, with negative consequences for achieving the desired long-term infrastructure system outcomes”, this research has increased our understanding of the ways in which that misalignment occurs, and the consequences that result. It found those consequences were material, and frequently not visible within the sub-system accountable for the delivery of those outcomes. That public infrastructure exists, not in its own right, but to be of benefit to society, is a central theme drawn from the definition of infrastructure itself. This research shows that it is not enough to be focused on technical outcomes. Infrastructure needs to move beyond how society interacts with an asset, to the outcomes that reflect the needs, beliefs, and choices of society as well as its ability to respond to change (aptitude). Although the research has confirmed its hypothesis and three supporting propositions, the research does not purport to offer ‘the solution’. Single solutions do not exist to address the challenges facing a complex adaptive system such as infrastructure. But the research does offer several system-oriented sense-making models at both the detailed and system-level. This includes the probing methodology by way of a diagnostic roadmap. These models aim to assist practitioners in managing the transition of projects, assets, and services into a wider infrastructure system, their potential, and in (re)orienting the organisation to the dynamic nature of the system and its societal imperative.