scholarly journals Using Lean Six Sigma to improve rates of day of surgery admission in a national thoracic surgery department

2019 ◽  
Vol 31 (Supplement_1) ◽  
pp. 14-21 ◽  
Author(s):  
Rachel Brown ◽  
Petra Grehan ◽  
Marie Brennan ◽  
Denise Carter ◽  
Aoife Brady ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Six Sigma ◽  
Performance Indicator ◽  
Enhanced Recovery ◽  
Lean Six Sigma ◽  
Process Efficiency ◽  
Secondary Outcome ◽  
Operational Process ◽  
Day Of Surgery Admission ◽  
Surgery Department

Abstract Objective The aim of this study is to improve rates of day of surgery admission (DOSA) for all suitable elective thoracic surgery patients. Design Lean Six Sigma (LSS) methods were used to enable improvements to both the operational process and the organizational working of the department over a period of 19 months. Setting A national thoracic surgery department in a large teaching hospital in Ireland. Participants Thoracic surgery staff, patients and quality improvement staff at the hospital. Intervention(s) LSS methods were employed to identify and remove the non-value-add in the patient’s journey and achieve higher levels of DOSA. A pre-surgery checklist and Thoracic Planning Meeting were introduced to support a multidisciplinary approach to enhanced recovery after surgery (ERAS), reduce rework, improve list efficiency and optimize bed management. Main Outcome Measure(s) To achieve DOSA for all suitable elective thoracic surgery patients in line with the National Key Performance Indicator of 75%. A secondary outcome would be to further decrease overall length of stay by 1 day. Results Over a 19 month period, DOSA has increased from 10 to 75%. Duplication of preoperative tests reduced from 83 to <2%. Staff and patient surveys show increased satisfaction and improved understanding of ERAS. Conclusions Using LSS methods to improve both operational process efficiency and organizational clinical processes led to the successful achievement of increasing rates of DOSA in line with national targets.

Requirements, challenges and impacts of Lean Six Sigma applications – a narrative synthesis of qualitative research

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohamed Alblooshi ◽  
Mohammad Shamsuzzaman ◽  
Michael Boon Chong Khoo ◽  
Abdur Rahim ◽  
Salah Haridy
Keyword(s):  
Six Sigma ◽  
Resistance To Change ◽  
Impact Category ◽  
Lean Six Sigma ◽  
Process Efficiency ◽  
Future Research ◽  
Narrative Synthesis ◽  
Qualitative Synthesis ◽  
Content Type ◽  
Research Studies

Purpose The purpose of this paper is to identify, present and categorise the main requirements, challenges and impacts of Lean Six Sigma (LSS) applications. Emphasis is given to the soft impacts of LSS applications, which are intangible in nature and difficult to quantify and measure, highlighting the most frequently cited ones. Design/methodology/approach A qualitative synthesis of the studies using the narrative synthesis approach is adopted to descriptively summarise and categorise the requirements, challenges and impacts of LSS applications. The studies were searched by using the following keywords: “LSS applications,” “LSS requirements,” “LSS challenges” and “LSS impacts” in almost all major electronic databases such as Emerald, Taylor and Francis, ScienceDirect and Wiley. A total of 116 articles published between 2007 and 2017 in 41 academic journals were collected and reviewed. Consideration was also given to a number of substantial publications in 2006, 2018 and 2019. Findings In addition to its process efficiency and financial impacts, LSS was found to have another impact category related to individual and organisational behaviours. Management commitment, training and organisational culture were concluded to be amongst the most important and required categories for successful LSS applications. It was also found that the lack of awareness of LSS tools and benefits and the lack of change management and resistance to change were amongst the most cited categories of implementation challenges. Research limitations/implications The studies published between 2007 and 2017 are mainly considered in this paper. It is believed that 10-year publication period considered in this research is sufficient to study the evolution, benefits, limitations and future trends of a particular research topic. However, the exclusion criteria used in the search process with respect to the articles’ year of publication and search terms and keywords may limit the generalisation of the research findings. In addition, the qualitative nature of this research study and the lack of empirical data to support its findings is another limitation that future research should consider. Practical implications This research paper may serve as a valuable source of information for LSS researchers as it will provide them with useful and new insights and directions for further research in LSS. It will also increase the awareness of LSS practitioners about the kind of impact LSS has, and therefore, achieve a better utilisation of its tools by ensuring availability of application requirements and overcoming application challenges. Originality/value This study differs from previous research studies as it focusses attention on the soft impacts of LSS applications and highlights them. The study identifies and prioritises LSS application impacts, requirements and challenges. The study on these aspects was found to be limited and lacking in previous research studies.

A new framework to support Lean Six Sigma deployment in SMEs

2019 ◽  
Vol 10 (1) ◽  
pp. 58-80 ◽  
Author(s):  
Carlos Abraham Moya ◽  
Daniel Galvez ◽  
Laurent Muller ◽  
Mauricio Camargo
Keyword(s):  
Case Studies ◽  
Six Sigma ◽  
Success Factors ◽  
Performance Indicator ◽  
Lean Six Sigma ◽  
Organizational Capabilities ◽  
Successful Implementation ◽  
Manufacturing Companies ◽  
Content Type ◽  
Readiness Level

Purpose The purpose of this paper is to propose an assessment approach to evaluate the organizational capabilities to deploy a Lean Six Sigma (LSS) strategy. Design/methodology/approach Based on a comprehensive literature review, critical success factors required to deploy LSS were defined. These key factors are evaluated by a questionnaire based on maturity grids and structured as a multi-criteria model to compute a potential LSS performance indicator. This approach is illustrated through two case studies. Findings To promote a successful implementation of LSS in SMEs, it is necessary to consider five main critical factors. The evaluation of these factors could be achieved thanks to a multi-criterion-based maturity indicator for the LSS implementation. The case studies show that this approach allows SMEs to understand their strengths and weaknesses and thus better prepare the implementation of LSS. Research limitations/implications The proposed tool identifies characteristics of companies leading to successful LSS implementation; but is not yet able to provide a detailed strategy to improve them. The case studies were applied to manufacturing companies; therefore, there is no evidence of conclusions in the context of services. Practical implications The proposed methodology will help managers and practitioners to evaluate the readiness level of a company to implement LSS. Then, they could estimate the effort required to achieve the LSS deployment. Originality/value This paper proposes a new metric of the capacity to implement the LSS successfully in SMEs: the Lean Six Sigma Global Index. This indicator is based on a survey completed by managers and supported by observable phenomena to establish a tailored diagnosis before the LSS implementation.

Developing a model for process improvement using multiple regression technique

2014 ◽  
Vol 26 (6) ◽  
pp. 625-638 ◽  
Author(s):  
Ashok Sarkar ◽  
Arup Ranjan Mukhopadhyay ◽  
Sadhan Kumar Ghosh
Keyword(s):  
Multiple Regression ◽  
Six Sigma ◽  
Model Development ◽  
Real Life ◽  
Analytical Techniques ◽  
Lean Six Sigma ◽  
Process Efficiency ◽  
Content Type ◽  
Study Approach

Purpose – Practitioners often face challenges in model development when establishing a relationship between the input and output variables and their optimization and control. The purpose of this paper is to demonstrate, with the help of a real life case example, the procedure for model development between a key process output variable, called the multi-stage flash evaporator efficiency, and the associated input process variables and their optimization using appropriate statistical and analytical techniques. Design/methodology/approach – This paper uses a case study approach showing how multiple regression methodology has been put into practice. The case study was executed in a leading Indian viscose fiber plant. Findings – The desired settings of the relevant process parameters for achieving improved efficiency have been established by appropriately using the tools and techniques from the Lean Six Sigma tool kit. The process efficiency, as measured by M3 of water evaporated per ton of steam, has improved from 3.28 to 3.48 resulting in satisfactory performance. Originality/value – This paper will be valuable to many practitioners of Six Sigma/Lean Six Sigma and researchers in terms of understanding the systematic application of quality and optimization tools in a real world situation.

scholarly journals Roadmap to the Enhanced Thoracic Surgical Journey

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
TaCharra Y. D. Woodard, MSN, APRN, ACNP-BC, AOCNP ◽  
Carla M. Patel, MSN, APRN, ACNP-BC ◽  
Garrett L. Walsh, MD
Keyword(s):  
Thoracic Surgery ◽  
Program Implementation ◽  
Enhanced Recovery ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Cancer Center ◽  
University Of Texas ◽  
Md Anderson ◽  
Surgery Department ◽  
Recovery Program

The Enhanced Recovery Program (ERP) is a comprehensive, multidisciplinary approach that directly impacts the functional recovery and quality of life of patients after surgery. Initiated in 2013 at The University of Texas MD Anderson Cancer Center by the Liver Surgery group and expanded to numerous specialties, the Thoracic and Cardiovascular Surgery Department developed a version of Enhanced Recovery After Thoracic Surgery in 2014. The benefits gained thus far include (1) decreased postoperative complications, (2) reduced hospital length of stay, (3) decreased opioid usage, (4) decreased healthcare costs, and (5) improved patient satisfaction. This article aims to provide a brief description of the history of the enhanced recovery approach and to identify the critical elements of the program necessary for improved patient care. It is intended to serve as a practical guide for program implementation in thoracic surgery departments at other institutions.

scholarly journals Green implementation of Lean Six Sigma projects in the manufacturing sector

2020 ◽  
Vol 11 (4) ◽  
pp. 711-729 ◽  
Author(s):  
Alireza Shokri ◽  
Gendao Li
Keyword(s):  
Environmental Impact ◽  
Environmental Sustainability ◽  
Six Sigma ◽  
Manufacturing Sector ◽  
Emerging Market ◽  
Lean Six Sigma ◽  
Process Efficiency ◽  
Production Volume ◽  
Traditional Values ◽  
Content Type

Purpose Historically, Lean Six Sigma (LSS) implementation has demonstrated a great deal of enhancement to process efficiency, profitability and customer satisfaction. The emerging market pressure for developing better quality, cheaper and greener products invokes a change of view in LSS economical effectiveness. The purpose of this study is to identify under which condition the final output of LSS projects with traditional strategic benefits are more environmentally friendly. Design/methodology/approach To investigate the choice of different types of LSS projects, the environmental impact under different conditions and the comparison of those conditions, the author developed an analytical mathematical model and analysed four different propositions. Findings The final price and production volume were recommended as mediating factors to leverage an LSS project to achieve a greener, customised and finance-oriented outputs. Research limitations/implications This research contributes to existing LSS research and knowledge development via promoting the different perspectives of LSS and environmental sustainability integration. Practical implications This study further enables managers to identify the cut-off point in relation to the production volume and finished prices to leverage the expected financial outputs and environmental impact of the LSS project. This would potentially promote a green LSS project in both implementation and output, alongside its traditional values. Originality/value This study uses a modelling approach to identify the conditions under which the actual methodology of the LSS project could be green via less energy consumption with consideration of expected LSS values and outcomes.

scholarly journals QUALITY BASED CREDIT RISK MITIGATION FOR BANK PERFORMANCE ENHANCEMENT: EMPIRIC STUDY IN AN INDONESIAN BANK

2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Nini Avieni
Keyword(s):  
Credit Risk ◽  
Six Sigma ◽  
Business Performance ◽  
Corporate Strategy ◽  
Performance Enhancement ◽  
Risk Mitigation ◽  
Lean Six Sigma ◽  
Process Efficiency ◽  
Business Units ◽  
Performance Quality

There is an ongoing controversy over whether risk mitigation inherently enhances business performance. The aim of this paper is to settle the controversy, and provide insights roles of risk mitigation on corporate strategy. Author examined implication of Lean Six Sigma at credit risk mitigation system at one of Indonesia banks.  Based on responses from 112 credit analysts and database of business units performance indicators, this research showed a relationship between the implication of Lean Six Sigma at credit risk mitigation system and unit bank's performance. Quality Based Credit Risk Mitigation which is credit risk mitigation using Lean Six Sigma system will enhance business units’ performance through improvement in credit quality and credit process efficiency.

EMPLOYEE ENGAGEMENT FOR HIGH FIRM PERFORMANCE: THE CASE OF LEAN SIX SIGMA AT A MALAYSIA TRADING COMPANY

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Hadijah Iberahim ◽  
Izmahariz Azman ◽  
Mohd Haniff Shahri ◽  
Nur Fara Ellyanie Abdul Hamid
Keyword(s):  
Knowledge Sharing ◽  
Employee Engagement ◽  
Six Sigma ◽  
Relevant Literature ◽  
Lean Six Sigma ◽  
Successful Implementation ◽  
Management Support ◽  
High Productivity ◽  
Trading Company ◽  
Goal Clarity

Lean Six Sigma (LSS) is a method that helps an organization to maximize profit and minimize cost. One of the essential factors for a successful LSS project is the availability of employees who are willing to engage. Employee engagement brings about a strong sense of belonging and high productivity. Consequently, engaged employees will work harder to achieve the mission of the organization. This paper discusses a case of LSS project with a low level of employee engagement. As a result, LSS was less likely helpful in sustaining company’s performance. The purpose of this study is to identify factors that contribute to employee engagement in LSS practices. Review of the relevant literature suggests four variables, which include goal clarity, management support and trust, knowledge sharing and transfer, and teamwork. The questionnaire survey applied census in collecting feedback from 80 respondents. Statistical analysis results indicate that goal clarity, management support, and trust are significant to employee engagement. However, knowledge sharing and transfer as well as teamwork are not substantial. It is recommended for the organization to give attention to all the four factors. This paper extended understandings on critical inputs to a successful implementation of LSS for sustainable company’s performance and growth. Keywords: Lean Six Sigma, Employee Engagement, Goal Clarity, Management Support and Trust, Teamwork, Knowledge Sharing.

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