Lean Six Sigma in Health Care and the Challenge of Implementation of Six Sigma Methodologies at a Veterans Affairs Medical Center

Purpose – A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA’s dual care policy; collect data and describe the current process for co-management of dual care veterans’ medications; and draft recommendations to improve the current process for dual care medications co-management. Design/methodology/approach – Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. Findings – A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. Research limitations/implications – This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. Practical implications – The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. Originality/value – The findings of this project will be of value to VA providers and policy makers and health care managers who plan to apply Lean Six Sigma techniques in their organizations to improve the quality of care for their patients.

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Chiropractic Consultation Requests in the Veterans Affairs Health Care System: Demographic Characteristics of the Initial 100 Patients at the Western New York Medical Center

Journal of Manipulative and Physiological Therapeutics ◽

10.1016/j.jmpt.2006.06.002 ◽

2006 ◽

Vol 29 (6) ◽

pp. 448-454 ◽

Cited By ~ 7

Author(s):

Andrew S. Dunn ◽

Jamie J. Towle ◽

Patrick McBrearty ◽

Suzanne M. Fleeson

Keyword(s):

Health Care ◽

New York ◽

Health Care System ◽

Medical Center ◽

Veterans Affairs ◽

Demographic Characteristics ◽

York Medical ◽

Care System

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Improving logistics supplier selection process using lean six sigma – an action research case study

Journal of Global Operations and Strategic Sourcing ◽

10.1108/jgoss-05-2020-0025 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Huay Ling Tay ◽

Hui Sen Aw

Keyword(s):

Health Care ◽

Six Sigma ◽

Supplier Selection ◽

Selection Process ◽

Lean Six Sigma ◽

Content Type ◽

Logistics Services ◽

Health Care Company ◽

Care Company

Purpose Outsourcing logistical activities have become a widely used approach for firms to avoid high fixed costs and heavy investment requirements and to achieve competitive advantages. Lean six sigma (LSS) has been accepted globally across sectors as a management strategy for achieving process excellence. The purpose of this paper is to feature the application of LSS for improving the supplier selection process (SSP) of outsourced logistics services in a multinational health-care company. Design/methodology/approach This study is based on an action research case study conducted on the SSP of the freight and distribution department in a multinational health-care company. This paper reports on the application of the LSS define-measure-analyze-improve-control (DMAIC) approach for reducing supplier selection lead time. Findings The study features a real-world case study of the LSS DMAIC application to improve the supplier selection process of a large health-care company. The key issues that were identified are lack of information visibility, top-down changes and unclear communication lines. To counteract these three root causes, the lean six sigma techniques that are implemented are the 5S, stakeholder analysis and standard operating procedure. Research limitations/implications This research provided empirical evidence of how practical challenges in SSP can be managed with the use of LSS. It further proposed plausible solutions for reducing and sustaining improved outcomes. As the study is limited to one case, the validity of the results can be improved by including more organisations and more case studies from other similar organisations. Originality/value Research in supplier selection processes rarely links continuous improvement ideology such as LSS to support strategic selection and procurement of logistics services. This paper could serve as a resource for both practitioners to derive useful implications and to academicians as it contributes to the LSS body of knowledge for further theory testing.

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Applying Lean Production and Six Sigma in Global Operations

Operations and Service Management ◽

10.4018/978-1-5225-3909-4.ch028 ◽

2018 ◽

pp. 582-612 ◽

Cited By ~ 1

Author(s):

Kijpokin Kasemsap

Keyword(s):

Health Care ◽

Organizational Performance ◽

Six Sigma ◽

Business Performance ◽

Service Industry ◽

Lean Production ◽

Lean Six Sigma ◽

Lean Product Development ◽

Strategic Goals ◽

Global Operations

This chapter aims to apply the Lean Production and Six Sigma in global operations, thus describing the theoretical and practical overviews of Lean Production; Lean Production in sustainable operations; Lean Production in human resource management; Lean Production in health care; Lean Production and environmental management; Lean product development; Lean Management and sustainability; Six Sigma; Six Sigma, learning, and knowledge management; Six Sigma in health care; Six Sigma in service industry; Lean Six Sigma; and the significance of Lean Production and Six Sigma in global operations. The creation of Lean Production and Six Sigma is crucial for modern organizations that seek to serve suppliers and customers, increase business performance, strengthen competitiveness, and acquire regular progress in global operations. The chapter argues that applying Lean Production and Six Sigma has the potential to enhance organizational performance and achieve strategic goals in global operations.

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Relationships between the Eligibility Process, Trust in the U.S. Health Care System, and Patient Satisfaction with the Houston Veterans Affairs Medical Center

Military Medicine ◽

10.7205/milmed.172.8.818 ◽

2007 ◽

Vol 172 (8) ◽

pp. 818-823 ◽

Cited By ~ 2

Author(s):

Ken Kato ◽

Kimberly J. O'Malley

Keyword(s):

Health Care ◽

Patient Satisfaction ◽

Health Care System ◽

Medical Center ◽

Veterans Affairs ◽

The U.S ◽

Care System

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Modelling of readiness factors for the implementation of Lean Six Sigma in healthcare organizations

International Journal of Lean Six Sigma ◽

10.1108/ijlss-12-2017-0146 ◽

2020 ◽

Vol 11 (4) ◽

pp. 597-633 ◽

Cited By ~ 2

Author(s):

V. Vaishnavi ◽

M. Suresh

Keyword(s):

Health Care ◽

Six Sigma ◽

Health Care Industry ◽

Lean Six Sigma ◽

Interaction Matrix ◽

Successful Implementation ◽

Care Organization ◽

Content Type ◽

Care Industry ◽

Expert Opinions

Purpose This paper aims to identify, analyze and categorize the major readiness factors for implementing Lean Six Sigma (LSS) in health-care organizations using total interpretive structural modelling technique. The readiness factors are identified would help the managers to recognize the areas that lack and provide importance to the successful implementation of LSS in those areas. The paper further intends to understand the hierarchical interrelationships among the readiness factors identified using dependence and driving power. Design/methodology/approach In total, 16 readiness factors are identified from the literature review and expert opinions are collected from hospitals. The scheduled interview is conducted based on a questionnaire survey in hospitals in the Indian context to identify the relevance of the relations among the readiness factors. The expert opinions are used in the initial reachability matrix and interpretative interaction matrix. Matrix impact cross multiplication applied to classification (MICMAC) analysis uses dependence and driving power to understand the hierarchical relationship among the readiness factors identified. Findings The result indicates that customer-oriented and goal management cultures are the key readiness factors for LSS. The execution technique and training are given according to the current demand of customers and goal change of organization. The manager needs to concentrate more on readiness factors to formulate the execution process of LSS for continuous improvement of the health-care organization. The readiness level helps the manager to identify the target area for LSS execution. Research limitations/implications This research focuses mainly on readiness factors for the implementation of LSS in the health-care industry. Practical implications This study would be useful for researchers and practitioners to understand the readiness factors before starting the implementation process of LSS. Originality/value Many research studies are being done on the success and failure rate of implementation of factors. The present study identifies the readiness factors related to LSS, especially for the health-care industry.

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Lean Six Sigma Methodology: The Nub to Boost the Public Healthcare System in Egypt

Journal of Public Administration and Governance ◽

10.5296/jpag.v10i1.16028 ◽

2020 ◽

Vol 10 (1) ◽

pp. 67

Author(s):

Wael Omran Aly

Keyword(s):

Health Care ◽

Six Sigma ◽

Healthcare Service ◽

Service System ◽

Lean Six Sigma ◽

Public Health Care ◽

Healthcare Sector ◽

Public Healthcare ◽

The Public ◽

The People

For many decades, the Egyptian people have suffered from deplorable public healthcare service featured by indolence, malfunction and traditionalism. Although, healthcare is a distinctive service industry concerning various complicated responsibilities; but the consecutive government of Egypt had badly handled such issue. Then, the apathetic performance of the public healthcare service becomes a dilemma for the people of Egypt; especially the poor among them. Therefore, the foundation of an adequate public healthcare service system, that respect the dignity of the people and respond to their arising health care needs; was frequently on the agenda priorities of the Egyptian governments after the 2011 and 2013 uprisings. Hence recently, the government -after reaching political and economic stability- seeks to build an ambitious newly public health care system to meet the expectation of the people to acquire high standard inexpensive and hasty public healthcare services. Consequently, in order to realize such aim; the Egyptian government had established the public agency for accreditation and quality control according to law no.2 of comprehensive healthcare insurance system issued at 2018. Then, it urges a national campaign to reform the public healthcare sector and to develop the efficacy and quality of its services. Hence, this paper aims to propose how the public healthcare organizations in Egypt can tackle various challenges and enhance adequately its capabilities; in order to be able to adopt the proposed Lean Six Sigma (LSS) methodology effectively; which can then provide an adequate framework for creating organized improvement exertions in healthcare; necessary to bestow guidelines on how to manage a quality service system to patient satisfaction by decreasing waste, variation and work disparity in the service processes.

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Utilizing Lean Six Sigma Methodology to Improve the Authored Works Command Approval Process at Naval Medical Center San Diego

Military Medicine ◽

10.1093/milmed/usy010 ◽

2018 ◽

Vol 183 (9-10) ◽

pp. e405-e410 ◽

Cited By ~ 1

Author(s):

Michelle M Valdez ◽

Maureen Liwanag ◽

Charles Mount ◽

Rechell Rodriguez ◽

Elisea Avalos-Reyes ◽

...

Keyword(s):

Six Sigma ◽

San Diego ◽

Medical Center ◽

Lean Six Sigma ◽

Approval Process ◽

Six Sigma Methodology

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First-case tardiness reduction in a tertiary academic medical center operating room: A lean six sigma perspective

Perioperative Care and Operating Room Management ◽

10.1016/j.pcorm.2016.12.001 ◽

2016 ◽

Vol 5 ◽

pp. 7-12 ◽

Cited By ~ 2

Author(s):

Pedro Ramos ◽

Eloisa Bonfá ◽

Patrícia Goulart ◽

Marion Medeiros ◽

Nélson Cruz ◽

...

Keyword(s):

Operating Room ◽

Six Sigma ◽

Medical Center ◽

Academic Medical Center ◽

Lean Six Sigma ◽

First Case ◽

Academic Medical

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Lean Six Sigma and Athletic Training: A Primer for Athletic Training Educators

Athletic Training Education Journal ◽

10.4085/1947-380x-19-84 ◽

2020 ◽

Vol 15 (4) ◽

pp. 259-268 ◽

Cited By ~ 2

Author(s):

Christine Noller ◽

David C. Berry

Keyword(s):

Health Care ◽

Quality Improvement ◽

Athletic Training ◽

Process Improvement ◽

Six Sigma ◽

Athletic Trainers ◽

Lean Six Sigma ◽

Health Care Facilities ◽

Athletic Training Educators ◽

Robust Process

Context Lean as a quality improvement philosophy is new to athletic training despite widespread use in health care for many years. Objective To introduce the concepts of Lean and Lean Six Sigma and create a primer document for athletic training educators in the classroom. Background Lean requires organizations to exercise effort along with several dimensions simultaneously to improve patient quality and efficiency while controlling costs and reducing waste. When appropriately executed, Lean transforms how an organization and its employees work, creating an avid quest for quality improvement and, ultimately, patient safety. Synthesis Lean is a cultural transformation that changes how an organization operates. It requires new habits, skills, and attitudes throughout the organization, from executives to front-line staff. Lean is a journey, not a destination. The culture of Lean involves the relentless pursuit of continuous quality improvement and is composed of 6 principles and numerous tools. Recommendation(s) Whether athletic trainers approach Lean or Lean Six Sigma in a leadership role, or as a stakeholder in a Kaizen event, all should have a working knowledge of the principles, methods, elements, philosophy, and tools of robust process improvement. Moreover, while no best-practice statement exists about how to incorporate Lean Six Sigma into a curriculum, addressing process improvement early may allow immersive-experience students an opportunity to engage in a process improvement initiative, facilitating a greater appreciation of the content, and offer opportunities to engage professionals from other disciplines. Conclusion(s) Lean is reproducible in sports medicine clinics, orthopedic practices, and outpatient and athletic health care facilities, but only when athletic trainers understand the application. Moreover, for this reason, athletic training programs should strongly consider adding a robust process improvement course/content to their graduate curriculums.

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