Lean and Six Sigma in acute care: a systematic review of reviews

2016 ◽  
Vol 29 (2) ◽  
pp. 192-208 ◽  
Author(s):  
Simon Deblois ◽  
Luigi Lepanto
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Acute Care ◽  
Six Sigma ◽  
Methodological Quality ◽  
Future Research ◽  
Content Type ◽  
Literature Reviews ◽  
Review Of Reviews

Purpose – The purpose of this paper is to present a systematic review of literature reviews, summarizing how Lean and Six Sigma management techniques have been implemented in acute care settings to date, and assessing their impact. To aid decision makers who wish to use these techniques by identifying the sectors of activity most often targeted, the main results of the interventions, as well as barriers and facilitators involved. To identify areas of future research. Design/methodology/approach – A literature search was conducted, using eight databases. The methodological quality of the selected reviews was appraised with AMSTAR. A narrative synthesis was performed according to the guidelines proposed by Popay et al. (2006). Data were reported according to PRISMA. Findings – The literature search identified 149 publications published from 1999 to January 2015. Seven literature reviews were included into the systematic review, upon appraisal. The overall quality of the evidence was poor to fair. The clinical settings most described were specialized health care services, including operating suites, intensive care units and emergency departments. The outcomes most often appraised related to processes and quality. The evidence suggests that Lean and Six Sigma are better adapted to settings where processes involve a linear sequence of events. Research limitations/implications – There is a need for more studies of high methodological quality to better understand the effects of these approaches as well as the factors of success and barriers to their implementation. Field studies comparing the effects of Lean and Six Sigma to those of other process redesign or quality improvement efforts would bring a significant contribution to the body of knowledge. Practical implications – Lean and Six Sigma can be considered valuable process optimization approaches in acute health care settings. The success of their implementation requires significant participation of clinical personnel from the frontline as well as clinical leaders and managers. More research is needed to better understand the factors of success and the barriers to their implementation, as well as their long-term impact. Originality/value – This is the first broad systematic review of reviews, synthesizing data pertaining to implementation issues and results in acute care settings, to be published. It will benefit health care managers assessing the potential of these approaches and the potential drawbacks associated with their implementation. Moreover, it identifies directions for future research.

Hospital information systems in developing countries: a state-of-the-art systematic review

Kybernetes ◽  
2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jie Lei ◽  
Jianming Liu ◽  
Wu Li
Keyword(s):  
Health Care ◽  
Information System ◽  
Developing Countries ◽  
Health Care Services ◽  
Developed Countries ◽  
Future Research ◽  
Local Conditions ◽  
Content Type ◽  
The Government

Purpose Hospital information system (HIS) can be examined as a vital factor for developing the quality of health care and cost managing. There exists abundant literature on HISs, but implementation-based literature of HIS is rare, typically about progressive countries. However, a study that can comprehensively review published articles is scarce. Therefore, this paper aims to examine the systematic and comprehensive study of HIS in developed countries. Together, the benefits and harms relevant to HIS’s different mechanisms have been considered, and the fundamental challenges of them are addressed to design more efficient HIS in the future. Design/methodology/approach HIS has been used globally for numerous years and is now being used in a wide area. HIS is broadly used in clinical settings. Information technology (IT) and information system have been suggested as a required piece to solve the health-care-related issues. Hence, to improve HIS’s ability, this paper conducted a review method concentratating on research related to HIS until 2019. A total of 21 papers were recognized and examined as principal research for the summary. Findings The authors found that HIS can help in reduction of medical mistakes, enhancement doctors’ performance and increase in the quality of the care provided. HIS management can be used to provide better health-care services. Therefore, HIS must be sensible and use clear structures. The authors conclude that, generally, with an increase in awareness, acceptability and the need for HIS worldwide, there will be more strategies and approaches available. Research limitations/implications First, this paper provides an outline of the status of HIS. Second, it identifies some distinct research gaps that could be worth studying. Some flawless work may be removed because of applying some filters to select the original articles. Surveying all the papers on the topic of HIS is impossible, too. Practical implications Design and sustainability of HIS is still a big issue for most developing countries, despite its wide usage in the developed countries. The technology is changing rapidly, so the field should be reviewed regularly. This paper suggests a suitable framework that will guide HIS in the local conditions of developing countries. Social implications The government will be assisted by the suggested solving ways in its performance and design of electronic health-care projects. Originality/value The study brings the viewpoints on the state of HIS mechanisms in developing countries. The paper’s results can offer visions into future research requirements. By providing comparative information and analyzing the current growths in this area, this study will support researchers and professionals to understand the progress in HIS mechanisms better.

scholarly journals Lean management in health care: a review of reviews of socio-technical components for effective impact

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marta Marsilio ◽  
Martina Pisarra
Keyword(s):  
Health Care ◽  
Implementation Process ◽  
Management Approach ◽  
Lean Management ◽  
Impact Measurement ◽  
Content Type ◽  
Four Dimensions ◽  
Support Organization ◽  
Review Of Reviews

PurposeThe aims of the implementation of lean management in health care are to improve quality of care, to eliminate waste and to increase efficiency. The purpose of this study is to contribute to the advancement of knowledge by investigating which main socio-technical factors are considered to be effective for the implementation and management of lean initiatives.Design/methodology/approachA systematic review of literature reviews on lean management in health care was conducted. The components of the socio-technical system are identified by moving from the socio-technical drivers that support organization-wide quality improvement practices and the lean implementation process in health care. The impacts of lean management are classified using the internal processes, patient, learning and financial dimensions.FindingsThe 28 reviews retrieved confirm the current and increasing interest in lean management. While more than 60% of them call for a system-wide approach, system-wide implementations have rarely been observed, and, instead, adoption in isolated units or departments, or the use of single techniques and tools, prevails. The most commonly investigated socio-technical components are organizational structure, techniques and tools and organizational culture and strategic management. Significant impacts are reported for all the four dimensions. Nonetheless, the review reveals that there is still a lack of evidence on the sustainability of lean results and a need for a standardized impact measurement system.Originality/valueThis work stands out as the first review of reviews of how the socio-technical components of the lean management approach obtain positive impacts within the patient, internal processes, learning and financial dimensions.

scholarly journals Psychometric properties of the Jefferson Scale of Empathy: a COSMIN systematic review protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Brett Williams ◽  
Bronwyn Beovich
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Methodological Quality ◽  
Grey Literature ◽  
Risk Of Bias ◽  
Measurement Properties ◽  
Future Research ◽  
Health Measurement ◽  
Jefferson Scale Of Empathy

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412

Lean Six Sigma for small- and medium-sized manufacturing enterprises: a systematic review

2019 ◽  
Vol 36 (3) ◽  
pp. 378-397 ◽  
Author(s):  
Paul Alexander ◽  
Jiju Antony ◽  
Bryan Rodgers
Keyword(s):  
Systematic Review ◽  
Six Sigma ◽  
Lean Six Sigma ◽  
Future Research ◽  
Research Gaps ◽  
Systematic Review Methodology ◽  
Content Type ◽  
Manufacturing Enterprises ◽  
Three Stages ◽  
Practical Implications

Purpose The purpose of this paper is to explore the most common themes within Lean Six Sigma (LSS) relating to small- and medium-sized enterprises (SMEs) within manufacturing organisations and to identify the research gaps in the existing literature. Design/methodology/approach Tranfield et al.’s (2003) systematic review methodology was utilised encompassing three stages: planning, conducting and reporting/dissemination. Findings The literature revealed that there are many areas in which LSS has been utilised with varying successes. In total, 52 journals have been reviewed and it has been concluded that although LSS is a powerful methodology, there are many gaps that exist in the literature and further research is needed to address these in the field of LSS. Research limitations/implications The papers included in the systematic review were peer-reviewed papers available in English. Due to these limitations, relevant papers may have been excluded. Moreover, the authors have excluded all conference and white papers for their inclusion in this study. Practical implications It is vital that LSS practitioners are fully aware of the benefits, limitations and impeding factors when implementing a LSS initiative. Therefore, this paper could provide valuable insights to ensuring maximum value, is obtained from LSS implementation in SMEs. Originality/value This systematic review identifies research gaps in the current literature and highlighting areas of future research which will be beneficial to many SMEs in their pursuit of value optimisation.

Process mining and lean six sigma: a novel approach to analyze the supply chain quality of a hospital

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Francisco Ramires ◽  
Paulo Sampaio
Keyword(s):  
Health Care ◽  
Supply Chain ◽  
Six Sigma ◽  
Process Mining ◽  
Lean Six Sigma ◽  
Content Type ◽  
Study Approach ◽  
Novel Approach

PurposeThis paper aims to depict the practical execution of the problem-solving structure provided by the define, measure, analyze, improve and control (DMAIC) framework in combination with the analytical power provided by process mining capabilities, to improve the supply chain quality of a health-care provider. Design/methodology/approachPrior to the study, a literature review was conducted to identify existing frameworks combining six sigma with process mining. The authors use a descriptive case study approach to explain how the two methodologies blend across the different phases of DMAIC in a health-care setting. FindingsThis case study describes how analyzing data extracted from core information systems has significant value to improvement initiatives when complemented by traditional quality methods. By intersecting process mining techniques with lean six sigma tools, the researchers found 65% of orders not complying with the target ordering time and 200 redundant purchases with high operational costs. Research limitations/implicationsBy depicting how the two methodologies can be intertwined, this paper complements existing research by presenting it as a viable quality improvement approach. Practical implicationsThis paper provides insights for six sigma and process mining practitioners on the benefits of combining both methodologies within the DMAIC structure. Implementing this blended approach can bring visibility to operations and accelerate process improvement initiatives. Originality/valueThe prime value of this paper lies in the integration of traditional six sigma methods with process mining as a technological approach in a health-care context, going beyond existing research, which, to the best of the knowledge, lacks descriptive case studies.

scholarly journals Systematic Review of Integrative Health Care Research: Randomized Control Trials, Clinical Controlled Trials, and Meta-Analysis

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Raheleh Khorsan ◽  
Ian D. Coulter ◽  
Cindy Crawford ◽  
An-Fu Hsiao
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Methodological Quality ◽  
Health Care Research ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Care Research ◽  
Integrative Health ◽  
Integrative Health Care

A systematic review was conducted to assess the level of evidence for integrative health care research. We searched PubMed, Allied and Complementary Medicine (AMED), BIOSIS Previews, EMBASE, the entire Cochrane Library, MANTIS, Social SciSearch, SciSearch Cited Ref Sci, PsychInfo, CINAHL, and NCCAM grantee publications listings, from database inception to May 2009, as well as searches of the “gray literature.” Available studies published in English language were included. Three independent reviewers rated each article and assessed the methodological quality of studies using the Scottish Intercollegiate Guidelines Network (SIGN 50). Our search yielded 11,891 total citations but 6 clinical studies, including 4 randomized, met our inclusion criteria. There are no available systematic reviews/meta-analyses published that met our inclusion criteria. The methodological quality of the included studies was assessed independently using quality checklists of the SIGN 50. Only a small number of RCTs and CCTs with a limited number of patients and lack of adequate control groups assessing integrative health care research are available. These studies provide limited evidence of effective integrative health care on some modalities. However, integrative health care regimen appears to be generally safe.

A morphological analysis of research literature on Lean Six Sigma for services

2018 ◽  
Vol 38 (1) ◽  
pp. 149-182 ◽  
Author(s):  
Vijaya Sunder M. ◽  
L.S. Ganesh ◽  
Rahul R. Marathe
Keyword(s):  
Systematic Review ◽  
Six Sigma ◽  
Morphological Analysis ◽  
Organizational Context ◽  
Lean Six Sigma ◽  
Future Research ◽  
Systematic Review Protocol ◽  
Research Gaps ◽  
Content Type ◽  
Review Protocol

Purpose The purpose of this paper is to review the existing literature on Lean Six Sigma (LSS) for services, construct a morphological analysis (MA) framework and identify research gaps to point to future research possibilities and priorities. Design/methodology/approach The MA framework is based on literature review of 175 papers published from 2003 to 2015, across 67 journals recognised by Scopus or ABS Academic Journal Quality Guide 2015. A three-phased methodology is used by the authors, with Phase1 featuring a five-stage systematic review protocol to identify relevant journal papers for review; Phase2 presenting a framework for classifying the reviewed papers in terms of their fundamental, methodological, chronological and sector-wise orientations; and Phase3 constructing an MA framework on the classified papers and identifying the research gaps. Findings The MA framework constructed based on six dimensions, namely, organizational context of applications, desired outcomes, implementation systems, LSS tools and techniques, integration with other management philosophies and evaluation methods, involving 40 focused themes, has revealed 355 distinct research gaps as opportunities for future research. Practical implications This paper confirms the existence of substantial scope and points to specific topics for further research in the area of LSS for services. The findings demonstrate the gaps in academic research on the subject. In addition, the study also helps organisational leaders and practitioners to look at LSS from a holistic perspective in the services context. Originality/value The MA framework of the existing literature on LSS for services presents a unique, systematic effort to identify research opportunities. In addition, a five-stage systematic review protocol is proposed in this paper. This could be valuable to researchers and practitioners in enabling them to systematically review the literature on research subjects of interest to them.

Six Sigma in healthcare: a systematic review of the literature

2018 ◽  
Vol 35 (5) ◽  
pp. 1075-1092 ◽  
Author(s):  
Jiju Antony ◽  
Pruksathorn Palsuk ◽  
Sandeep Gupta ◽  
Deepa Mishra ◽  
Paul Barach
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Six Sigma ◽  
Success Factors ◽  
Quality Of Healthcare ◽  
Healthcare Sector ◽  
Content Type ◽  
Six Sigma Methodology ◽  
Six Sigma Approach

Purpose The purpose of this paper is to illustrate the systematic role played by Six Sigma methodology in improving the quality of healthcare. The literature review identifies the relevant opportunities for successful introduction and development of Six Sigma approach in healthcare sector. Design/methodology/approach A systematic methodology to identifying literature on Six Sigma in healthcare is presented. Web of Science, Medline, Emerald Insight, ASQ and ProQuest databases (1998-2016) were searched, and 68 papers of fair methodological quality were identified. Findings The findings of the systematic review reveal a growing interest in research on Six Sigma adoption in healthcare. The findings indicate that Six Sigma applications in healthcare have been focused on the entire hospital with no real focus on a particular department or function. The key findings on benefits, success factors, challenges and common tools of Six Sigma from the existing literature are also presented in the paper. Research limitations/implications The papers included in the systematic review were peer-reviewed papers available in English. Due to these limitations, relevant papers may have been excluded. Moreover, the authors have excluded all conference and white papers for their inclusion in this study. Originality/value This paper can serve as a guide on how Six Sigma approach can be applied to improve the quality of healthcare. The authors also believe that this is possibly the most comprehensive systematic literature review on the topic and will set the foundation for various research avenues based on the key findings of this study.

Do performance measurement models have any impact on primary health care? A systematic review

2020 ◽  
Vol 25 (4) ◽  
pp. 319-334
Author(s):  
Brahim Zaadoud ◽  
Youness Chbab ◽  
Aziz Chaouch
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Performance Measurement ◽  
Conceptual Framework ◽  
Conceptual Frameworks ◽  
Content Type ◽  
Primary Health

PurposeThe purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to compare if the frameworks of performance measurement in primary health care have an influence on performances of health centers.Design/methodology/approachWe conducted a systematic review of the literature to (1) identify the conceptual framework for measuring quality management systems, (2) assess the effects of conceptual framework on quality improvement and quality of care outcomes. We opted for the frameworks that are more cited in the literature and we analyzed and compared between these frameworks.FindingsEight dimensions were identified for assessing performance in Primary Health Care Facilities “PHCF” in more than 50% frameworks: Effectiveness, Safety, Accessibility, Equity, Efficiency, Acceptability, Patient Centeredness and Timeliness.Research limitations/implicationsThe limits of this study can be represented by the following elements: (1) lack of exhaustiveness with regard to the current Frameworks. (2) The evaluation of reliability and validity of the qualitative studies remains difficult to appreciate. (3) Most of the evaluation tools of the primary health care are not validated yet. (4) The difference in performance levels between countries, especially for the developed countries and the multitude of the frames of measure of performance, limits the comparability of the results.Practical implicationsThis study provides a conceptual and descriptive literature on the different conceptual frameworks for performance measurement in primary health care, and a practical and useful tool for comparison between the different conceptual frameworks. Several organisations of accreditation or certification introduced, developed, incorporated and checked the indicators of clinical quality in the organizations of health care. Some studies revealed links with the governance, the access, the continuity, the coordination, the efficiency and the strength primary care (Dionne Kringos, 2018). Improvements in the quality of care have been observed in the results of accreditation and certification bodies regarding hospital infection control infrastructure, organization and performance.Originality/valueEven if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Until now, it is not still common to make evaluation of the quality of care in the “PHCF” to obtain the relevant information. The necessity of having performance measurement tools, which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality.

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