Lean Six Sigma for the healthcare sector: a multiple case study analysis from the Indian context

2019 ◽  
Vol 37 (1) ◽  
pp. 90-111 ◽  
Author(s):  
Shreeranga Bhat ◽  
Jiju Antony ◽  
E.V. Gijo ◽  
Elizabeth A. Cudney
Keyword(s):  
Case Studies ◽  
Six Sigma ◽  
Medical Records ◽  
Lean Six Sigma ◽  
Healthcare Sector ◽  
Value Stream Mapping ◽  
Private Hospitals ◽  
Content Type ◽  
Multiple Case ◽  
The Impact

Purpose The purpose of this paper is to explore the voice of the customer, key performance indicators, critical to quality characteristics, critical success factors, and commonly used tools and techniques for deploying the Lean Six Sigma (LSS) strategy in Indian private hospitals, with special attention to the medical records. Design/methodology/approach The study utilizes the action research methodology to obtain a greater understanding of the use of LSS in the Indian healthcare sector. Multiple case studies were designed and successfully deployed to understand and ascertain challenges in LSS implementation. Five case studies were carried out in the Medical Records Departments (MRD) of four private hospitals in India. Findings Patients perceive that waiting in queue harms their health, which can be rectified by addressing the cycle time of the system. The research also found that effective leadership, availability of data, involvement of cross-functional team and effective communication are critical to the success of LSS projects. In addition, control charts, cause and effect diagram, 5S, gemba, two-sample t-test, standardization, waste analysis and value stream mapping are some of the common tools used to improve healthcare systems. Research limitations/implications The research was restricted to studying the impact of LSS on the workflow and resource consumption of the MRD in Indian allopathic hospitals only. The validity of the results can be improved by including more hospitals and more case studies from the healthcare sector in different countries. Originality/value The findings will enable researchers, academicians and practitioners to incorporate the results of the study in LSS implementation within the healthcare system to increase the likelihood of successful deployment. This will provide greater stimulus across other departments in the hospital sector for wider and broader application of LSS for creating and sustaining process improvements.

scholarly journals Lean Six Sigma implementation and sustainability roadmap for reducing medication errors in hospitals

2020 ◽  
Vol 33 (1) ◽  
pp. 33-55
Author(s):  
Yaifa Trakulsunti ◽  
Jiju Antony ◽  
Jacqueline Ann Douglas
Keyword(s):  
Case Studies ◽  
Medication Errors ◽  
Six Sigma ◽  
Phase 1 ◽  
Hospital Setting ◽  
Lean Six Sigma ◽  
Healthcare Sector ◽  
Phase 3 ◽  
Content Type ◽  
Key Characteristics

PurposeThe purpose of this study is to propose a Lean Six Sigma (LSS) roadmap to guide healthcare practitioners in the implementation of LSS along with a customized LSS tool kit for reducing medication errors.Design/methodology/approachThe authors initially critically reviewed several frameworks/roadmaps of Lean, Six Sigma and LSS which have been proposed in healthcare sector from the existing literature. This review has led to an understanding of key characteristics, limitations and reasons behind the development of such frameworks/roadmaps. A conceptual roadmap was developed and then validated by a number of LSS experts and a healthcare practitioner. Based on the previous studies and taking LSS experts’ opinions into account, a revised roadmap for reducing medication is presented.FindingsThe roadmap for LSS in reducing medication errors is developed. This roadmap includes three phases: Phase 1 cultural readiness for LSS employment in reducing medication errors; Phase 2 preparation, initialization and implementation; and Phase 3 sustainability.Research limitations/implicationsThe roadmap has been tested with only a handful of practitioners of LSS. Moreover, only two case studies have been carried out in a Thai hospital setting which followed the roadmap. In order to improve the validity of research, more case studies need to be executed and more people should be used for testing the roadmap with varied cultures.Originality/valueThis is the first attempt in the development of a LSS roadmap that healthcare practitioners can follow to reduce medication errors using LSS methodology and sustaining LSS in their organizations.

Using Lean Six Sigma in small and medium-sized enterprises for low-cost/high-effect improvement initiatives: a case study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nikolaos A. Panayiotou ◽  
Konstantinos E. Stergiou ◽  
Nikolaos Panagiotou
Keyword(s):  
Case Studies ◽  
Six Sigma ◽  
Success Factors ◽  
Low Cost ◽  
Lean Six Sigma ◽  
Small Scale ◽  
Content Type ◽  
High Effect ◽  
The Impact

PurposeThe purpose of this paper is the implementation of Lean Six Sigma (LSS) in a manufacturing small and medium-sized enterprise (SME) in Greece in order to understand the contribution of LSS in its process improvement and to identify the parameters playing a crucial role in LSS adoption by SMEs. The ability to achieve high-effect improvements without cost investment is also examined to cope with low investment margin that is a characteristic of SMEs.Design/methodology/approachThis case study is based on the combination of Define, Measure, Analyze, Improve and Control (DMAIC) phases with the Yin's method for case studies for a complete and efficient implementation and presentation of the project.FindingsThe analysis of this case study revealed that by accomplishing specific critical success factors for the fulfillment of the LSS project, the company attained important benefits by utilizing only the working hours of employees. It was also found that the improvements of LSS projects can be measured using other metrics which can indirectly be translated into monetary terms.Practical implicationsThe paper can be a useful guide of how SMEs can achieve high-impact improvements with low or no investment cost utilizing LSS initiatives in small-scale projects.Originality/valueAccording to the literature, there is a need for more case studies concerning LSS implementation in SMEs. Examples of how low-cost/high-effect improvement initiatives can be implemented have not been adequately presented before. The assessment of the impact of improvement initiatives with non-monetary measures is also innovative.

Impact of lean six sigma at pharmacy unit on hospital profitability before and during Covid-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
A. Heri Iswanto
Keyword(s):  
Six Sigma ◽  
Inpatient Care ◽  
Design Method ◽  
Lean Six Sigma ◽  
Term Care ◽  
New Normal ◽  
Content Type ◽  
Unit Level ◽  
The Impact

Purpose The purpose of this paper is to compare the impact of lean six sigma (LSS) implementation carried out in a pharmaceutical unit on the profitability of outpatient and inpatient care before and during the Covid-19 pandemic. Design/method/approach The data were analyzed descriptively to see the development patterns in four periods: before implementation, during the implementation before the pandemic, during the pandemic and during the enforcement of new normal, in general, and by the length of stay (LOS). Findings The inventory purchase in the pharmaceutical unit dramatically decreased after implementation even during the pandemic and new normal wherein the pre-pandemic it decreased by 27%, during the pandemic 29% and in the new normal 37% compared to pre-LSS. The hospital deficit decreased after implementation before the pandemic by 26% and during the pandemic by 10% from the pre-LSS time. However, during the new normal, the deficit increased by 29%, indicating a diminished effect of LSS on the hospital profits. Research limitations/implications This research raised the possible implication that the implementation of LSS needed to be carried out in the entire hospital to have a large effect, especially on the inpatient care and long-term care installations. Originality/value This research provided empirical evidence regarding the effect of the Covid-19 pandemic on the ability of LSS at the unit level to provide efficiency at the unit level and the entire hospital at various levels of LOS.

Lean Six Sigma in higher education institutes: an Irish case study

2019 ◽  
Vol 10 (4) ◽  
pp. 948-974 ◽  
Author(s):  
Seamus J. O’Reilly ◽  
Joe Healy ◽  
Tom Murphy ◽  
Rónán Ó’Dubhghaill
Keyword(s):  
Higher Education ◽  
Six Sigma ◽  
Single Case ◽  
Lean Six Sigma ◽  
Research Approach ◽  
Content Type ◽  
Training Programmes ◽  
The Impact

Purpose This paper aims to contribute to a developing literature on continuous improvement (CI), enabled by Lean Six Sigma (LSS), in higher education institutions (HEIs). It reports on the key learning points arising from the initial steps taken by an Irish university on its CI journey. Design/methodology/approach A case study strategy was adopted following a participatory research approach. This approach supports reflexivity and also provides access to all relevant documentation and staff within the case university. Thematic analysis was supported by data reduction and display techniques. Findings The introduction of a LSS approach rather than a reliance on lean alone introduced a structured methodology (DMAIC) that supported simplification of a number of administrative processes. A number of specific improvements were achieved including: Cycle time and cost reduction; customer or employee satisfaction; and rework and error reduction. The findings support the importance of the Readiness Factors as identified by Antony (2014), with particular insight into the role of senior and middle management, the impact of training and deployment of expertise. Research limitations/implications This paper is based on an ongoing, longitudinal, empirical study of a single case study in Ireland. Originality/value This paper tracks the development of CI in a HEI in a longitudinal manner and adds to the emerging the literature in this area. The paper evaluates the role of management at various levels, analyses the use of LSS tools and techniques and evaluated the role of training and capacity building. Implications for Management are shared including: design and role of training programmes, role of champions at various organisational levels, including key functional areas and sustaining momentum.

Analyzing the Lean Six Sigma enabled organizational performance to enhance operational efficiency

2020 ◽  
Vol 27 (8) ◽  
pp. 2401-2434
Author(s):  
Shruti J. Raval ◽  
Ravi Kant ◽  
Ravi Shankar
Keyword(s):  
Organizational Performance ◽  
Six Sigma ◽  
Role Model ◽  
Operational Efficiency ◽  
Lean Six Sigma ◽  
Optimum Level ◽  
Content Type ◽  
Efficient Organization ◽  
Manufacturing Organizations ◽  
The Impact

PurposeThe aim of this analysis is to review the Indian manufacturing organizations practicing Lean Six Sigma (LSS) tools/techniques with an objective of monitoring the performance of an organization and to develop recommendation for strategies to benchmark organizational operational efficiency.Design/methodology/approachThis study offers insights of the LSS performance measurement aspects of the Indian manufacturing organizations based on Data envelopment analysis (DEA) approach. The five inputs and two outputs are considered on the basis of literature review and discussed with the practitioners.FindingsIn this analysis, the relative efficiency score of 18 Indian manufacturing organizations has been determined in order to assist evaluation of the impact of monetary investment on the outputs. The present analysis not only investigates the optimum level of input variables but also lays down a significant observation that an organization having higher profit and inventory turnover ratio is not necessarily an efficient organization.Practical implicationsThe results assist to determine the best practice units, potential source of inefficiency and deliver beneficial data for the consistent enhancement of the operational efficiency. The DEA results assist managers and decision makers to derive appropriate strategies to enhance their performance with reference to the efficient organization and to regard it as their role model.Originality/valueThis analysis renders a DEA based framework of LSS practicing Indian manufacturing organizations. The framework is unique in terms of its input-outputs variable selection and measurement procedure.

Environmental education in libraries – theoretical foundations and practical implementation

2020 ◽  
Vol 41 (4/5) ◽  
pp. 279-293 ◽  
Author(s):  
Małgorzata Fedorowicz-Kruszewska
Keyword(s):  
Sustainable Development ◽  
Environmental Education ◽  
Case Studies ◽  
New Paradigm ◽  
Professional Literature ◽  
Content Type ◽  
Multiple Case ◽  
Main Components ◽  
The Impact

PurposeThe purpose of this paper is to explain the concepts related to environmental education in the context of sustainable development, to indicate the links between them as well as to identify and organize elements of library activities that have the potential to implement environmental education.Design/methodology/approachThe method of analysis and criticism of scientific and professional literature and research reports was used. The multiple case study method was also used.FindingsAn analysis of literature and multiple case studies confirms the assumption that sustainable development is now a new paradigm of librarianship. Among the goals of sustainable development are environmental goals, which in libraries can be achieved through environmental education. A broad approach to environmental education has been proposed, which is implemented not only by using library services but also by building green collections, contacts with environmentally involved librarians, using ecological library infrastructure, observing sustainable management methods in libraries, cooperation between the library and the external environment in terms of the natural environment.Research limitations/implicationsAn analysis of 20 case studies was carried out regarding the implementation of pro-environmental measures in libraries. Examination of a larger number of case studies would probably give a more complete picture of this area of activity in libraries. The next stage of research should be the development of standards/guidelines in the field of environmental education in libraries, and then the development of methods and techniques for assessing the quality of library activities in this area and methods for assessing the impact of libraries on society and the environment in the field of environmental education.Practical implicationsThe paper indicates – based on case study analyses – those library elements that have potential in the field of environmental education. They were ordered in categories that were assigned to the three main components of a library: people, artefacts and processes.Social implicationsSustainable development is a new library paradigm. The paper focuses on the environmental area, specifically environmental education. It has been recognized that libraries have considerable potential for environmental education and should be seen as socially responsible organizations that take responsibility for the impact of their decisions and actions on society and the environment.Originality/valueThe paper explains the basic concepts of environmental education and the relationships between them. It defines the area of environmental education in libraries in terms of library activity elements that can be used to organize them according to the three main components of a library, which are people, artefacts and processes. The paper also indicates that sustainable development should be treated as a new paradigm of librarianship, and environmental education as a new research field of library and information science.

Lean Six Sigma: a clinical treatment for the recovery of Indian manufacturing sector from the after-effects of coronavirus

2020 ◽  
Vol 17 (3) ◽  
pp. 311-322 ◽  
Author(s):  
Harsimran Singh Sodhi
Keyword(s):  
Six Sigma ◽  
Manufacturing Industry ◽  
Manufacturing Sector ◽  
Lean Six Sigma ◽  
Clinical Treatment ◽  
Content Type ◽  
After Effects ◽  
The World ◽  
Tools And Techniques ◽  
The Impact

PurposeManufacturing industry is quite badly hit due to the coronavirus. Manufacturing has been stopped in every country. The present study will provide assistance to the practitioners to recover manufacturing sector from the after-effects of coronavirus.Design/methodology/approachA thorough review of the recent articles published in the newspaper and web has been done to make a viewpoint on the global industrial impact due to epidemic corona. Reports of WHO, IMF, World Bank, RBI and so forth are also reviewed. Further, Lean Six Sigma has been suggested which can be implemented to recover manufacturing industry from the ill effects of corona.FindingsIn present study the problem causd in the manufacturing sector due to corona virus has been identified and a clinical treatment for the same has been proposed by using the tools and techniques of Lean Six Sigma.Originality/valueThe impact of coronavirus has become a huge issue not only for the physical health of human beings but also for the economic health of most of the countries in the world, as it is pushing the world economy toward huge economic depression. Therefore, it becomes the moral responsibility of industrial experts to suggest the tools and techniques to the manufacturing industry for faster recovery.

scholarly journals LEAN SIX SIGMA: MULTIPLE CASE STUDY

2018 ◽  
Vol 9 (1) ◽  
pp. 74
Author(s):  
Orlando Roque Da Silva ◽  
Alessandro Marco Rosini ◽  
Arnoldo J H Guevara ◽  
Angelo Palmisano ◽  
Delvio Venanzi
Keyword(s):  
Six Sigma ◽  
Lean Manufacturing ◽  
Lean Six Sigma ◽  
Value Stream Mapping ◽  
Exploratory Research ◽  
Value Stream ◽  
Multiple Case ◽  
Mapping Techniques ◽  
And Control

Lean Six Sigma is a management focused on quality and productive performance in operating systems. This article discusses the foundations of this methodology through of two different conceptions of management, Lean Manufacturing and Six Sigma. First of the article explain the DMAIC (define measure, analyze, improve and control) and their respective phases, after the Lean philosophy with the sipoc and value stream mapping techniques. The article aims to show integration of these two conception and their results. The methodology consisted in a theory was based on a literature search an exploratory research which consisted of three case studies in differences companies located in Sorocaba, São Paulo. In this article studies the applying of Lean Six Sigma and its results.

scholarly journals Logistics services and Lean Six Sigma implementation: a case study

2016 ◽  
Vol 7 (3) ◽  
pp. 324-342 ◽  
Author(s):  
Leopoldo Gutierrez-Gutierrez ◽  
Sander de Leeuw ◽  
Ruud Dubbers
Keyword(s):  
Six Sigma ◽  
Process Management ◽  
Relevant Information ◽  
Lean Six Sigma ◽  
Consumer Electronics ◽  
Value Stream Mapping ◽  
Content Type ◽  
Control Approach ◽  
Logistics Services

Purpose This paper aims to analyze the application of Lean Six Sigma (LSS) framework for supporting continuous improvement (CI) in logistics services. Both the lean philosophy and the Six Sigma methodology have become two of the most important initiatives for CI in organizations. The combination of both alternatives – LSS – brings significant benefits for companies applying this method, and its influence in logistics services can be relevant. Design/methodology/approach A case study on the logistics services of a large consumer electronics company is performed. In this sector, high quality in logistics services is crucial. Using within-case and cross-case analyses, the paper discusses the implementation of LSS in two internal logistics processes. Findings The paper identifies important implementation aspects when applying LSS to logistics services, such as CI structure, strategic analysis, cross-functional teams and process management. Furthermore, the paper discusses the potential in logistics services of the DMAIC (define, measure, analyze, improve and control) approach and tools such as value stream mapping, SIPOC (supplier, input, process, output, and customer) and process mapping. Practical implications The paper analyzes two logistics processes where LSS has been applied – a payment process and a request-to-ship process. The analysis of both processes offers relevant information about organizational implementation in a logistics services environment about process improvement and about the use of LSS tools. Originality/value First, this paper addresses the gap in literature about LSS and logistics’ activities. Furthermore, the case company, with more than 9,000 employees and distributing its products to more than 100 countries, constitutes a valuable source of information to obtain insights into the implications of implementing LSS in logistics services.

Implementing a Lean Six Sigma standardized toolset in a manufacturing company: a case study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nikolaos A. Panayiotou ◽  
Konstantinos E. Stergiou ◽  
Vassilis Chronopoulos
Keyword(s):  
Case Studies ◽  
Six Sigma ◽  
Success Factors ◽  
Manufacturing Sector ◽  
Lean Six Sigma ◽  
Small Scale ◽  
Manufacturing Companies ◽  
Content Type ◽  
Manufacturing Company

PurposeThe first purpose of this paper is the implementation of Lean Six Sigma (LSS) in a manufacturing company operating in South East Europe in order to understand the importance of critical success factors (CSFs) in LSS adoption and to find out the benefits that the company gained. The second purpose is to propose a standardized toolset based on DMAIC phases, for the application of LSS in small scale projects, in order to facilitate LSS adoption by more manufacturing companies.Design/methodology/approachThis case study is based on the interlacement of the Yin's method about case studies and the DMAIC method for the improved deployment of LSS.FindingsThe analysis of this case study shows that the company attained to benefit financially, operationally and organizationally from the implementation of LSS. The already existing mentality of CI inside the company helped the project procedure and the application of changes and improvements fulfilling LSS adoption CSFs.Practical implicationsThe paper constructs a toolset and studies the role of CSFs in order to achieve the desirable benefits in a manufacturing environment, constituting a guide for future LSS initiatives.Originality/valueAs stated by literature reviews, even though there are several papers concerning LSS implementation in the manufacturing sector, there is a need for more case studies papers, such as this one, in order to enrich the literature. In this paper, it is also the first time that a specific toolset for small scale projects is proposed based on to DMAIC which can be implemented in further LSS projects.

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