Characteristics of established kaizen event programs: an empirical study

Managing inpatient bed setup: an action-research approach using lean technical practices and lean social practices

PURPOSE

This article aims to introduce a guide to improving hospital bed setup by combining lean technical practices (LTPs), such as kaizen and value stream mapping (VSM) and lean social practices (LSPs), such as employee empowerment.

DESIGN/METHODOLOGY/APPROACH

Action research approach was employed to analyze the process of reconfiguration of bed setup management in a Brazilian public hospital.

FINDINGS

The study introduces three contributions: (1) presents the use of VSM focused specifically on bed setup, while the current literature presents studies mainly focused on patient flow management, (2) combines the use of LSPs and LTPs in the context of bed management, expanding current studies that are focused either on mathematical models or on social and human aspects of work, (3) introduces a practical guide based on six steps that combine LSPs and LSPs to improve bed setup management.

RESEARCH LIMITATIONS/IMPLICATIONS

The research focused on the analysis of patient beds. Surgical beds, delivery, emergency care and intensive care unit (ICU) were not considered in this study. In addition, the process indicators analyzed after the implementation of the improvements did not contemplate the moment of the COVID-19 pandemic. Finally, this research focused on the implementation of the improvement in the context of only one Brazilian public hospital.

PRACTICAL IMPLICATIONS

The combined use of LSPs and LTPs can generate considerable gains in bed setup efficiency and consequently increase the capacity of a hospital to admit new patients, without the ampliation of the physical space and workforce.

SOCIAL IMPLICATIONS

The improvement of bed setup has an important social character, whereas it can generate important social benefits such as the improvement of the admission service to patients, reducing the waiting time, reducing hospitalization costs and improving the hospital capacity without additional physical resources. All these results are crucial for populations, their countries and regions.

ORIGINALITY/VALUE

While the current literature on bed management is more focused on formal models or pure human and social perspectives, this article brings these two perspectives together in a single, holistic framework. As a result, this article points out that the complex bed management problem can be efficiently solved by combining LSPs and LTPs to present theoretical and practical contributions to the important social problem of hospital bed management.

Food supply chain waste reduction for a circular economy in the COVID-19 pandemic: a longitudinal study of New Zealand consumers

Purpose

Food waste (FW) reduction, of which household wastage comprises a large fraction, has an important role in promoting the circular economy (CE). This study investigates how certain consumer traits impact household FW, particularly in the face of external shocks.

Design/methodology/approach

The authors conducted a qualitative and longitudinal study, spanning three periods in New Zealand. A preliminary model is constructed from the outcomes of a survey with 178 participants. Then, the authors carried out 29 semi-structured interviews to refine the preliminary model and adapt it to the analysis of household waste behavior.

Findings

Different segments of consumers have distinct response patterns in successive lockdowns, and these patterns impact household FW reduction and food supply chain (FSC) management. The key findings include (1) for government, quick responses to quash unhelpful rumors help to reduce public concerns around FSC interruption; (2) for retailers, the pandemic has hastened the growth of online shopping; being able to expand the distribution channel in a short time is a critical issue; and (3) for consumers, the experience of lockdown has different impacts on different groups of consumers. This variation of experience may either enhance or exacerbate FW in households.

Originality/value

This paper complements the existing literature on the FSC and contributes to household FW and CE literature by providing a framework that integrates external impacts, consumer segmentation to reflect on waste management, and the possible applications of the proposed framework.

Kaizen event process quality: towards a phase-based understanding of high-quality group problem-solving

Purpose

As a problem-solving tool, the kaizen event (KE) is underutilised in practice. Assuming this is due to a lack of group process quality during those events, the authors aimed to grasp what is needed during high-quality KE meetings. Guided by the phased approach for structured problem-solving, the authors built and explored a measure for enriching future KE research.

Design/methodology/approach

Six phases were used to code all verbal contributions (N = 5,442) in 21 diverse, videotaped KE meetings. Resembling state space grids, the authors visualised the course of each meeting with line graphs which were shown to ten individual kaizen experts as well as to the filmed kaizen groups.

Findings

From their reactions to the graphs the authors extracted high-quality KE process characteristics. At the end of each phase, that should be enacted sequentially, explicit group consensus appeared to be crucial. Some of the groups spent too little time on a group-shared understanding of the problem and its root causes. Surprisingly, the mixed-methods data suggested that small and infrequent deviations (“jumps”) to another phase might be necessary for a high-quality process. According to the newly developed quantitative process measure, when groups often jump from one phase to a distant, previous or next phase, this relates to low KE process quality.

Originality/value

A refined conceptual model and research agenda are offered for generating better solutions during KEs, and the authors urge examinations of the effects of well-crafted KE training.

Proposed guidelines for treatment of recurrent failures for sustainability of results in the post-project improvement stage process

Purpose

The maintenance of process improvement programs within organizations is not an easy task. Some processes do not maintain the results achieved with the improvement project and again present low performance shortly after completion of the project. This paper aims to identify the socio-technical causes responsible for the loss of process performance after applying improvement projects, in order to support the mitigation of the problem.

Design/methodology/approach

A systematic review of the literature was carried out, which allowed the selection of 28 articles. The empirical stage used the benchmarking technique, along a large Brazilian mining company with an international standard of production and quality. This organization has been using improvement projects for more than ten years.

Findings

The research complements the literature regarding the prioritization of the 26 identified failures and the identification of seven new failure factors and two resources. Findings in this study can be an inspiration for other organizations, considering the similarity of methodological aspects of improvement projects since internationally standardized methodologies such as Six Sigma, Lean, Kaizen and 5S are used.

Originality/value

The research presented a proposal of guidelines that corroborate to the mitigation of loss of process performance after improvement project.

Sustainability and Kaizen: Business Model Trends in Healthcare

Kaizen, or continuous improvement, is a management tool that allows the identification of activities that have no value in the processes examined. This identification leads to the improvement of these processes within any organization and promotes economic and social sustainability, and to a lesser extent environmental sustainability. Kaizen, already widely and successfully employed in the industrial sector, is now being applied in the health sector. However, the health sector tends to publish only the results of how processes have been improved in finely focused areas and the resulting benefits. The majority of the benefits focus on time and cost reduction. In this study, the authors carried out a bibliometric analysis using the Scimat program, which maps the thematic evolution of Kaizen in the health sector and its relationship with sustainability, in order to promote the interest of the health sector for this type of process improvement. The findings confirm that the implementation of Kaizen is recent and constantly evolves and grows, and that it can help economic and social sustainability, and to a lesser extent environmental sustainability.

An Enhanced Kaizen Event in a Sterile Processing Department of a Rural Hospital: A Case Study

Operating Rooms (ORs) generate the largest revenues and losses in a hospital. Without the prompt supply of sterile surgical trays from the Sterile Processing Department (SPD), the OR would not be able to perform surgeries to its busy schedule. Nevertheless, little emphasis has been brought in the medical literature to research on surgical instrument processing in the medical literature. The present study was done applies an Enhanced Kaizen Event (EKE) in the SPD of a rural hospital to identify sources of waste and minimize non-value-added steps in the SPD processes. The EKE consisted of three successive Plan-Do-Check-Act (PDCA) cycles, which focused on improvements at the departmental level first, then at an area level, and finally at the station level. The EKE yielded an improved streamlined workflow and a new design for the SPD layout, one of its areas, and a workstation. This paper aims at building a methodology, including identified steps. Results exhibited a 35% reduction in travel distance by the staff, eliminating non-value-added processes, reducing errors in the sterilization process, and eliminating cross-contamination for sterilized materials.

Value stream mapping in education: addressing work stress

Purpose

Teachers of primary education experience high levels of stress but lack rational coping strategies to reduce their work stress. The paper develops a value stream mapping for education approach and examines its use as a rational coping strategy for teams of teachers and other employees to overcome work-related stressors.

Design/methodology/approach

The research process consists of two phases. First, a value stream mapping approach for education is developed, based on literature research. Next, the approach is validated in an action research study to reduce work stress of teachers in educational services. The processes that have been selected by the teachers relate to coping with increased variety, long and uncertain throughput times and unclear specifications.

Findings

Value stream mapping for education (VSM4EDU) is a well-structured improvement method based on principles of visualization, participation and process thinking, which helps teachers without background in lean thinking to analyse their processes. Using this method has enabled the team to develop rational coping strategies to reduce their work-related stress.

Research limitations/implications

VSM4EDU has been validated using action research at a single school, which implicates deep insight, but further testing at other schools is welcome. Moreover, VSM4EDU has not been used to develop a future state map.

Practical implications

Value stream mapping is useful in educational settings as long as the educational context is respected in the approach.

Social implications

VSM4EDU empowers teachers and helps to develop co-operation in teams.

Originality/value

The validation of value stream mapping for education is well-documented and original.

Kaizen and continuous improvement – trends and patterns over 30 years

Purpose

The purpose of this paper is to depict how Kaizen and continuous improvement (CI) are represented in scientific journals focusing on quality management (QM) from the 1980s until 2017. Additionally, the study aims to examine how Kaizen is studied and described and how the relationship between Kaizen and CI is portrayed.

Design/methodology/approach

The study applies a mixed methods approach to search for tendencies and outlines concerning Kaizen and CI in four scientific journals focusing on QM and two focusing on OM. The data set contains entries from 1980 until 2017, which makes it possible to depict how Kaizen has evolved over more than 30 years.

Findings

The findings show that Kaizen and CI attained special interest in the mid-1990s, after which interest appears to have decreased. However, the findings imply that a regenerated interest for the areas spiked post 2010. In addition, the results indicate that Kaizen is on the one hand accepted by one part of the management community but on the other hand completely ignored by the rest. Finally, the data illuminate a need to strengthen and clarify Kaizen’s theoretical basis and its relationship to CI.

Practical implications

If an aspiration exists to increase the success rate of Kaizen implementation, the results from the study highlight the need to address and clarify epistemological, terminological and theoretical issues.

Originality/value

Prior data mining studies pinpointing how Kaizen and CI have evolved over the last 30 years appear not to exist.

Systematic bibliometric analysis on Kaizen in scientific journals

Purpose

Since Masaaki Imai coined the term Kaizen in the mid-1980s, it has been seen as a key element for the competitiveness of Japanese companies, and it is currently a widely discussed philosophy and is applied in a wide range of organizations throughout the world. The purpose of this paper is to serve as guidance for researchers who are developing their studies in the field of the Kaizen philosophy, in order to improve their knowledge on the most relevant articles, the most productive authors or the key scientific journals that make up this subject.

Design/methodology/approach

In order to fulfill the proposed objective, a descriptive bibliometric study was carried out with the analysis of citations from 138 articles included in the multidisciplinary database Scopus (Elsevier) until 2016. For the search of documents, a tracking strategy was chosen that allowed for the development of the ad hoc database required to analyze each of the basic variables of the bibliometric indicators.

Findings

The results obtained show a growing interest of the scientific community in its study in the last decade, as shown by the significant increase in citations received by articles, despite the reduction in the number of papers published in the last two years.

Research limitations/implications

The main limitations are derived from the choice of a specific database, as well as the specific search equation.

Originality/value

The study presents an in-depth analysis of the current state of research regarding the Kaizen philosophy through its bibliometric study, providing useful information for academics and professionals by providing a series of significant indicators to measure the bibliographic material.

A novel Kaizen technique for service quality: case study in educational organization

Purpose

The development and application of systematic procedures enabling Kaizen methodology development are still very rare, especially in the service industry. The purpose of this paper is to suggest a set of innovative improvement methodologies of service quality to enhance the extent and depth of Kaizen in the service domain.

Design/methodology/approach

Combining the importance-performance analysis (IPA) method with impact matrix cross-reference multiplication applied to a classification (MICMAC), which is more convenient in calculation and application, and Fuzzy theory not only effectively integrates opinions of multiple experts, but also improves the conventional MICMAC method, which can only make binary judgment on the mutual influence of elements, by making it able to judge the degree of influence, thereby delivering more accuracy in evaluating the results.

Findings

This innovative method which integrates Fuzzy-MICMAC with IPA displayed its usability in the analysis and research of a certain university library on service quality, and significant differences were found on comparing it with the conventional IPA method. The comparison and suggestion were proposed.

Research limitations/implications

The number of the experts involved and samples under investigation were limited, hence findings were not comprehensive enough and cannot be generalized. This sets the direction for future research.

Originality/value

This proposed method helps in overcoming the lack of systematic procedures enabling Kaizen methodology for service quality. It has the advantage of integrating existing tools and models effectively, which not only improve the shortcomings of the conventional methods, but also result in more convenient calculation and application, to promote Kaizen in service domain.

Prioritising the enablers for the successful implementation of Kaizen in China

Purpose

The purpose of this paper is to develop a better understanding of how Sino-Japanese joint ventures implemented the three Japanese improvement methods, i.e. Kaizen, Kaikaku and Kaizen Blitz. The specific objectives of this study are to identify the key enablers for the three improvement methods; and to identify the most selected improvement method.

Design/methodology/approach

This study employs a fuzzy analytic hierarchy process to pairwise-compare the three improvement methods. Data are collected from 28 industry experts from Sino-Japanese joint ventures. The study then adopts extent analysis approach for pairwise comparisons and extent analysis to obtain synthetic extent values for priority weights.

Findings

The results of the study indicate that personnel (humanware) factor enablers are the most important factor for Kaizen, whilst software factor enablers (essential rules, policies and institutional arrangements) weight second and hardware factor enablers (physical, measurable hard facts or resources) weight last. The study also reviews that Kaizen is the most selected improvement method among the three.

Research limitations/implications

The sample of this study is limited to Sino-Japanese ventures in Guangzhou, China. This study only identifies the key improvement enablers based on interviews with shop floor managers and improvement experts.

Practical implications

Practical implications are threefold: the improvement implementations should be based on factors such as regular training, incentives for motivations and shop floor management; improvement methods are transferable and standard operations may only have small effects on collecting improvement ideas; and Kaizen is the appropriate method to support long-term and process-oriented improvements.

Originality/value

This study is the first to specifically pairwise-compare the three Japanese improvement methods and to identify priorities of their key enablers in Sino-Japanese joint ventures.

Utilizing Kaizen process and DFSS methodology for new product development

Purpose

The purpose of this paper is to propose a new framework for early design stage utilizing the benefits of Kaizen events, and Design for Six Sigma (DFSS) methodology. To gain a better understanding of the proposed method, a case study of a diesel engine development was presented where the proposed methodology was followed.

Design/methodology/approach

This paper proposes a hybrid Kaizen DFSS methodology consisting of four Kaizen milestone events with pre-work preceding these events. The events are in line with the four phases of DFSS methodology (define, characterize, optimize, and verify).

Findings

In order for the proposed method to succeed, few key enablers should be available such as management buy-in and support, effective resources utilization, and proper planning. However, this methodology should be utilized for key projects where criticality is high and deadlines are nearby.

Practical implications

As proved by two projects, one of them is presented in this paper; the use of the proposed methodology is effective and can bring significant positive changes to an organization.

Originality/value

Although Kaizen is an old and well-known process, it is to the best of the author’s knowledge that Kaizen has not been utilized in the early design stages of new product development projects. In this paper, a hybrid methodology combining traditional DFSS systematic approach conducted using Kaizen improvement events is proposed and supported by a real-life case study.

The relationship between organizational culture and quality techniques, and its impact on operational performance

Purpose

– The purpose of this paper is to investigate if a firm’s organizational culture affects the set of quality techniques it uses, and if these quality techniques affect the relationship between organizational culture and operational performance.

Design/methodology/approach

– Based on data collected from 250 firms in Brazil and Denmark, structural equation modeling is used to investigate the relationship between organizational culture and the use of quality techniques, and its impact on operational performance. Four quality technique groups, four cultural profiles adopted from the Competing Values Framework and a set of operational performance indicators are used to operationalize the study.

Findings

– Culture does not appear to be an unequivocal predictor of the use of quality techniques. Furthermore, while most quality technique groups contribute indirectly to the total effect on operational performance in the developmental, group and hierarchical cultures, the performance effects are insignificant for all four groups in the rational culture.

Practical implications

– Managers need to be actively aware of the cultural characteristics of their organization before adopting quality techniques, in order to benefit most from the use of these techniques.

Originality/value

– Most previous studies address the relationships between culture, quality management and performance at the level of quality practices. This study takes the unitarist-pluralist discussion to the level of quality techniques and extends that discussion to what should be its core, namely, the influence of quality techniques on the performance impact of culture.