Assessing the state of lean and six sigma practices in healthcare in Mexico

Characterization of Lean Six Sigma projects in healthcare settings: empirical research

Purpose

This paper aims to characterize a sample of Lean Six Sigma (LSS) projects in healthcare settings and discuss some specificities of operational excellence (OPEX) initiatives in hospitals and healthcare organizations in the USA.

Design/methodology/approach

A content analysis involving a sample of 23 documents shared by US hospitals was performed in order to achieve the research objectives. Such analysis was based on a conceptual framework developed from the literature review. It was also applied to a quantitative approach, including descriptive statistics, hypothesis testing and correspondence analysis that supported the research.

Findings

Most LSSH projects were focused on business transformation and strategic improvements. Simple techniques and tools were predominant such as descriptive statistics, process mapping, 5S and spaghetti charts, usually implemented by Green Belts and Black Belts through the define, measure, analyze, improve and control (DMAIC) method. In addition to the expressive findings reported, these projects' results have been aligned with lead time and operational cost reduction, quality improvement and capacity increase.

Research limitations/implications

The study adds knowledge to the OPEX literature by analyzing the Lean Six Sigma healthcare (LSSH) in hospitals and healthcare institutions in the USA. It also demonstrates that different approaches, such as the kaizen event and DMAIC project show different results according to some techniques and tools applied in the hospital environment.

Originality/value

The empirical evidence presented in this study provides scenery of the LSS practices in the healthcare settings, highlighting the implementation areas, outcomes, tools and techniques mostly used in the North American healthcare institutions.

Utilization of Lean & Six Sigma quality initiatives in Indian healthcare sector

PURPOSE

The purpose of this paper is to investigate the utilization of Lean & Six Sigma quality initiatives in healthcare sector in India.

METHODOLOGY

The survey questionnaires were sent to 454 hospitals through registered postal in all the states of India. The survey questionnaire was designed to assess different quality initiatives; currently implemented in Indian hospitals, factors align with organization's objectives, reasons for not implementing Lean & Six Sigma and contribution of Lean & Six Sigma projects in healthcare improvement projects etc. A separate section in the questionnaire provides the feedback on implementation of Lean & Six Sigma in various hospitals. The relationships between Lean & Six Sigma and healthcare performance have also been established in this paper.

FINDINGS

It is found that 15 Nos. of hospitals have implemented the Lean tools while 14 Nos. have implemented the Six Sigma tools out of 109 collected responses. This shows the utilization of Lean & Six Sigma in Indian healthcare sector. The 'Lack of knowledge' and 'Availability of resources' are the major reasons for not implementing Lean & Six Sigma. It is also observed that 22% running projects were related to Lean & Six Sigma out of various improvement projects running in various hospitals.

ORIGINALITY

There is lack of evidences of similar studies that determines the utilization of Lean & Six Sigma in Indian healthcare sector at the national level. This paper will provide important breakthrough to academicians and healthcare practitioners, who are involved in Lean & Six Sigma research.

SOCIAL IMPLICATIONS

The present study will create awareness among healthcare practitioners across India for utilization of quality tools that will provide direct benefits to the society.

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review is to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve. The review was performed according to PRISMA. We used six databases to search for studies published from 2002 to 2019. Out of 5732 studies, 39 measuring one or more defined outcomes were included. Hospital length of stay (LOS) was measured in 23 studies, 16 of which reported a reduction, turnover time (TOT) decreased in six out of eight studies, while the turnaround time (TAT) and on-time starts (OTS) improved in all five and seven studies, respectively. Moreover, eight out of nine studies reported an earlier discharge time, and the boarding time decreased in all four cases. Meanwhile, the readmission rate did not increase in all nine studies. Lastly, staff and patient satisfaction improved in all eight studies. Our findings show that by focusing on reducing non-value-added activities, LH contributed to improving patient flow and efficiency within inpatient care.

Analyzing barriers and strategies for implementing Lean Six Sigma in the context of Indian SMEs

Purpose

The purpose of this study is to investigate the barriers for implementing Lean Six Sigma (LSS) in small and medium-sized enterprises (SMEs) and present a framework that provides prioritized strategies to overcome the barriers.

Design/methodology/approach

The barriers and strategies are identified via a comprehensive literature review and validated by industry experts. The study uses the fuzzy Technique for Order of Preference by Similarity to Ideal Solution (fuzzy TOPSIS) to analyze the barriers and strategies for determining the prioritized list of strategies.

Findings

The findings reveal that there are sixteen barriers to LSS implementation in Indian SMEs. To overcome these barriers, this study reveals twelve strategies. The analysis shows that “effective management” is the most crucial strategy to overcome the barriers for implementing LSS in Indian SMEs.

Research limitations/implications

This research guides SMEs practitioners to efficiently and effectively implement LSS, which, in turn, can enhance the performance of SMEs.

Originality/value

This study contributes to the literature by integrating the strategies with the barriers for implementing LSS in Indian SMEs. Besides, this study provides the prioritized list of strategies to overcome the barriers for implementing LSS in Indian SMEs.