Application of Lean Six Sigma in conservative dentistry: an action research at an Indian dental college

Critical analysis of Lean Six Sigma black belt certification courses offered in Brazil

Purpose

This study aims to present an overview and analyze the Lean Six Sigma Black Belt (LSSBB) certifications offered by institutions operating in Brazil.

Design/methodology/approach

This research analyzed LSSBB certification courses offered by 48 institutions in Brazil by comparing the syllabi of the classes to the reference model proposed by the American Society for Quality (ASQ) in the Six Sigma Black Belt Body of Knowledge. This study employed the content analysis technique and hierarchical cluster analysis to analyze the data.

Findings

The results revealed a lack of standardization in the content of Lean Six Sigma (LSS) training in Brazil. 100% of the LSSBB courses analyzed covered four of the 108 techniques recommended by the ASQ Body of Knowledge (i.e. data types, measurement scales, sampling, and data collection plans and methods). In contrast, more than 75% of the courses covered all techniques related to the macro areas of organization-wide planning and deployment, organizational process management and measures, measure, and improve. The major shortcoming of LSS training is related to the macro area Design for Six Sigma framework and methodologies. LSS training is offered in a highly concentrated area in Brazil, the wealthiest region, where universities play a crucial role in disseminating LSS.

Originality/value

The literature lacks studies that critically examine LSS certification courses. There is little research on LSS in Brazil and there are no studies on LSS training in this country.

Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review

Despite the increasing utilization of lean practices and digital technologies (DTs) related to Industry 4.0, the impact of such dual interventions on healthcare services remains unclear. This study aims to assess the effects of those interventions and provide a comprehensive understanding of their dynamics in healthcare settings. The methodology comprised a systematic review following the PRISMA guidelines, searching for lean interventions supported by DTs. Previous studies reporting outcomes related to patient health, patient flow, quality of care, and efficiency were included. Results show that most of the improvement interventions relied on lean methodology followed by lean combined with Six Sigma. The main supporting technologies were simulation and automation, while emergency departments and laboratories were the main settings. Most interventions focus on patient flow outcomes, reporting positive effects on outcomes related to access to service and utilization of services, including reductions in turnaround time, length of stay, waiting time, and turnover time. Notably, we found scarce outcomes regarding patient health, staff wellbeing, resource use, and savings. This paper, the first to investigate the dual intervention of DTs with lean or lean–Six Sigma in healthcare, summarizes the technical and organizational challenges associated with similar interventions, encourages further research, and promotes practical applications.

Application of Six Sigma methodology to enhance the productivity and performance of a hotel in the UAE

Purpose

The hotel industry is one of the primary sectors contributing to every country's economy by promoting and reinforcing tourism. The pandemic situation across the globe is forcing the hospitality industry to adopt a suitable operational excellence (OPEX) methodology and its associated tools to deliver quality service at an affordable cost. However, there is limited evidence of applying one of the prominent OPEX methodologies, such as Six Sigma (SS), to enhance the hospitality industry's productivity and performance. Thus, the purpose of the study is to explore the application of the SS methodology to reduce the cycle time of a pantry workstation in a United Arab Emirates (UAE) hotel sector.

Design/methodology/approach

The research adopted a case study approach using DMAIC (define-measure-analyse-improve-control) phases to improve the performance of the minibar updating process attached to the hotel rooms. In addition, the study effectively used several tools, including normality tests, control charts, capability analysis, cause and effect diagram, failure mode effects analysis (FMEA), value stream mapping (VSM) and GEMBA, to validate the root causes and draw robust inferences.

Findings

The average cycle time and standard deviation of the pantry process were drastically reduced. Further, the analysis showed that the process capability index was substantially improved. Consequently, a notable improvement in the process performance was witnessed, which has resulted in a profit of $50,000 per annum in the hotel.

Practical implications

The article provides a structured and disciplined approach of SS in a hotel which can be used as a benchmarking document by the academicians, practitioners and policymakers for OPEX within the hospitality industry. Further, it paves the way to develop a road map for applying SS in the hospitality sector.

Originality/value

As per the authors' knowledge, to date, no case study has been reported in top tier refereed journals regarding the application of SS in the hotel sector. Thus, the current case study bridges this gap and reiterates that SS can be effectively used with meticulous planning and deployment in the hospitality industry.

The implementation of Lean Six Sigma framework in the Indian context: a review and suggestions for future research

Purpose

The purpose of this work is to gain insights about Lean Six Sigma (LSS) in the Indian context by reviewing the related literature for one decade based on various perspectives, such as author profile, year of publication, type of firm, type of methodology used, type of industry for which the research work is carried out and the key findings from the research.

Design/methodology/approach

This study reviews the research related to LSS from the articles published in the reputed journals. The literature used for reviewing is derived from the sources, including Science direct, Google scholar, IEEE, Taylor and Francis Group, Emerald Insight, Springer, Inderscience and Elsevier during the period between 2010 and 2021. Totally, the authors have included 141 LSS-related research articles that are published in the Indian context. The keywords used are Lean Six Sigma, Lean Six Sigma in the Indian context, Lean Sigma and LSS to identify and consolidate the research papers published during this timeframe.

Findings

The research papers collected from various reputed journals, including Scopus and non- Scopus enlisted, are classified and grouped under various categories to identify the class of author who publishes more in this field, research trend over the years, the type of firm which implements LSS, the research methodology which is commonly used in LSS and related research and also the key takeaway from these articles are highlighted. Further, the authors have also identified the major contributions of researchers in various sectors during this period in India.

Originality/value

This classification framework and the systematic review help in identifying the research gap and in giving directions for future researchers. It will be useful for researchers and practitioners working on the area of LSS, rural and urban entrepreneurs, start-up managers, professionals working in micro, small and medium enterprises (MSMEs) and executives of the Make in India Project to make India as Aatmanirbhar Bharat Abhiyan. Further, the clear direction of progress over the current decade in manufacturing industries, service sectors and processing industries can help the professionals working in these sectors.

Strategies for successful deployment and sustainment of Lean Six Sigma in healthcare sector in India: a multi-level perspective

Purpose

This study aims to present Lean Six Sigma (LSS) deployment and sustainment strategies for the healthcare sector from a multi-level perspective. The objective is to present LSS implementation insights to enable policymakers, practitioners and academicians to test and develop an LSS framework for healthcare sectors.

Design/methodology/approach

The strategies identified are the result of a multi-method research design involving literature review, action research (AR) and Delphi study. Further, the AR portion of the study involved more than 10 years of projects focused on the deployment of LSS in the healthcare sector.

Findings

The strategies include a holistic view from the multi-level perspective, considering the Top Management Level, Middle Management Level and Operational Level. The authors ascertained 27 strategies across the three levels of organizational structure for the effective deployment of LSS. Further, the authors present a customized LSS “pocket guide” from the healthcare perspective for quick reference.

Research limitations/implications

The strategies delineated in this study are based on the Indian healthcare section only; thus, further research in additional geographic contexts is needed. Also, further research is necessary to provide additional empirical validation of the effects of the identified strategies on LSS program outcomes and to verify that the strategies operate at the proposed organizational levels. Future research should also focus on identifying the interrelationships between strategies within and across levels, developing a “road map” for LSS implementation in hospitals and designing the LSS curriculum for medical schools and other medical training programs.

Practical implications

Observations of this study can contribute to developing a holistic framework for successful LSS implementation in the healthcare sector for academicians, practitioners and policymakers. This, in turn, ensures an enhanced value proposition, improved quality of life and reduced healthcare operational costs. Thus, it ensures a win-win situation among all the stakeholders of the healthcare sector.

Originality/value

The strategies put forth will enable the LSS researchers, academicians and, more particularly, practitioners to delve deeper into specific enablers and safeguard the LSS deployment from backlash. The research has two significant benefits. Firstly, it enhances the understanding of LSS from the healthcare perspective. Secondly, it provides direction for future studies with specific components for hospitals’ LSS framework, which can be further tested, refined and improved.

Performance and service quality enhancement in a healthcare setting through lean six sigma strategy

Purpose

The article intended to excavate the Lean Six Sigma (LSS) deployment challenges, Critical Success Factors (CSF), tools and techniques, and managerial implications in an Indian healthcare setting.

Design/methodology/approach

The article illustrates a case study established using Action Research (AR) approach. Further, the case study is based on the Define, Measure, Analyze, Improve, Control (DMAIC) phases of LSS. The performance and service quality of the Endodontics department of a dental college attached to a hospital is enhanced and sustained through the LSS strategy.

Findings

The processing time of Root Canal treatment is reduced by determining the root causes for delay and implementing sustainable solutions. The structured deployment of the LSS strategy helped the Endodontics department to reduce the processing time from an average of 116 min–84 min. Thus, the process's sigma level is enhanced from 0.06 to 4.17 and assisted in sustaining the results.

Research limitations/implications

The case study's findings are based on the single AR carried out at an Endodontics department of a dental college hospital based on LSS strategies. Even though this study's results cannot be generalized, the deliverables of the case study can be used to develop the LSS roadmap for the dental colleges to enhance the service quality and safety of the patients.

Originality/value

The article provides step-by-step details for implementing LSS in dental college hospitals with critical analysis based on robust statistical tools and techniques. The case study provides evidence of the adoption of LSS in medical college education and provides the confidence to adopt the same through novice users. The study's findings may persuade the policymakers to add LSS in the medical education curriculum to reinforce safety and reduce errors in the healthcare system.