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Tortorella GL, Prashar A, Antony J, Fogliatto FS, Gonzalez V, Godinho Filho M. Industry 4.0 adoption for healthcare supply chain performance during COVID-19 pandemic in Brazil and India: the mediating role of resilience abilities development. Oper Manag Res 2023. [PMCID: PMC10060137 DOI: 10.1007/s12063-023-00366-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Affiliation(s)
- Guilherme Luz Tortorella
- The University of Melbourne, Melbourne, Australia
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
- Universidade Federal de Santa Catarina, Florianöpolis, Brazil
| | | | - Jiju Antony
- Khalifa University of Science and Technology, Abu Dhabi, UAE
| | | | | | - Moacir Godinho Filho
- Metis Lab, EM Normandie Business School, Normandie, France
- Federal University of Sao Carlos, Sao Carlos, Brazil
- Aalborg University, Aalborg, Denmark
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Sony M, Antony J, Tortorella GL. Critical Success Factors for Successful Implementation of Healthcare 4.0: A Literature Review and Future Research Agenda. Int J Environ Res Public Health 2023; 20:4669. [PMID: 36901679 PMCID: PMC10001551 DOI: 10.3390/ijerph20054669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
The digitization of healthcare services is a major shift in the manner in which healthcare services are offered and managed in the modern era. The COVID-19 pandemic has speeded up the use of digital technologies in the healthcare sector. Healthcare 4.0 (H4.0) is much more than the adoption of digital tools, however; going beyond that, it is the digital transformation of healthcare. The successful implementation of H 4.0 presents a challenge as social and technical factors must be considered. This study, through a systematic literature review, expounds ten critical success factors for the successful implementation of H 4.0. Bibliometric analysis of existing articles is also carried out to understand the development of knowledge in this domain. H 4.0 is rapidly gaining prominence, and a comprehensive review of critical success factors in this area has yet to be conducted. Conducting such a review makes a valuable contribution to the body of knowledge in healthcare operations management. Furthermore, this study will also help healthcare practitioners and policymakers to develop strategies to manage the ten critical success factors while implementing H 4.0.
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Affiliation(s)
- Michael Sony
- WITS Business School, University of Witwatersrand, Johannesburg 2158, South Africa
- Oxford Brookes Business School, Oxford Brookes University, Oxford OX3 0BP, UK
| | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
| | - Guilherme L. Tortorella
- Mechanical Engineering Department, The University of Melbourne, Melbourne, VIC 3010, Australia
- IAE Business School, Universidad Austral, Buenos Aires B1630FHB, Argentina
- Production Engineering Department, Universidade Federal de Santa Catarina, Florianopolis 88040-900, SC, Brazil
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McLean RS, Antony J, Garza-Reyes JA, Samadhiya A. A continuous improvement implementation framework for manufacturing companies: a Delphi study-based approach for development and validation. IJQRM 2023. [DOI: 10.1108/ijqrm-04-2021-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PurposeDue to the absence of industry and region-specific implementation guides, change efforts, in particular continuous improvement implementations, continue to report high failure rates. The purpose of this paper is, therefore, to present a finalised implementation framework specifically tailored for manufacturing companies.Design/methodology/approachA conceptual framework derived from the existing literature is validated, through a Delphi study, by an expert panel to review its content and suitability for a practical application.FindingsThis paper proposes a finalised framework tailored to the practical needs of users. The results of the Delphi approach offer a phased implementation framework that provides an overview of the implementation process of continuous improvement initiatives and the key activities involved. The framework is suitable for use by both business leaders and continuous improvement practitioners with varying degrees of previous implementation experience.Research limitations/implicationsThe research was carried out in the UK and is specifically focused on the manufacturing industry. It is therefore not clear the applicability of the framework presented to other regions and industries. The framework, although validated through several phases of research, still requires practical application and testing.Originality/valueBusiness leaders and continuous improvement practitioners will benefit from having the necessary content presented in a manner that will promote its practical application. It has also been demonstrated that the framework is robust in its content, incorporating the literature findings as well as the experience of an expert panel encompassing 20 people.
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Mittal A, Gupta P, Kumar V, Antony J, Cudney EA, Furterer SL. TQM practices and their impact on organisational performance: the case of India’s deming-award industries. Total Quality Management & Business Excellence 2023. [DOI: 10.1080/14783363.2023.2177148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- Ankesh Mittal
- Department of Mechanical Engineering, Asra College of Engineering and Technology, Bhawanigarh, India
| | - Pardeep Gupta
- Department of Mechanical Engineering, Sant Longowal Institute of Engineering and Technology, Longowal, India
| | - Vimal Kumar
- Department of Information Management, Chaoyang University of Technology, Taichung, Taiwan
| | - Jiju Antony
- Department of Industrial and System Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Elizabeth A. Cudney
- John E. Simon School of Business, Maryville University, Town and Country, MO, USA
| | - Sandra L. Furterer
- Department of Industrial and Systems Engineering, The Ohio State University, Columbus, OH, USA
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Zulfiqar M, Antony J, Swarnakar V, Sony M, Jayaraman R, McDermott O. A readiness assessment of Quality 4.0 in packaging companies: an empirical investigation. Total Quality Management & Business Excellence 2023. [DOI: 10.1080/14783363.2023.2170223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Maryam Zulfiqar
- Coca Cola Beverages Pakistan Limited Lahore, Punjab, Pakistan
| | - Jiju Antony
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Vikas Swarnakar
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Michael Sony
- PDM-DB: Digital Business, Wits Business School, University of the Witwatersrand, Johannesburg, South Africa
| | - Raja Jayaraman
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Olivia McDermott
- Regulatory Affairs and Lean Six Sigma Quality Management, National University of Ireland, Dublin, Galway
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Keramida E, Psomas EL, Antony J. Critical success factors of lean in the public services sector: the case of the Greek citizen's service centers. TQM 2022. [DOI: 10.1108/tqm-09-2022-0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PurposeThe aim of this study is to determine the most critical success factors (CSFs) of lean adoption in a specific Greek public services subsector namely citizen's service centers (CSCs) and to define their underlying structure (latent constructs).Design/methodology/approachIn this study an online structured questionnaire survey was distributed to all the Greek CSCs and six hundred and seventy-two employees responded and fully completed the questionnaire. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to assess the reliability and validity of the latent constructs of the Lean CSFs.FindingsData analysis revealed that the latent constructs of the lean CSFs, namely communication, top management commitment and leadership, organizational culture, training and education, change and project management, availability of resources, teamwork, and employee involvement and empowerment are of major importance for the adoption of lean in the CSCs.Research limitations/implicationsThe small percentage of the responding employees of the Greek CSCs, given their large population and the subjective nature of the data collected constitute the main limitations of the present study.Practical implicationsThe findings of this research can guide managers and decision makers of CSCs in recognizing the key factors that potentially will influence the successful adoption of lean, and the enhancement of the quality management initiatives of these services organizations. Moreover, the formulated model can also serve as a reference for academics and researchers to generate new research ideas. Finally, the results may offer guidelines to managers of public services organizations of other countries with a similar structure of the public sector.Originality/valueThe present study is stimulated by the existing gap identified in the literature in the field of the public sector. Building on the public sector literature, this is the first study that evaluates the importance of the CSFs of lean in the Greek CSCs and defines their underlying structure.
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Al Zaabi Y, Antony J, Arturo J, Tortorella G. Operational excellence methodologies in the energy sector: A systematic literature review. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2157715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Yousuf Al Zaabi
- School of Social Sciences, Heriot-Watt University, Edinburgh, UK
| | - Jiju Antony
- School of Social Sciences, Heriot-Watt University, Edinburgh, UK
| | - Jose Arturo
- College of Business, Law and Social Sciences, University of derby, England, UK
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Antony J, Swarnakar V, Gupta N, Kaur J, Jayaraman R, Tortorella GL, Cudney E. Critical success factors for operational excellence initiatives in manufacturing: a meta-analysis. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2157714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Jiju Antony
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Vikas Swarnakar
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Neha Gupta
- Amity School of Business, Amity University, Uttar Pradesh, India
| | - Jaspreet Kaur
- Vivekananda Institute of Professional studies, New Delhi, India
| | - Raja Jayaraman
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Guilherme Luz Tortorella
- The University of Melbourne, Melbourne, Australia
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
- Department of Mechanical Engineering, Universidade Federal de Santa Catarina, Florianopolis, Brazil
| | - Elizabeth Cudney
- John E. Simon School of Business, Maryville University, St. Louis, MO, USA
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Singh M, Rathi R, Antony J. Interpretive model of enablers of Data-Driven Sustainable Quality Management practice in manufacturing industries: ISM approach. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2132141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mahipal Singh
- School of Mechanical Engineering, Lovely Professional University, Punjab, India
| | - Rajeev Rathi
- School of Mechanical Engineering, Lovely Professional University, Punjab, India
| | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi, UAE
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Swarnakar V, Singh AR, Antony J, Tiwari AK, Garza-Reyes JA. Sustainable Lean Six Sigma project selection in manufacturing environments using best-worst method. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2139675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Vikas Swarnakar
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - A. R. Singh
- Department of Mechanical Engineering, National Institute of Technology, Raipur, India
| | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Anil Kr Tiwari
- Department of Mechanical Engineering, National Institute of Technology, Raipur, India
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Komkowski T, Antony J, Garza-Reyes JA, Tortorella GL, Pongboonchai-Empl T. The integration of Industry 4.0 and Lean Management: a systematic review and constituting elements perspective. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2141107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Tim Komkowski
- Edinburgh Business School, Heriot-Watt University, Edinburgh, UK
| | - Jiju Antony
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
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Musamih A, Salah K, Jayaraman R, Yaqoob I, Al-Hammadi Y, Antony J. Blockchain-based solution for COVID-19 vaccine waste reduction. J Clean Prod 2022; 372:133619. [PMID: 35999948 PMCID: PMC9389451 DOI: 10.1016/j.jclepro.2022.133619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/20/2022] [Accepted: 08/09/2022] [Indexed: 05/29/2023]
Abstract
Coronavirus 2019 (COVID-19) vaccines have been produced on a large scale since 2020. However, large-scale vaccine production has led to two forms of waste; namely, overproduction and underutilization. Most of today's systems and technologies used to manage waste data related to COVID-19 vaccines fall short of providing transparency, traceability, accountability, trust, and security features. In this paper, we address the problem of COVID-19 vaccines waste due to their overproduction and underutilization. We propose a blockchain-based solution that is composed of five phases: registration, commitment; production and delivery; consumption; and waste assessment. These phases make up the complete life cycle of a COVID-19 vaccine, and they are governed by several smart contracts to ensure accountability of all the actions taken by the involved entities and reduce any excessive waste caused by overproduction, overordering, or underconsumption. We ensure security, traceability, and data provenance by recording all actions through smart contracts in the form of events on an immutable ledger. We utilize decentralized storage such as the InterPlanetary File System (IPFS) to reduce the costs posed by large-sized file storage when stored on-chain. We present algorithms that describe the logic behind our developed smart contracts. We test and validate the functionalities of our proposed solution. We conduct security, cost, and scalability analyses to show that our solution is affordable, scalable, and secure. We compare our solution with the existing blockchain-based solutions to show its novelty and superiority. The smart contract code is made publicly available on GitHub.
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Affiliation(s)
- Ahmad Musamih
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Khaled Salah
- Department of Electrical Engineering and Computer Science, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Raja Jayaraman
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Ibrar Yaqoob
- Department of Electrical Engineering and Computer Science, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Yousof Al-Hammadi
- Department of Electrical Engineering and Computer Science, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
| | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
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Louzada PDS, Sigahi TF, Moraes GHSMD, Rampasso IS, Anholon R, Antony J, Cudney EA. Critical analysis of Lean Six Sigma black belt certification courses offered in Brazil. TQM 2022. [DOI: 10.1108/tqm-08-2022-0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study aims to present an overview and analyze the Lean Six Sigma Black Belt (LSSBB) certifications offered by institutions operating in Brazil.Design/methodology/approachThis 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.FindingsThe 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/valueThe 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.
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Antony J, Swarnakar V, Salentijn W, Shokri A, Doulatabadi M, Bhat S, McDermott O, Jayaraman R, Sony M. A global study on applicability of ISO 18404:2015 for SMEs: an exploratory qualitative study. TQM 2022. [DOI: 10.1108/tqm-08-2022-0276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeISO 18404:2015 standard defines the proficiencies to the attainment of distinct competency levels with either Lean Manufacturing or Six Sigma or separately combined strategy Lean Six Sigma (LSS). The purpose of this paper is to perform a detailed investigation of the applicability of current LSS competency standard in SMEs and examine the need for further improvement.Design/methodology/approachA qualitative-based semi-structured interview method was utilized globally by interviewing a group of LSS professionals with knowledge about the LSS implementation working in different leading organizations. All participants were asked to review the standard before the interview process to ensure that they are familiar with the standard.FindingsThe results reveal that the current ISO 18404:2015 standard does not fit SMEs to implement the LSS approach as it has several shortfalls that need to be fixed before its adoption or an urgent need to develop a more customized LSS standard for SMEs. The outcome further helps organizations understand theoretical knowledge about ISO 18404:2015, its role in operational excellence implementation, pros, cons, critical success factors and required changes for further improvement within the standard.Research limitations/implicationsThere were very limited baseline studies in the literature. A mixed method strategy that includes qualitative and quantitative data would yield better data so that more robust outcomes can be derived from the research.Originality/valueTo the best of authors' knowledge, this is the first empirical research on the applicability of ISO 18404:2015 for SMEs, which encapsulate opinions of LSS professionals working in several SMEs.
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Antony J, McDermott O, Sony M, Toner A, Bhat S, Cudney EA, Doulatabadi M. Benefits, challenges, critical success factors and motivations of Quality 4.0 – A qualitative global study. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2113737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Jiju Antony
- Department of Industrial & Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Olivia McDermott
- College of Science and Engineering, National University of Ireland, Galway, Ireland
| | - Michael Sony
- WITS Business School, University of Witwatersrand, Johannesburg, South Africa
| | - Aidan Toner
- College of Science and Engineering, National University of Ireland, Galway, Ireland
| | - Shreeranga Bhat
- Department of Mechanical Engineering, St Joseph Engineering College, India
| | | | - Mehran Doulatabadi
- Asia-Pacific Centre for Operational Excellence Research, Johor Bahru, Malaysia
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Ahmad RW, Al Khader W, Jayaraman R, Salah K, Antony J, Swarnakar V. Integrating Lean Six Sigma with blockchain technology for quality management – a scoping review of current trends and future prospects. TQM 2022. [DOI: 10.1108/tqm-06-2022-0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this research is to study and analyze the literature that integrates Lean Six Sigma (LSS) approach with blockchain technology in different sectors for improved quality management.Design/methodology/approachThis study presents a scoping review on the application of integrated LSS and blockchain technology in the manufacturing and healthcare sector. Further, the authors examined existing blockchain-based solutions on a variety of dimensions, including application area, technical approach, methodology, application scenario, various blockchain platforms, purpose, and monitoring parameters. The authors study LSS approaches in detail, as well as the key benefits that blockchain technology can enable. Finally, the authors discuss significant research problems to be addressed in order to develop a highly efficient, resilient, and secure quality management framework using blockchain technology.FindingsIt has been observed that the adoption of blockchain technology for quality management and assurance is influenced by several factors such as transaction execution speed, throughput, latency. Also, prior blockchain-based solutions have neglected to leverage the benefits of LSS methodologies for effective quality management.Originality/valueThis is the first study to explores the influence of blockchain technology on quality management and assurance in manufacturing and healthcare industry. Furthermore, prior research has not examined how integrating the LSS methodology with blockchain technology can aid in the control of product quality management.
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Antony J, Sony M, McDermott O, Swarnakar V, Galli B, Doulatabadi M, Kaul R. An empirical study into the reasons for failure of sustaining operational excellence initiatives in organizations. TQM 2022. [DOI: 10.1108/tqm-05-2022-0176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeOperational excellence (OPEX) initiatives such as Lean, Six Sigma, Lean Six Sigma and Agile have some common characteristics that can be understood through their adoption in organizations. The objective of this research is to present the results of an online survey highlighting the most critical reasons for failure of OPEX initiatives.Design/methodology/approachThis study presents the results of a survey from 106 experts from different countries who have been involved in OPEX implementation. The experts were Six Sigma Master Black Belts, Black Belts and Champions from different manufacturing and service organizations. The developed questionnaire was initially tested with the help of seven experts to ensure their technical validity and soundness.FindingsThe study found 15% of companies surveyed have not adopted any form of OPEX methodology. The top three reasons for non-adoption of OPEX were also found. In terms of the use of various OPEX methodologies, more than 75% of companies were employing Six Sigma and less than 50% were engaged in Lean initiatives. Another surprising result was that less than 5% of the companies were utilizing Kaizen and other continuous improvement methodologies for improving the efficiency and effectiveness of organizational processes. The study further finds top five failure factors for sustaining OPEX initiatives in manufacturing, service, large and small organizations.Research limitations/implicationsThe study reports the outcomes based on an online survey with limited sample size. Moreover, the number of samples from small and medium-sized enterprises (SMEs) was less than 25, and therefore it was difficult to make any robust conclusions in the comparison of failure factors between large enterprises and SMEs.Originality/valueTo the best of the authors’ knowledge, this is the first empirical study that has attempted to explore the reasons for failure of OPEX initiatives. The authors argue that a greater understanding of the reasons for failure of OPEX initiatives can provide an input to develop a framework that can mitigate the failures and costs associated with such failures.
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Bhat S, Antony J, E.V. G, Koul R, Cudney EA, Chakraborty A. A study on critical failure factors of Design for Six Sigma in Indian companies: results from a pilot survey. TQM 2022. [DOI: 10.1108/tqm-03-2022-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeWhile Six Sigma (SS) has been deployed effectively in Indian manufacturing and service sectors as a process improvement methodology, the implementation of Design for Six Sigma (DFSS) for robust product and service development has not shown noticeable results. Therefore, this article aims to determine the critical failure factors (CFFs) of DFSS in the Indian context.Design/methodology/approachThe paper presents the results of a pilot survey on the CFFs of DFSS in Indian companies. The survey participants were specialists in DFSS who have been involved in DFSS projects in their past and present companies. Moreover, the pilot study participants were DFSS Champions, Master Black Belts, Black Belts and Green Belts from the manufacturing and service sectors.FindingsCompany-wide applications of DFSS are very limited in India. Most of the DFSS project failures are reported in the Analyse phase of the project. The results indicated that all 18 CFFs used in the survey have a significant impact on project failures. Also, it was determined that all CFFs are positively correlated with each other. Further, a strong correlation was observed between the voice of the customer (VOC) and project selection and prioritisation. In addition, effective training showed a strong correlation with the right selection of tools.Research limitations/implicationsThe pilot survey was based on a limited sample size. Moreover, the study is confined to only the Indian context and data were collected through the authors' networks. However, respondents were proficient, certified and involved in DFSS project deployment in the manufacturing and service sectors. Therefore, the study's findings are useful and meaningful to draw robust inferences.Originality/valueTo the best of the authors' knowledge, this is the first empirical study conducted in the Indian context to identify the reasons for DFSS project failures. The study's findings can aid academicians and practitioners in comprehending and critically examining the CFFs of DFSS before executing a project. Moreover, the research outcome motivates policymakers to create an ecosystem to effectively adopt DFSS for start-ups and micro, small and medium enterprises (MSME) to ensure a circular economy and support the “Atmanirbhar Bharat” initiative.
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Sahu AK, Sharma M, Raut RD, Sahu AK, Sahu NK, Antony J, Tortorella GL. Decision-making framework for supplier selection using an integrated MCDM approach in a lean-agile-resilient-green environment: evidence from Indian automotive sector. TQM 2022. [DOI: 10.1108/tqm-12-2021-0372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeToday, proficient practices are required to stimulate along various boundaries of the supply chain (SC) to exploit manufacturing resources economically, effectually and gracefully for retaining operational excellence. Accordingly, varieties of paramount practices, i.e. Lean, Agile, Resilient and Green practices, are integrated in present study with the objective to develop a Decision Support Framework (DSF) to select robust supplier under the extent of Lean-Agile-Resilient-Green (LARG) practices for a manufacturing firm. The framework is developed and validated in the Indian automotive sector, where the primary data is collected based on perceptions of the respondents working in an automotive company.Design/methodology/approachLARG metrics can ponder ecological balance, customer satisfaction, associations, effectiveness and sustainability and thus, the study consolidated LARG practices in one umbrella to develop a DSF. The analytical approach under DSF is developed by the integration AHP, DEMATEL, ANP, Extended MOORA and SAW techniques in present study to evaluate a robust supplier under the aegis of LARG practices in SC. DSF is developed by scrutinizing and categorizing LARG characteristics, where the selected LARG characteristics are handled by fuzzy sets theory to deal with the impreciseness and uncertainty in decision making.FindingsThe study has identified 63 measures (15 for Lean, 15 for Agile, 14 for resilient and 19 for Green) to support the robust supplier selection process for manufacturing firms. The findings of study explicate “Internal communication agility”, “Interchangeability to personnel resources”, “Manufacturing flexibility”, “degree of online solution”, “Quickness to resource up-gradation”, “Manageability to demand and supply change”, “Overstocking inventory practices” as significant metrics in ranking order. Additionally, “Transparency to share information”, “Internal communication agility”, “Manufacturing Flexibility”, “Green product (outgoing)” are found as influential metrics under LARG practices respectively.Practical implicationsA technical DSF to utilize by the managers is developed, which is connected with knowledge-based theory and a case of an automobile manufacturing firm is presented to illustrate its implementation. The companies can utilize presented DSF to impose service excellence, societal performance, agility and green surroundings in SC for achieving sustainable outcomes to be welcomed by the legislations, society and rivals. The framework represents an important decision support tool to enable managers to overcome imprecise SC information sources.Originality/valueThe study presented a proficient platform to review the most significant LARG alternative in the SC. The study suggested a cluster of LARG metrics to support operational improvement in manufacturing firms for shifting gear toward sustainable SC practices. The present study embraces its existence in enrolling a high extent of collaboration amongst clients, project teams and LARG practices to virtually eradicate the likelihood of absolute project failure.
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Trakulsunti Y, Antony J, Jayaraman R, Tortorella G. The application of operational excellence methodologies in logistics: a systematic review and directions for future research. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2071695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yaifa Trakulsunti
- Department of Industrial Management Technology and Logistics, Nakhon Si Thammarat Rajabhat University University, Nakhon Si Thammarat, Thailand
| | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Raja Jayaraman
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Guilherme Tortorella
- School of Engineering, University of Melbourne Faculty of Science, Victoria, Australia
- Universidade Federal de Santa Catarina, Florianopolis, Brazil
- Department of Industrial Engineering, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Koemtzi MD, Psomas E, Antony J, Tortorella GL. Lean manufacturing and human resources: a systematic literature review on future research suggestions. Total Quality Management & Business Excellence 2022. [DOI: 10.1080/14783363.2022.2071256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maria D. Koemtzi
- School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Evangelos Psomas
- Department of Business Administration of Food and Agricultural Enterprises, University of Patras, Agrinio, Greece
| | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
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Sony M, Antony J, Mc Dermott O. How do the technological capability and strategic flexibility of an organization impact its successful implementation of Industry 4.0? A qualitative viewpoint. BIJ 2022. [DOI: 10.1108/bij-09-2021-0541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeIndustry 4.0 (I 4.0) consists of numerous digital technologies applied in organizations strategically to add value to the customer. Different organizations have varying degrees of technological capability and strategic flexibility. This paper aims to explore the relationship between technological capability and strategic flexibility on successful implementation of I 4.0.Design/methodology/approachA qualitative study using a grounded theory approach is conducted on 34 senior managers from Europe and North America who have implemented I 4.0 participated in this study through a theoretical sampling frame.FindingsThis study finds that technological capability and strategic flexibility have an impact on the successful implementation of I 4.0. The study also finds that different dimensions of technological capability also impact I 4.0. The interactive effect of strategic flexibility and technological capability is also noted. The study also develops a framework for successful implementation of I 4.0.Practical implicationsThis study can be used by managers while implementing I 4.0 to devise a strategic roadmap for acquiring technological capability with I 4.0 technologies. Besides, it will help the managers to consider the bidirectional relationship between technological capability and strategic flexibility while formulating I 4.0 strategy for successful implementation of I 4.0 in their organizations.Originality/valuePrevious studies have examined the importance of I 4.0 technologies. However, this study extends the previous works by suggesting how technological capability and strategic flexibility can help in the successful implementation of I 4.0.
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Abstract
PurposeThe pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of medical cyber–physical system (MCPS) in the healthcare is one of the means of transforming the landscape of the traditional healthcare service delivery system. The purpose of this study is to critically examine the impact of MCPS on the quality of healthcare service delivery.Design/methodology/approachThis paper uses an evidence-based approach, the authors have conducted a systematic literature review to study the impact of MCPS on healthcare service delivery. Fifty-four articles were thematically examined to study the impact of MCPS on eight characteristics of the healthcare service delivery proposed by the world health organisation.FindingsThe study proposes support that MCPS will positively impact (1) comprehensiveness, (2) accessibility, (3) coverage, (4) continuity, (5) quality, (6) person-centredness, (7) coordination, (8) accountability and (9) efficiency dimension of the healthcare service delivery. The study further draws nine propositions to support the impact of MCPS on the healthcare service delivery.Practical implicationsThis study can be used by stakeholders as a guide point while using MCPS in healthcare service delivery systems. Besides, healthcare managers can use this study to understand the performance of their healthcare system. This study can further be used for designing effective strategies for deploying MCPS to be effective and efficient in each of the dimensions of healthcare service delivery.Originality/valueThe previous studies have focussed on technology aspects of MCPS and none of them critically analysed the impact on healthcare service delivery. This is the first literature review carried out to understand the impact of MCPS on the nine dimensions of healthcare service delivery proposed by WHO. This study provides improved thematic awareness of the resulting body of knowledge, allowing the field of MCPS and healthcare service delivery to progress in a more informed and multidisciplinary manner.
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Lizarelli FL, Chakraborty A, Antony J, Jayaraman R, Carneiro MB, Furterer S. Lean and its impact on sustainability performance in service companies: results from a pilot study. TQM 2022. [DOI: 10.1108/tqm-03-2022-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this empirical research is to understand the application of Lean practices (technical and social) and tools in the service sector, whose implementation is less studied, despite its economic relevance. The study aims to extend previous studies that focused on the relationship between Lean and operational and financial performance, and analyzing the impact on sustainability, encompassing economic, social and environmental perspectives.Design/methodology/approachA pilot survey was conducted with Lean experts in European service companies. The authors have utilized various professional contacts on LinkedIn and a satisfactory response rate was obtained for analysis.FindingsThe results of the study showed that there are several motivating factors for the implementation of Lean, the highlights being improving customer satisfaction, efficiency, delivery and cost reduction. The most frequently used Lean tools are related to the identification of improvement opportunities and causes of problems. The pilot survey also made it possible to identify the greater use of technical practices than social practices. The sustainability performance analysis showed that the better performance of service companies is in the economic dimension.Originality/valueThe authors have identified no empirical studies linking Lean and sustainable performance in the service sector. This study bridges this cognitive gap through a pilot study and therefore makes an original contribution to the current literature.
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Abstract
Healthcare 4.0 is inspired by Industry 4.0 and its application has resulted in a paradigmatic shift in the field of healthcare. However, the impact of this digital revolution in the healthcare system on healthcare service quality is not known. The purpose of this study is to examine the impact of healthcare 4.0 on healthcare service quality. This study used the systematic literature review methodology suggested by Transfield et al. to critically examine 67 articles. The impact of healthcare 4.0 is analyzed in-depth in terms of the interpersonal, technical, environmental, and administrative aspect of healthcare service quality. This study will be useful to hospitals and other stakeholders to understand the impact of healthcare 4.0 on the service quality of health systems. Besides, this study critically analyses the existing literature and identifies research areas in this field and hence will be beneficial to researchers. Though there are few literature reviews in healthcare 4.0, this is the first study to examine the impact of Healthcare 4.0 on healthcare service quality.
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Affiliation(s)
- Michael Sony
- WITS Business School, University of Witwatersrand, Johannesburg, South Africa
| | - Jiju Antony
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Olivia McDermott
- College of Engineering and Science, National University of Ireland, Gallway, Ireland
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Ramadan MA, Al Dhaheri MK, Maalouf M, Antony J, Bhat S, Gijo EV. Application of Six Sigma methodology to enhance the productivity and performance of a hotel in the UAE. TQM 2022. [DOI: 10.1108/tqm-11-2021-0325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PurposeThe 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/approachThe 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.FindingsThe 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 implicationsThe 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/valueAs 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.
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Gupta M, Antony J, Eskildsen JK. Guest editorial. TQM 2022. [DOI: 10.1108/tqm-01-2022-316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Antony J, Sony M, McDermott O, Jayaraman R, Flynn D. An exploration of organizational readiness factors for Quality 4.0: an intercontinental study and future research directions. IJQRM 2021. [DOI: 10.1108/ijqrm-10-2021-0357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Quality 4.0 incorporates the role of automation and digitization and provides competitive advantage for organizations by enhancing customer experience and increase profitability. The purpose of this study is to critically examine the organizational readiness factors for the successful implementation of Quality 4.0 implementation and assess their importance.Design/methodology/approach This study applies a quantitative research methodology to examine readiness factors of Quality 4.0 in organizations by 147 senior management professionals in various organizations including manufacturing and service companies in America, Asia and Europe participated through an online survey.FindingsThe readiness factors for Quality 4.0 were critically ranked amongst manufacturing and service organizations by senior management professionals from three continents. Five significant reasons for non-adoption of Quality 4.0 were lack of resources, inability to link Quality 4.0 with the corporate strategy and objectives, lack of understanding of benefits, high initial investment and the current quality management strategy and methods are already delivering good results hence unsure of the need for Quality 4.0. The handling of big data in quality management was the most important factor for adopting Quality 4.0, irrespective of the size and nature of the organization. More accuracy and less errors and improved decision-making the factors of adopting Quality 4.0 in service sector were not significant for manufacturing sector. Small and medium-sized enterprises (SMEs) reported that costs and time savings over the long run were not so significant.Practical implications This study is focussed on the significance of pros and cons of adopting Quality 4.0 in organizations. Senior managers in both large and SMEs can benefit immensely from understanding before investing heavily towards implementing Quality 4.0. The importance of identified organizational readiness factors for the successful adoption of Quality 4.0 can be used as indicators to understand how ready an organization is to implement Quality 4.0. The top three readiness factors for the successful adoption of Quality 4.0 were identified as: top management commitment, leadership and organizational culture. Improved understanding of the readiness factors can be highly beneficial to senior quality professionals in both manufacturing and service companies in the journey towards successful implementation of Quality 4.0.Originality/value This is the first empirical study on assessing Quality 4.0 readiness factors at an intercontinental level and therefore serves as a foundation for many future studies. The study provides a theoretical foundation for the Quality 4.0 in terms of organizational readiness for successful adoption and overcoming implementation challenges. During the planning, implementation and progress review of Quality 4.0, review the readiness factors while planning and resourcing a Quality 4.0 implementation strategy to ensure effective performance.
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Hundal GS, Thiyagarajan S, Alduraibi M, Laux CM, Furterer SL, Cudney EA, Antony J. The impact of Lean Six Sigma practices on supply chain resilience during COVID 19 disruption: a conceptual framework. Total Quality Management & Business Excellence 2021. [DOI: 10.1080/14783363.2021.2014313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gaganpreet Singh Hundal
- Department of Computer and Information Technology, Purdue University, West Lafayette, IN, USA
| | | | - Manal Alduraibi
- Department of Computer and Information Technology, Purdue University, West Lafayette, IN, USA
| | - Chad Matthew Laux
- Department of Computer and Information Technology, Purdue University, West Lafayette, IN, USA
| | - Sandra L. Furterer
- Department of Engineering Management, Systems and Technology, University of Dayton, Dayton, OH, USA
| | | | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
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Stuart MJ, Antony J, Withers TK, Ng W. Systematic review and meta-analysis of external ventricular drain placement accuracy and narrative review of guidance devices. J Clin Neurosci 2021; 94:140-151. [PMID: 34863429 DOI: 10.1016/j.jocn.2021.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Insertion of external ventricular drain (EVD) is one of the most common neurosurgical procedures performed worldwide. This is generally performed freehand, on the basis of anatomical landmarks. There is significant variability in the reported accuracy of freehand placement, lacking Level I evidence. We present the first meta-analysis of freehand EVD placement accuracy and technologies or techniques to enhance accuracy. METHODS We report a systematic review of the Pubmed, Embase, and Cochrane Central databases according to MOOSE (Meta-analysis Of Observational Studies) guidelines. 37 studies were included for qualitative analysis and 19 studies (2983 cases) for quantitative analysis. RESULTS There is substantial heterogeneity in the outcome measures used to report EVD placement accuracy. Of those nineteen studies reporting accuracy using the Kakarla grading system the mean rate of ideal ipsilateral frontal horn placement was 73% (standard deviation ±7%). The use of formal stereotaxic guidance is consistently reported to improve accuracy to >90%, although with variable outcome measures. However, the reported efficacy of other guidance devices or techniques is highly variable. The quality of studies directly comparing all existing non-stereotaxic devices with freehand EVD placement is poor and precludes any assertion of superiority to freehand insertion. CONCLUSIONS We provide the first meta analysis of freehand placement accuracy. There is insufficient data to perform a meta-analysis of the relative efficacy of interventions to improve accuracy. Qualitative synthesis of reports of stereotaxic guidance is suggestive of higher accuracy than freehand placement.
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Affiliation(s)
- M J Stuart
- Department of Neurosurgery, Townsville University Hospital, QLD 4814, Australia; School of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia.
| | - J Antony
- Department of Neurosurgery, Gold Coast University Hospital, QLD 4215, Australia; School of Medicine, University of Queensland, St Lucia, QLD 4072, Australia
| | - T K Withers
- Department of Neurosurgery, Gold Coast University Hospital, QLD 4215, Australia; School of Medicine, Griffith University, QLD 4215, Australia
| | - W Ng
- Department of Neurosurgery, Gold Coast University Hospital, QLD 4215, Australia; School of Medicine, Griffith University, QLD 4215, Australia
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Noronha A, Bhat S, Gijo E, Antony J, Laureani A, Laux C. Performance and service quality enhancement in a healthcare setting through lean six sigma strategy. IJQRM 2021. [DOI: 10.1108/ijqrm-07-2021-0226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Antony J, Swarnakar V, Cudney E, Pepper M. A meta-analytic investigation of lean practices and their impact on organisational performance. Total Quality Management & Business Excellence 2021. [DOI: 10.1080/14783363.2021.2003194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Vikas Swarnakar
- Department of Mechanical Engineering, National Institute of Technology, Raipur 492010, Chhattisgarh, India
| | - Elizabeth Cudney
- John E. Simon School of Business, Maryville University, St. Louis, MO, USA
| | - Matthew Pepper
- School of Business, University of Wollongong, Wollongong, Australia
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Puram P, Sony M, Antony J, Gurumurthy A. A conceptual framework for a systemic understanding of barriers during lean implementation. TQM 2021. [DOI: 10.1108/tqm-09-2021-0261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Multiple organisations which have attempted to implement lean production/manufacturing/thinking have failed to achieve significant benefits. Practitioners and researchers have identified the barriers that hinder successful implementation. This study first consolidates such lean implementation barriers that are common across all industry sectors. Further, a systemic understanding of lean barriers is attempted by determining causal relationships between barriers and their relative causal strength.
Design/methodology/approach
Barriers to lean implementation were first identified from extant literature and categorised into broad barrier groups. These barrier groups were classified into four categories as specified by Liker's 4P model of lean–philosophy, people and partnership, processes and problem-solving. Additionally, interrelations between barriers, both within and among these four categories were determined.
Findings
The barriers classified under philosophy were the most critical as it affects the barriers in other groups. Similarly, barriers such as lack of leadership and top management commitment, lack of resources, shortage of lean consultants and trainers, lack of systemic understanding of lean and the need for its implementation, lack of lean expertise and training were found to be the most critical causal barriers.
Research limitations/implications
Highly critical barriers in terms of causality should be addressed with high priority, as effective measures against them may eliminate or reduce the impact of other barriers.
Originality/value
This study addresses the confusion regarding the high number of lean barriers in extant literature by providing a systemic understanding of the same. By exploring the interrelations among barriers, the most important causal barriers and barrier types (4Ps) are identified, the knowledge of which could improve lean implementation success. This is a novel attempt in the domain of lean.
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Antony J, Sony M, Furterer S, McDermott O, Pepper M. Quality 4.0 and its impact on organizational performance: an integrative viewpoint. TQM 2021. [DOI: 10.1108/tqm-08-2021-0242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Quality 4.0 is managing quality during the fourth industrial revolution. It is used by modern-day organizations as a strategy to compete and thrive in the marketplace. The purpose of this study is to analyze the potential impact of Quality 4.0 on organizational performance.
Design/methodology/approach
This study through an integrative literature review critically analyzed 41 previous literature articles to study the impact of Quality 4.0 on various metrics of organizational performance.
Findings
The results of the review suggest that Quality 4.0 may have an impact on financial performance, customer value proposition, internal business processes, learning and growth, environmental performance and social performance.
Research limitations/implications
This study is limited by the databases reviewed. The second limitation is that this study considered articles published in the English language. Therefore, articles published in other languages were not considered in this study.
Practical implications
Organizations can use the findings of this study to strongly leverage the implementation of Quality 4.0 to reach their strategic objectives and improve competitive advantage.
Originality/value
This is the first study to explore the impact of Quality 4.0 on organizational performance through an integrative literature review.
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Antony J, Sony M, McDermott O, Furterer S, Pepper M. How does performance vary between early and late adopters of Industry 4.0? A qualitative viewpoint. IJQRM 2021. [DOI: 10.1108/ijqrm-05-2021-0134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Industry 4.0 is a new trend among organizations. Some organizations have been early adopters or later adopters of Industry 4.0. The purpose of this paper is to investigate how performance effects vary between early and late adopters of Industry 4.0.
Design/methodology/approach
This study applies a qualitative research methodology using grounded theory. 14 senior management professionals who have implemented Industry 4.0 participated in this study through a theoretical and snowball sampling approach. These professionals were from manufacturing and service sectors, from North America, Europe and Asia. The study used semi structured open-ended interviews to capture the organizational performance on operational, financial, environmental and social dimensions.
Findings
The findings were analyzed in terms of four broad themes which emerged from the interviews. In operational performance the operational and implementation cost will be higher for early adopters. The late adopters may enjoy the advantage in terms of improved business models. In terms of financial performance, the early adopters may see a marginal increase in profit and increased stock price compared to late adopters. The performance on the environmental dimension will see early adopters enjoying material efficiency, energy savings and an improved image of the company compared to late adopters. In social performance, the early adopters will provide a better quality of work life, safer manufacturing environment. However, the resistance from labor unions will be higher for early adopters compared to late adopters.
Practical implications
Organizations must decide the timing of implementation of Industry 4.0. This study will act as a guide wherein they can decide to be an early adopter or late adopter based on knowledge of the resulting performance consequences.
Originality/value
This is the first paper that studies the performance effects of early versus late adopters of Industry 4.0.
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Antony J, Scheumann T, Sunder M. V, Cudney E, Rodgers B, Grigg NP. Using Six Sigma DMAIC for Lean project management in education: a case study in a German kindergarten. Total Quality Management & Business Excellence 2021. [DOI: 10.1080/14783363.2021.1973891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Tim Scheumann
- School of Social Sciences, Edinburgh Business School, Heriot-Watt University, Edinburgh, UK
| | | | | | - Bryan Rodgers
- Edinburgh Business School, Heriot-Watt University, Edinburgh, UK
| | - Nigel P. Grigg
- Department of Operations and Engineering Innovation, Massey University, Palmerston North, New Zealand
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Taha O, Mazzuchi TA, Sarkani S, Antony J, Furterer S. Uncovering inefficiencies in the workers’ compensation industry using Lean methodology. TQM 2021. [DOI: 10.1108/tqm-06-2021-0163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to apply Lean in the workers’ compensation industry. It focuses on identifying patterns of repetitive non-value-added transnational activities for physical-therapy patients and healthcare providers. It addresses the research gap in this field.
Design/methodology/approach
In this study, we designed and deployed multiple case studies to better understand the journey of an injured worker within the worker compensation system in the United States of America. We partnered with Concentra Inc., a leading national healthcare provider in the field of workers’ compensation having 520 medical centers in 44 states. Both case studies included conducting direct observations, Gemba walk, in five clinics in two states: Florida and Pennsylvania. We analyzed the data of 263 injured workers with 8 or more physical therapy visits who got admitted to Concentra clinics in both states over the period of 31 days.
Findings
The results revealed that the time intervals at which activities associated with physical therapy treatment pre-authorization accounted for 91.59% of the total non-value-added activities and are thus the key administrative factor leading to process inefficiency in the state of Florida. The Process Cycle Efficiency of Pennsylvania was 75.36% compared to 53.16% of Florida. The injured workers in Florida needed 39.58 days on average to complete eight physical therapy visits compared to 27.92 days in Pennsylvania (a median of 34.09 vs 22.15 days).
Research limitations/implications
This study is limited as it only focuses on processes on the healthcare provider side. An expanded value stream map that includes the treatment pre-authorization process on the insurance side would be beneficial for generating more potential solutions to streamline the process.
Practical implications
This study shows that Lean could play a critical role in identifying and quantifying continuous improvement opportunities that could accelerate patient’s treatment, reduce administrative burden on healthcare providers and improve the overall claim cost of insurance companies. It provides data-driven argument for insurance companies to consider eliminating physical therapy pre-authorization.
Originality/value
This is the first study to apply Lean methodology in the workers’ compensation field.
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McAdam R, Galbraith B, McComb S, Antony J, Vijaya Sunder M. Development of Sustainable Lean Patient Value in Healthcare: A Long-Term Condition Context. Total Quality Management & Business Excellence 2021. [DOI: 10.1080/14783363.2021.1964357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rodney McAdam
- Ulster University Business School, Ulster University, Jordanstown, UK
| | - Brendan Galbraith
- Ulster University Business School, Ulster University, Jordanstown, UK
- College of Business, Zayed University, Abu Dhabi, UAE
| | - Stephen McComb
- Ulster University Business School, Ulster University, Jordanstown, UK
| | - Jiju Antony
- Edinburgh Business School, Heriot-Watt University, Edinburgh, UK
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Antony J, McDermott O, Sony M. Quality 4.0 conceptualisation and theoretical understanding: a global exploratory qualitative study. TQM 2021. [DOI: 10.1108/tqm-07-2021-0215] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PurposeQuality 4.0 has a unique potential to create a competitive advantage for organisations by improving customer experience and enhancing profitability. The purpose of this study is to examine Quality 4.0, the9; benefits, motivating factors, critical success factors and the skills required by quality professionals in the successful implementation of Quality 4.0. The study also investigates the organisational readiness factors9 and challenges that need to be addressed before Quality 4.0 adoption and assess their importance.Design/methodology/approachA qualitative interview approach was utilised by interviewing a panel of senior management, engineering and continuous improvement (CI); professionals working in leading companies in Asia, Europe and America who are currently deploying Quality 4.0.FindingsThis study provides a theoretical base for the Quality 4.0 body of knowledge in terms of an organisation’s adoption and overcoming implementation challenges and providing examples of Quality 4.0 application. Organisations can use this study to understand what Quality 4.0 means to industry, the benefits and motivating factors for implementing, the Critical Success Factors, challenges, the organisational readiness factors and the role of leadership in a Quality 4.0 deployment. In addition, the study looks at the skills required by future Quality 4.0 professionals in terms of hard skills, soft skills and a curriculum for educating future quality management professionals. The respondents cited that predictive analytics, sensors and tracking, and electronic feedback loops are the most critical technologies for driving Quality 4.0.Research limitations/implicationsOne of the limitations of this research was that as this area is a nascent area the researchers were limited in their literature review. The second limitation was that the study was based on 12 interviews. A more comprehensive longitudinal study would yield more data so that better and robust conclusions can be derived from the study.Originality/valueThis is the first empirical study on Quality 4.0, which captures the viewpoints of senior management professionals on a full range of topics related to Quality 4.0 motivation for deployment, implementation and readiness for its adoption.
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Alexander P, Antony J, Cudney E. A novel and practical conceptual framework to support Lean Six Sigma deployment in manufacturing SMEs. Total Quality Management & Business Excellence 2021. [DOI: 10.1080/14783363.2021.1945434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Paul Alexander
- School of Social Sciences, Edinburgh Business School, Heriot Watt University, Edinburgh, UK
| | - Jiju Antony
- Department of Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Elizabeth Cudney
- John E. Simon School of Business, Maryville University, St. Louis, MO, USA
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Antony J, Sony M, McDermott O. Conceptualizing Industry 4.0 readiness model dimensions: an exploratory sequential mixed-method study. TQM 2021. [DOI: 10.1108/tqm-06-2021-0180] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeOrganizations use Industry 4.0 readiness models to evaluate their preparedness prior to the implementation of Industry 4.0. Though there are many studies on Industry 4.0 readiness models, the dimensions of readiness differ. Besides, there is no study empirically validating the readiness model in different sectors or types of organization. The purpose of this study is to conceptualize the dimensions of the Industry 4.0 readiness model and subsequently evaluate the criticality of these dimensions in manufacturing, service, small and medium-sized enterprises (SMEs) and large enterprises (LEs).Design/methodology/approachThe study uses an exploratory sequential mixed method design. In phase one, 37 senior managers participated through a purposive sampling frame. In phase two, 70 senior managers participated in an online survey.FindingsThe results of the study indicated that the Industry 4.0 readiness model has 10 dimensions. Further, the criticality of the dimensions as applied to different sectors and type of organizations is put forward. This study will help manufacturing, services, SMEs and LEs to evaluate Industry 4.0 readiness before commencing the deployment of Industry 4.0.Practical implicationsThe findings can be very beneficial for Industry 4.0 practitioners and senior managers in different organisations to understand what readiness dimensions need to be considered prior to implementation of Industry 4.0 technology.Originality/valueThis paper makes an attempt to conceptualize the Industry 4.0 readiness model and utilizes an exploratory mixed method for critically evaluating the dimensions related to the model.
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Jach P, Antony J, Thomson SP, Cudney B, Furterer S. Voice of the customer as a tool for service quality analysis in public transport. TQM 2021. [DOI: 10.1108/tqm-05-2021-0134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore the voice of the customer (VOC) of public transport (PT) users and non-users and to identify the role VOC plays in PT service quality analysis and improvement practices.
Design/methodology/approach
This research is based on quantitative and qualitative data collection. Quantitative data were collected through two questionnaires; the first is based on ranking data: 192 responses and the second on the Kano model: 46 responses. The qualitative data was obtained through 10 semi-structured interviews with senior management from seven bus companies in the UK.
Findings
Findings indicate that VOC differs between PT users and non-users and compared with the perspectives of PT Providers. The research also revealed that VOC plays a crucial role in PT service quality improvement (QI).
Practical implications
The findings can be used by PT service providers to better understand the VOC of PT users and non-users, which will assist in strategic and QI decision-making. Furthermore, an in-depth study of VOC in PT is provided, which progresses the academic field on this topic and advances research in this area.
Originality/value
This research brings new insight into the most important quality attributes for PT users and non-users. Moreover, the paper fundamentally contributes to the literature, which until now had severely limited input pertaining to the role of VOC in PT and little knowledge of service QI tools and practices in this sector.
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Bouranta N, Psomas E, Antony J. Human factors involved in lean management: a systematic literature review. Total Quality Management & Business Excellence 2021. [DOI: 10.1080/14783363.2021.1936481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Nancy Bouranta
- Department of Business Administration of Food and Agricultural Enterprises, School of Economics & Business, University of Patras, Agrinio, Greece
| | - Evagelos Psomas
- Department of Business Administration of Food and Agricultural Enterprises, School of Economics & Business, University of Patras, Agrinio, Greece
| | - Jiju Antony
- School of Social Sciences, Heriot-Watt University, Edinburgh, UK
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Maheshwari R, Sankaralingam R, Chinnadurai S, Antony J, Chilukuri B, Mani M. POS1397 HYDROXYCHLOROQUINE INDUCED RETINAL TOXICITY IN PATIENTS WITH RHEUMATIC DISEASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Retinal toxicity from hydroxychloroquine (HCQ) is rare, but the vision loss maybe irreversible and could have medicolegal consequences.Objectives:To determine the prevalence and assess the predictors of retinal toxicity due to HCQ in patients with rheumatic diseases. There is paucity of literature on retinal toxicity due to HCQ in rheumatic diseases.Methods:A retrospective observational study was conducted in the Department of Clinical Immnuology and Rheumatology, Sri Ramachandra Institute of Higher Education and Research,Chennai, India from November 2018-May 2020, on patients taking HCQ for more than 6 months. All patients underwent ophthalmological screening at baseline and every 6 months, and thereafter by modern day screening methods-Humphrey Visual Field (HVF)10-2, Spectral Domain Optical Coherence Tomography(SD-OCT), except for patients with evidence of suspected retinal toxicity at baseline.Fundus autofluorescence (FAF) was done in feasible patients.Results:9 out of 743(1.2%) patients were identified to have retinal toxicity, detected via fundus examination (n=9), SD-OCT (n=8/9), HVF 10-2 (n=6/9), FAF (n=1/9). 55.5% (n=5/9) had Rheumatoid Arthritis(RA) and 44.4% (n=4/9) had Systemic Lupus Erythematosus(SLE) as their primary diagnosis. 77.7% (n=7/9) were females. The mean age was 47.5 years (20-72 years).75%(n=3/4) of SLE patients were below 30 years of age. The average daily and cumulative dose of HCQ in these 9 patients were 244 mg (200-400mg) and 311.22g(73-730g)respectively, whereas the mean recommended dose as per real body weight was 287.2mg/day. Average duration of HCQ consumption was 3.6 years (1-10 years).Only 11.1% (n=1/9) had presented with visual complaints of black floaters.Conclusion:The asymptomatic nature of this irreversible toxicity, warrants frequent screening.Retinal toxicity was not age-related.Toxicity was manifested at low daily and cumulative doses.Screening should be done atleast every 6 months by fundus examination.Objective tests like HVF and SD-OCT should be done annually, especially in patients with underlying rheumatic diseases.The early manifestation of retinal toxicity in young SLE patients could have a genetic association and needs further evaluation.References:[1]Mortada A Abozaid et al. hydoxychloroquine retinopathy in a ohort of patients from upper Egypt.Journal of Egyptioan Ophthalmological Society 2017;110:110-113[2]Roy AN,Samala V,Kumar YA,Fatima SS.Assessing the risk of retinopathy in Indian patients using hydroxychloroquine for rheumatic and musculoskeletal Diseases:A Retrospective Observational Study.Indian J Rheumatol 2020.Disclosure of Interests:None declared
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Antony J, Sankaralingam R, Maheshwari R, Chilukuri B, Chinnadurai S. AB0235 RITUXIMAB (BIOSIMILAR) IN RHEUMATOID ARTHRITIS: CLINICAL & IMMUNOLOGICAL RESPONSE TO VARYING DOSES- EXPERIENCES FROM A TERTIARY CARE CENTER IN SOUTH INDIA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Rituximab (RTX) is a chimeric monoclonal antibody against CD20. There is a paucity of studies done with RTX biosimilars. This is a Retrospective and Observational study from January 2018 to December 2019 done in the Department of Clinical Immunology & Rheumatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.Objectives:1.To find the effects of varying doses of RTX in attaining clinical remission in RA.2.To find if CD19, CD20 & IgG help in identifying impending flare & if these levels help in deciding the timing of the next dose of RTX.Methods:Rheumatoid arthritis (RA) cases who were given Rituximab from January 2018 were selected. Clinical Response at 6 & 12 months & wherever feasible at 18 & 24 months was assessed by Simplified Disease Activity index (SDAI). RTX initial dose was given at 0 and 14 days followed by fixed dose at six months interval.CD19, CD20 B cell count, IgG levels were tested in patients in whom it was feasible at baseline & 6 months (select patients at 12,18 &24 months). Patients were divided in to 5 groups (DMARD naïve, DMARD resistant & Interstitial Lung disease (ILD) [Lung involvement>20% in Computed Tomography (CT)]) and (500mg & 1g). Patients were divided into three clinical groups, (DMARD naïve, DMARD resistant & Interstitial Lung disease (ILD) [Lung involvement>20% in Computed Tomography (CT)]) and two treatment groups (500mg & 1g) based on clinical indication for RTX and dose of RTX, respectively. In patients with ILD, CT scan & FVC were compared at baseline & 12 months.Results:29 patients (seropositive 28 (RF/Anti CCP/BOTH+VE), seronegative 1) were given RTX for RA over a 2-year period of which 12 had CD19, CD20 & IgG tested. Mean SDAI reduction from baseline to 6 months post treatment was 30%, 32% & 14% while complete remission (SDAI<3.3) was attained in 100%, 18% & 20% in DMARD naïve, DMARD resistant & ILD groups, respectively. CD19, CD20 & IgG reduced from 18.6%, 18.4% & 18.53g/L to 3.7%,3.7% & 9.7g/L respectively FVC improved from 62.4% to 67% at 12. The percentage of patients with lung involvement >20% reduced from 53.3% to 46.7%. Flare was observed in one patient who received 500mg RTX. CD19, CD20 & IgG levels increased from 7.9%, 8% & 9.8g/L to 27%, 25% & 13g/L respectively. 3 patients in the 1g group were followed up at 12,18 & 24 months. In these patients there were no flares or worsening symptoms. 1 patient was double negative for RF & Anti CCP and this patient did not attain clinical remission even after 2 doses of 1g RTX.Conclusion:[1]Patients with early arthritis (diagnosis made within 1 year) and who were DMARD naïve had an excellent response to Rituximab.[2]Complete remission was observed in more patients the 1g compared to 500mg group.[3]Reduction in CD19 & CD20 was associated with significant reduction in the SDAI score.[4]There was no significant reduction of CD19 & CD20 with 500mg dose of Rituximab where either a partial remission or mild flare was observed.[5]There was reduction in the lung involvement to less than 20%(CT) in few patients with 1g dose.[6]Double negative Rheumatoid arthritis poorly responded to Rituximab.[7]The positive effects of 1g Rituximab could be noted up to 24 months.[8]Flare of RA was associated with significant increase in CD19 & CD20.Disclosure of Interests:None declared
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Maheshwari R, Sankaralingam R, R R, Chinnadurai S, Chilukuri B, Mani M, Antony J. AB0773 PATTERN OF MACROPHAGE ACTIVATION SYNDROME IN RHEUMATIC DISEASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Macrophage activation syndrome (MAS) is a rare, potentially fatal condition complicating autoimmune diseases, as their initial manifestation or during its course.Objectives:To describe the pattern of MAS and its salient features in patients with rheumatic diseases.Methods:A retrospective observational study was conducted in 16 patients diagnosed with MAS, due to rheumatic diseases in Department of Rheumatology, SRIHER, Chennai from January 2018-December 2020.Results:The primary diseases were Systemic Lupus Erythematosus(SLE) in 75%(n=12),Adult Onset Still Disease(AOSD) in18.7%(n=3) and Kikuchi Disease in 6.25%(n=1). 50%(n=8) presented with MAS as the initial manifestation.Others had a known rheumatic disease with an average duration of 6.5 years.Occult MAS was seen in 25%(n=4). The most frequent clinical features were unremitting fever(n=15) and splenomegaly(n=15).All had hyperferritinemia-mean of 2971.10 ng/mL(531-12536).Sub group analysis showed significant hypofibrinogenemia(129.8 vs 200.62 mg/dl) in patients presenting with MAS as their initial manifestation.Transaminitis(666/252.5 vs 243/217.62 U/L), hypertriglyceridemia(316 vs 275.8 mg/dl), high LDH(2490 vs 938.75) were more severe in this group, but not significant.All with SLE had increased disease activity, with 50%(n=8) having SLEDAI 2K of ≥15.Bone marrow aspiration showed haemophagocytes in 81.25%(n=13).H score of >169 was seen in 93.75%(n=15). Infection was the commonest trigger for MAS(n=9)-bacterial(n=5), viral(n=4), fungal(n=1) and mycobacterial(n=2),followed by parturition(n=1).All patients were managed with pulse steroids followed by intravenous cyclophosphamide(n=8), rituximab(n=2), mycophenolate mofetil(n=2) in SLE, tocilizumab(n=2) and etoposide(n=1) in AOSD.Mortality rate was 18.75%(n=3).Conclusion:Spectrum of MAS in rheumatic diseases could be occult, associated with infection,high disease activity,or lead to mortality. High index of clinical suspicion is required, due to overlap of features like fever, cytopenias and organomegaly in MAS & SLE.Hyperferritinemia, high LDH, & transaminitis could aid in differentiating & early diagnosis. New criteria for rheumatic diseases,including these parameters are needed, especially in resource-limited settings where sIL-2Rα & NK cell activity tests are not feasible.References:[1]Stuart J.Carter et al. Macrophage activation syndrome in adults:Recent advances in pathophysiology, diagnosis and treatment. Rheumatology 2019;58;5-17[2]Ai-Chun Liu et al.Macrophage activation syndrome in systemic lupus erythematosus:a multicentre,case-control study in China.Clin Rheumatol 2017.Table 1.MAS-SALIENT FEATURESFEATURESINITIAL MANIFESTATIONS [n=8]KNOWN RHEUMATIC DISEASES[n=8]P VALUE(<0.05)Primary rheumatic diseasesSLE5(62.5%)7(87.5%)-AOSD2(25%)1(12.5%)Kikuchi disease1(12.5%)0Fever8(100%)7(87.5%)0.30Respiratory2(25%)5(62.5%)0.13Neurological1(12.5%)4(50%)0.10Bleeding2(25%)1(12.5%)0.52Splenomegaly8(100%)7(87.5%)0.30Hepatomegaly6(75%)3(37.5%)0.13Haemoglobin(g/dl)8.58(5.4-11.7)8.2(5.2-11.5)0.70WBC count(/μL)5550(1000-11800)3477.5(1200-6200)0.19Platelet count(x 109/l)1.41(0.30-2.4)1.35(0.32-1.8)0.90ESR(mm/hr)76.75(42-137)68(20-127)0.65AST(U/L)666(36-3481)257.75(45-642)0.36ALT(U/L)252.5(18-790)217.62(28-1044)0.82LDH(U/L)2490.12(164-16,000)938.75(357-1569)0.44Ferritin(ng/ml)2187.46(532-7500)3754.75(531-12536)0.37Triglycerides(mg/dl)316(53-551)275.8(160-317)0.52Fibrinogen(mg/dl)129.8(76-178)200.62(140-292)0.009Complement 3(mg/dl)39.14(13-60)[n=5]57.72(32-95)[n=7]0.16Complement 4(mg/dl)4.24(1.2-6)[n=5]14.22(2.8-34)[n=7]0.07Anti dsDNA antibodies[ELISA] IU/ml596.2(90-1151)[n=5]316.82(10-800)[n=7]0.26MAS-Macrophage activation syndrome,WBC-white blood cell,ESR-erythrocyte sedimentation rate,AST-aspartate aminotransferase, ALT-alanine aminotransferase, LDH-lactate dehydrogenase, dsDNA-double standed deoxyribonucleic acidDisclosure of Interests:None declared
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Noronha A, Bhat S, Gijo E, Antony J, Bhat S. Application of Lean Six Sigma in conservative dentistry: an action research at an Indian dental college. TQM 2021. [DOI: 10.1108/tqm-03-2021-0078] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PurposeThe article evaluates the obstacles, lessons learned and managerial implications of deploying Lean Six Sigma (LSS) in a dental college hospital in India.Design/methodology/approachThe work adopts the action research (AR) methodology to establish a case study, which is carried out using the LSS define–measure–analyze–improve–control (DAMIC) approach in a dental college. It uses LSS tools to enhance the productivity and performance of the Conservative Dentistry Department of a dental college and to unravel the obstacles and success factors in applying it to the education and healthcare sector together.FindingsThe root cause for high turn-around time (TAT) is ascertained using LSS tools and techniques. The effective deployment of the solutions to the root causes of variation assists the dental college to reduce the TAT of the Conservative Dentistry process from an average of 63.9 min–36.5 min (i.e. 42.9% improvement), and the process Standard Deviation (SD) was reduced from 2.63 to 2 min. This, in turn, raises the sigma level from 0.48 to 3.23, a noteworthy successful story for this dental college.Research limitations/implicationsWhile the results and recommendations of this research are focused on a single case study, it is to be noted that the case study is carried out with new users of LSS tools and techniques, especially with the assistance of interns. This indicates the applicability of LSS in dental colleges; thus, the adopted modality can be further refined to fit India's education and hospital sector together.Originality/valueThis article explains the implementation of LSS from an aspiring user viewpoint to assist dental colleges and policymakers in improving competitiveness. In addition, the medical education sector can introduce an LSS course in the existing programme to leverage the potential of this methodology to bring synergy and collaborative research between data-based thinking and the medical field based on the findings of this study. The most important contribution of this article is the illustration of the design of experiments (DOE) in the dental college process.
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Antony J, McDermott O, Sony M, Cudney EA, Snee RD, Hoerl RW. A study into the pros and cons of ISO 18404: viewpoints from leading academics and practitioners. TQM 2021. [DOI: 10.1108/tqm-03-2021-0065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper aims to present and summarise the arguments for and against the ISO 18404 standard and the perceived advantages and disadvantages of implementing it.Design/methodology/approachA qualitative interview approach was utilised by interviewing a panel of leading academics and practitioners familiar with Lean Six Sigma.FindingsThe results indicate that Lean Six Sigma professionals have conflicting opinions on ISO 18404. An overwhelming majority of the panel questioned the “quality” of the standard and whether it is “fit for purpose”, while others see the advantages of a common standard in helping continuous improvement deployment.Research limitations/implicationsAs the standard has not been widely adopted, there were limited examples on ISO 18404 discussion in the literature. Much of the current literature focuses on the theoretical application of the standard, with sparse practical examples providing case study deployment. Also, the interviews were short and at a high level. There is an opportunity for further study and analysis. It was difficult to find qualified interviewees who were familiar with the standard. A very real constraint when conducting research into ISO 18404 is to obtain a balanced view of the standard from those who have a vested interest in its continuation and evolution, or not.Originality/valueThe paper provides a resource for people to obtain insight into the value or non-value add of a standard in Lean Six Sigma and the appropriate details of such a standard. These results can form the basis of a case for the implementation of the standard for those organisations currently trying to decide whether to implement it or not.
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Barclay RC, Cudney EA, Shetty S, Antony J. Determining critical success factors for lean implementation. Total Quality Management & Business Excellence 2021. [DOI: 10.1080/14783363.2021.1894919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Sushil Shetty
- Global Continuous Improvement Manager, Entegris, Round Rock, TX, USA
| | - Jiju Antony
- Edinburgh Business School, Heriot Watt University, Edinburgh, UK
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Abstract
PurposeCOVID-19 has changed life as we know. Data are scarce and necessary for making decisions on fighting COVID-19. The purpose of this paper is to apply Six Sigma techniques on the current COVID-19 pandemic to distinguish between special cause and common cause variation. In the DMAIC structure, different approaches applied in three countries are compared.Design/methodology/approachFor three countries the mortality is compared to the population to distinguish between special cause variation and common cause variation. This variation and the patterns in it are assessed to the countries' different approaches to COVID-19.FindingsIn the DMAIC problem-solving approach, patterns in the data are distinguished. The special cause variation is assessed to the special causes and approaches. The moment on which measures were taken has been essential, as well as policies on testing and distancing.Research limitations/implicationsCross-national data comparisons are a challenge as countries have different moments on which they register data on their population. Furthermore, different intervals are taken, varying from registering weekly to registering yearly. For the research, three countries with similar data registration and different approaches in fighting COVID-19 were taken.Originality/valueThis is the first study with Master Black Belts from different countries on the application of Six Sigma techniques and the DMAIC from the viewpoint of special cause variation on COVID-19.
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