The concept of Statistical process control (SPC) was given by the physicist Walter Shewhart in order to improve the industrial manufacturing. The SPC was firstly applied in laboratory and after then shifted to patient level in hospitals. As there is more involvement of human in healthcare, the chances of errors are also more. SPC i.e., control chart can help in determining the source of errors by identifying the special and common causes of variations. This paper presents the review of literature on the application of SPC and control chart in healthcare sector. Forty articles are selected out of 142 potentially relevant searched studies. Selected studies are categorised into eight departments. Literature survey shows that most of work on control chart applications in healthcare is carried out in Surgery, Emergency and Epidemiology departments. US, UK and Australia are the main customers where maximum amount of work was done. The US is the country where control chart in healthcare sector have been used at regular interval. This shows the gap of deploying control chart in different departments and different countries as well. The CUSUM and EWMA chart came into picture in healthcare sector after 2008 and are used at regular interval.

Purpose The purpose of this paper is to implement Six Sigma approach to decrease the length of stay (LOS) of neonatal jaundice patients in an Indian government rural hospital situated in northern hill region. Design/methodology/approach Six Sigma’s Define–Measure–Analyse–Improve–Control procedure is applied in order to decrease the LOS of neonatal jaundice patients. The mean and standard deviation have been computed as 34.53 and 20.01 h, respectively. The cause and effect diagram is used in the “Analyse” phase of the Six Sigma. The regression analysis and GEMBA observation techniques are used to validate the causes identified through cause and effect diagram. Findings The waiting time for registration, waiting time for tests, waiting time for phototherapy and time for discharge implementation are the main factors that are responsible for longer LOS. Based on the identified root causes, some recommendations are suggested to the hospital administration and staff members in order to reduce the LOS. Research limitations/implications The present research is limited to provide recommendations to the hospital administration to reduce LOS and it entirely depends upon the implementation of the administration. However, target of administration is to reduce the LOS up to 24 h. Practical implications Six Sigma model will reduce bottlenecks in LOS and enhance service quality of hospital. The developed regression model will help the doctors and staff members to assess and control the LOS by controlling and minimising the independent variables. Social implications The project will directly provide benefits to society, as LOS will decrease and patients’ satisfaction will automatically increase. Originality/value Six Sigma is a developed methodology, but its application in paediatric department is very limited. This is the first ever study of applying Six Sigma for neonatal jaundice patients in India.

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Purpose The purpose of this paper is to investigate the utilization of Lean & Six Sigma quality initiatives in healthcare sector in India. Methodology The survey questionnaires were sent to 454 hospitals through registered postal in all the states of India. The survey questionnaire was designed to assess different quality initiatives; currently implemented in Indian hospitals, factors align with organization’s objectives, reasons for not implementing Lean & Six Sigma and contribution of Lean & Six Sigma projects in healthcare improvement projects etc. A separate section in the questionnaire provides the feedback on implementation of Lean & Six Sigma in various hospitals. The relationships between Lean & Six Sigma and healthcare performance have also been established in this paper. Findings It is found that 15 Nos. of hospitals have implemented the Lean tools while 14 Nos. have implemented the Six Sigma tools out of 109 collected responses. This shows the utilization of Lean & Six Sigma in Indian healthcare sector. The ‘Lack of knowledge’ and ‘Availability of resources’ are the major reasons for not implementing Lean & Six Sigma. It is also observed that 22% running projects were related to Lean & Six Sigma out of various improvement projects running in various hospitals. Originality There is lack of evidences of similar studies that determines the utilization of Lean & Six Sigma in Indian healthcare sector at the national level. This paper will provide important breakthrough to academicians and healthcare practitioners, who are involved in Lean & Six Sigma research. Social implications The present study will create awareness among healthcare practitioners across India for utilization of quality tools that will provide direct benefits to the society.

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