Evidence suggests that specifically designed frameworks to implement Lean Six Sigma (LSS) projects to tackle particular problems are more effective than "generic" versions. This paper proposes an implementation framework to effectively deploy LSS to improve a key operation and performance indicator, i.e. ship loading commercial time, of one of the largest world producer of iron ore. This article therefore contributes with a refined framework to effectively implement LSS, and documents its successful application and effectiveness within the context of the case organisation. The LSS framework and project contributed in helping the studied organisation to improve both the capability of its ship loading process and commercial time by more than 30 percent, resulting in operational savings in the range of $300,000 USD per year. The systematic nature of the framework proposed also helped the organisation to establish a standardise routine to improve its operations. Managerial implications exposing the challenges faced during the implementation of LSS are also discussed to serve as lessons learnt to be considered in other LSS projects. Managers and engineers in charge of improving operations and processes can benefit from this paper as it can be used as a guide to direct the conduction of LSS projects and the empirical application of its principles and tools.

uHear in any setting lacks specificity in the range of normal hearing and is highly unreliable in giving the exact hearing threshold in clinical settings. However, there is a potential for the use of uHear if it is used to rule out moderate hearing loss, even in a clinical setting, as exemplified by our study. This method needs standardization through further research.

Objectives: Lean management (LM) principles were first developed by a Japanese manufacturing company to maximise value and minimise waste in the automotive industry. However, these principles can also be applied in the healthcare sector. This study aimed to illustrate the process of implementing LM principles in a radiation oncology department to streamline workflow and identify and reduce waste. Methods: This study took place in the Department of Radiation Oncology, Royal Hospital, Muscat, Oman, in December 2016. A value stream map (VSM) was created for the chain of processes followed in the department. A waste analysis was conducted to determine which processes did not add value for the patient or healthcare provider. Results: Based on the VSM analysis, only six out of 13 steps were found to be of value. Necessary and unnecessary non-value-adding activities were identified. Sources of waste included parking and registration. In addition, variabilities in workload were noted. Conclusion: Overall, LM principles improve workflow, reduce waste and enhance patient and staff satisfaction. In the current study, the application of LM principles helped to improve value in a radiation oncology department.Keywords: Health Services Administration; Healthcare Quality Assurance; Total Quality Management; Organization and Administration; Efficiency; Oman.

PurposeThis paper gives the background to the ISO 18404:2015 standard and explains its rationale. It aims to correct misconceptions and erroneous statements about the standard appearing in the paper by Antony et al. (2021) and to demonstrate the usefulness of the standard in a wide range of application sectors.Design/methodology/approachA review of recently reported misconceptions and erroneous statements is presented and clarifications are provided. A qualitative interview approach was utilised to obtain the views of leading academics and practitioners familiar with Six Sigma and Lean in a range of sectors and from different parts of the world. This includes the results of a survey for capturing expectations and requirements for the next ISO18404 version.FindingsClarifications were needed to correct some misconceptions and erroneous statements in recently published work. However, on review, the reports of the interviews in Antony et al. (2021) indicate that most Lean Six Sigma professionals have positive experiences with ISO 18404:2015 and see the advantages of a common standard in helping continuous improvement deployment. Possible causes of some reported negative results are already scheduled to be addressed in the forthcoming review of ISO 18404:2015.Research limitations/implicationsA very real constraint when conducting research into ISO 18404:2015 is to obtain a balanced view of the standard from those who have a vested interest in its continuation and evolution, or not. Whilst the authors cannot claim to be any more objective than Antony et al.’s (2021) authors and commentators, they are, in contrast to that group, highly knowledgeable about the reality of the standard, rather than speculating in ignorance.Practical implicationsA very real constraint when conducting research into ISO 18404:2015 is to obtain a balanced view of the standard which is balanced with respect from those who have a vested interest in its continuation and evolution, or not. Whilst the current authors cannot claim to be any more objective than previous authors, Antony et al.’s (2021) authors and commentators, they are, in contrast to that group, highly knowledgeable about the reality of the standard, rather than speculating in ignorance.Originality/valueThe paper gives a clear description of the ISO standard development process and provides a resource for people to obtain insight into the value or non-value add of a standard in Six Sigma and Lean, 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 or not to implement it.