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Purpose Healthcare environments are highly complex and full of variation and inefficiency. However, variation and inefficiency can be measured and improved, providing better quality care at a lower cost. This study aims to report the application of Lean Six Sigma (LSS) in a haematology laboratory in a university hospital in Egypt. Design/methodology/approach The authors used case study research. Applying the define, measure, analyse, improve and control phases of the DMAIC methodology together with lean tools, the problem was identified, the process mapped, the causes analysed and improvements implemented. Findings Results show that LSS can be successfully implemented in challenging public sector healthcare settings. Management commitment, generating and implementing ideas from frontline staff, using a variety of quality tools and previous LSS training were all key to success. This is evidence that the LSS methodology is adaptable to any process, people or place. Originality/value There are no publications on LSS implementation in health care in Egypt. This study demonstrates the successful use of LSS in a university hospital (public sector) in a developing country, sharing insight into the facilitators and barriers in a real context with others in the healthcare field.

During the past decades, the incidence of the most common non-Hodgkin's lymphomas has increased dramatically worldwide. In Egypt, it is the fifth most common cancer in both the sexes. The purpose of this study is to study the problem of non-Hodgkin's lymphomas in Alexandria, Egypt: incidence rates and trend. The method employed was record reviewing for estimation of the annual incidence rates of non-Hodgkin's lymphoma and their trends. The general incidence rate of non-Hodgkin's lymphoma was 5.90 in 1995 and reached 8.99 in 2004, with a peak (9.40) in the year 2002. The male incidence of non-Hodgkin's lymphoma demonstrated an obvious rise from 1995 to 1998, with a slowing from 1999 to 2002, followed by another evident rise from 2003. Women showed an increase in non-Hodgkin's lymphoma incidence rates from 1995 to 2000, then a decline afterwards, till 2004. As regards the population from 15 to 60 years old, there was a rise through the period from 1994 to 1999, then a drop from 2000 to 2004. In the elderly group, the incidence rate was doubled during the 10 years (from 13.36/100 000 in 1995 to 26.65 in 2004). The incidence of non-Hodgkin's lymphoma increased steadily from 1995 to 2004 in Alexandria, particularly in the elderly population. The importance of developing additional strategies for screening and prevention of non-Hodgkin's lymphoma, in this group, on the basis of epidemiological evidences is warranted.

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