Application of Lean Six Sigma methodology to reduce the cycle time of out-patient department service in a rural hospital

Bhat, Shreeranga; Jnanesh, N A

doi:10.1504/ijhtm.2014.064257

Cited by 42 publications

(30 citation statements)

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“…In the cases studied, the barriers faced were primarily associated with human factors, including employee distrust, medical interests, conflicts of interest, the frustration of previous attempts, adverse reactions due to lean healthcare's origins in the manufacturing sector and leadership with little training or involvement; other barriers included the lack of knowledge about new lean concepts and technological barriers such as employee computer use. These results corroborate the results found in several papers, such as Aij et al (), Bhat and Jnanesh (), Bhat et al () and Bhat and Jnanesh (), among others.…”

Section: Case Descriptionssupporting

confidence: 93%

Lean healthcare in developing countries: evidence from Brazilian hospitals

Costa

Filho

Rentes

et al. 2015

Int J Health Plann Mgmt

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The present study evaluates how five sectors of two Brazilian hospitals have implemented lean healthcare concepts in their operations. The main characteristics of the implementation process are analyzed in the present study: the motivational factor for implementation, implementation time, form (consultancy or internal), team (hospital and consultants), lean implementation continuity/sustainability, lean healthcare tools and methods implemented, problems/improvement opportunities, lean healthcare barriers faced during the implementation process, and critical factors that affected the implementation and the results obtained in each case. The case studies indicate that reducing patient lead times and costs and making financial improvements were the primary factors that motivated lean healthcare implementation in the hospitals studied. Several tools and methods were used in the cases studied, especially value stream mapping and DMAIC. The barriers found in both hospitals are primarily associated with the human factor. Additionally, the results obtained after implementation were analyzed and improvements in financial aspects, productivity and capacity, and lead time reduction of the analyzed sectors were observed. Further, this study also exhibited four propositions elaborated from the results obtained from the cases that highlighted barriers and challenges to lean healthcare implementation in developing countries. Two of these barriers are hospital organizational structure (and, consequently, how the senior management works with medical staff), and outsourcing hospital activities. This study also concluded that the initialization and maintenance of lean healthcare implementation rely heavily on external support because lean healthcare subject knowledge is not yet available in the healthcare organization, which represents a challenge. Copyright © 2015 John Wiley & Sons, Ltd.

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Section: Case Descriptionssupporting

confidence: 93%

Lean healthcare in developing countries: evidence from Brazilian hospitals

Costa

Filho

Rentes

et al. 2015

Int J Health Plann Mgmt

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“…Further, the average waiting time was reduced by 97 per cent (from 32 to 1 min) and the average number in queue was reduced by 97 per cent (from 11 patients to 1 patient). Further, the hospital realized a savings of $7,000 annually in terms of overhead costs (Bhat and Jnanesh, 2014).…”

Section: Multiple Case Study Design and Analysismentioning

confidence: 99%

Lean Six Sigma for the healthcare sector: a multiple case study analysis from the Indian context

Bhat¹,

Antony²,

Gijo

et al. 2019

IJQRM

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Purpose The purpose of this paper is to explore the voice of the customer, key performance indicators, critical to quality characteristics, critical success factors, and commonly used tools and techniques for deploying the Lean Six Sigma (LSS) strategy in Indian private hospitals, with special attention to the medical records. Design/methodology/approach The study utilizes the action research methodology to obtain a greater understanding of the use of LSS in the Indian healthcare sector. Multiple case studies were designed and successfully deployed to understand and ascertain challenges in LSS implementation. Five case studies were carried out in the Medical Records Departments (MRD) of four private hospitals in India. Findings Patients perceive that waiting in queue harms their health, which can be rectified by addressing the cycle time of the system. The research also found that effective leadership, availability of data, involvement of cross-functional team and effective communication are critical to the success of LSS projects. In addition, control charts, cause and effect diagram, 5S, gemba, two-sample t-test, standardization, waste analysis and value stream mapping are some of the common tools used to improve healthcare systems. Research limitations/implications The research was restricted to studying the impact of LSS on the workflow and resource consumption of the MRD in Indian allopathic hospitals only. The validity of the results can be improved by including more hospitals and more case studies from the healthcare sector in different countries. Originality/value The findings will enable researchers, academicians and practitioners to incorporate the results of the study in LSS implementation within the healthcare system to increase the likelihood of successful deployment. This will provide greater stimulus across other departments in the hospital sector for wider and broader application of LSS for creating and sustaining process improvements.

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“…The adoption of Lean within Healthcare has created interest in both trade and academic journals since it seemingly offers a response to the simultaneous pressures to improve improved internal air quality. In their research, Bhat and Jnanesh (2014) showed how Lean Six Sigma methodology had been applied to reduce the cycle time of out-patient department service in a rural Indian hospital from 4.27 minutes to 1.5 minutes. They also noted a 97% reduction in average waiting time in the system and 91% decrease in queue length.…”

Section: Lean In Healthcarementioning

confidence: 99%

“…"Lean" is one of these operations management initiatives that has received significant attention from both practitioners and scholars within service environments (Panchak, 2003;de Souza, 2009;Mazzocato et al, 2010;Burgess and Radnor, 2012;Vegting et al, 2012;Toussaint and Berry, 2013;Bhat and Jnanesh, 2014). The application of Lean processes is alluring for healthcare managers globally because of the promise of combining cost reductions with outstanding standards of health service to patients.…”

Section: Introductionmentioning

confidence: 99%

Implementing operations strategy through Lean processes within health care

Matthias

Brown

2016

IJOPM

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Healthcare is perhaps the most personal and important service people experience, yet is not a service that people necessarily seek (Berry and Bendapudi 2007). Although the focus tends towards the technical aspect of service provision, 'patient experience' transcends a purely medical and organisational perspective (Makarem and Al-Amin 2014). Providing healthcare services in an environment where patients are increasingly experience-aware and evertighter financial constraints prevail, presents challenges both for service design and performance in operations management (Zomerdijk and Voss 2010, Dey et al. 2013, Tax et al. 2013). This highlights the important role of operations strategy because it becomes the means by which a range of operations management initiatives can be defined and implemented within organisations (Hill and Hill 2011), including healthcare providers. 'Lean' is one of these operations management initiatives that has received significant attention from both practitioners and scholars within service environments (Panchak 2003,

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Application of Lean Six Sigma methodology to reduce the cycle time of out-patient department service in a rural hospital

Cited by 42 publications

References 0 publications

Lean healthcare in developing countries: evidence from Brazilian hospitals

Lean healthcare in developing countries: evidence from Brazilian hospitals

Lean Six Sigma for the healthcare sector: a multiple case study analysis from the Indian context

Implementing operations strategy through Lean processes within health care

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