Implementing lean management/Six Sigma in hospitals: beyond empowerment or work intensification?

Abstract

This article analyses a process improvement project based on Lean Six Sigma (LSS) techniques in the emergency department (ED) of a large Australian hospital. We consider perspectives of the clinical and managerial staff involved in the project implementation, its implications for empowerment and work intensification. We find that the project appeared to improve patient flow from the ED to the wards and to have positive implications for some staff. However, these achievements tended to be the result of senior staff using the project to leverage resources and create desirable outcomes, rather than the result of the use of LSS, in particular. We found some evidence of work intensification, but this was attributable to wider systemic issues and budget constraints, rather than being a direct consequence of the use of LSS. We argue that translating LSS from a manufacturing context into the politicised and professionalised context of healthcare changes the usual questions about empowerment or work intensification to questions about the influences of powerful stakeholders.

Investigating the readiness of people in manufacturing SMEs to embark on Lean Six Sigma projects

“…The result of this research is also consistent with the studies undertaken by Kanpp (2015), Lam et al (2015), Antony (2014), Bamber et al (2014), Stanton et al (2014), Zu et al (2010), Calvo-Mora et al (2014), Laohavichien et al( 2011), andBaird et al (2011) who argue that organisational culture and behavioural factors are key enablers for any TQM practice including LSS. This study has found a strong relationship between organisational culture and readiness to implement LSS in German manufacturing SMEs.…”

“…Apart from a few opinion pieces which focus on human resource issues and readiness for LSS implementation in the service sector (Antony, 2014;Stanton et al, 2014;Bamber et al, 2014;Fazzari and Levitt, 2008;Hensley and Dobie, 2005), no rigorous research evidence has emerged that explores the role of organisational and individual behavioural factors in promoting readiness and enabling LSS in the manufacturing SMEs. Moreover, the few articles that are available are not supported by empirical research.…”

“…When some of this research is explored closely it is clear that there are parallels with other areas of operations management. For example, a longitudinal study of LSS found a positive association between human resource management practices such as empowerment, extensive training and teamwork with TQM in the manufacturing and service sector (Lam et al, 2015;Stanton et al, 2014;Menezes et al, 2010). A further LSS study in the large "heavy automotive manufacturing supply" sector in developing countries (e.g.…”

Exploring the Interaction Between Internal Customer Satisfaction and Talent Waste: A Lean Management Perspective

“…"Lean" has evolved to the state of art in manufacturing environment (Dombrowski & Mielkea, 2013) however, principles of lean are also used commonly in service sectors including finance, healthcare, education, hospitality etc. (Maskell & Kennedy, 2007;Stanton, et al, 2014;Balzer, Brodke, & Kizhakethalackal, 2015;Vlachos & Bogdanovic, 2013). Shah and Wards (2007) defined lean as "an integrated socio-technical system whose main objective is to eliminate waste by concurrently reducing or minimizing supplier, customer, and internal variability."…”

Teamworking and Lean revisited: a reply to Carter et al.

“…It also seems that our non-inclusion of these references comes as much more of a shock and an affront to Carter et al than (Cullinane et al, 2014) contained two, two articles (Bouville and Alis, 2014;Thirkell and Ashman, 2014) contained one each, and three (Lindsay et al, 2014;Sparrow and Otaye-Ebede, 2014;Stanton et al 2014 et al, 1999) is cited as many as three times, only one (Stewart et al, 2009) has two citations, two items (Mehri, 2006;Sprigg and Jackson, 2006) have just one citation each, and the other four (Danford, 1999;Delbridge, 1998;Lewchuk andRobertson, 1997, Sprigg et al, 2007) provide no real account of how consideration of the 'omitted' references might contribute to this. They describe the ways in which they claim that this literature portrays lean teams (Carter et al, 2015: 4), but provide no specific references to back this up.…”