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

Abstract

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.

Lean Six Sigma competitiveness for micro, small and medium enterprises (MSME): an action research in the Indian context

“…Thus, it ensures the active participation of the members from the organization under study. This exploratory nature assists not only to develop a case study but also to determine the answers to the RQs with more insight (Coughlan and Coghlan, 2002;Bhat et al, 2019). Moreover, it is one of the better methodologies in operations management research to tap the potential of the practitioners and academicians' TQM 33,2 Particulars LSS Principle 1.…”

“…In addition, most of the LSS researches are empirical in nature, which demands real-world/ primary data and subsequently, this data assists in developing the case study. Since, quality problems in the manufacturing context are usually treated as a case in terms of documentation and analysis, AR is the better and dominant approach for LSS to unearth the answers to RQs and ensure organizational change (Aboelmaged, 2010;Bhat et al, 2019). The researchers, being Master Black Belt (MBB) in Six Sigma, assisted the industry in validating the potential causes and deployment of solutions to enhance the system.…”

“…The Six Sigma methodology focuses on variation reduction and sets a target to bring in processes and results in accordance with the requirements of the customer (Antony et al, 2019;Gijo et al, 2014). The integration of Lean Thinking and Six Sigma Approach complements each other by consolidating the strengths and abating the weaknesses of each other, and thereby ensuring improved process with minimum NVA and variations (Antony et al, 2016a;Bhat et al, 2019;Ricciardi et al, 2019).…”

Exploring the use of operational excellence methodologies in the era of COVID-19: perspectives from leading academics and practitioners

“…The combined LSS strategy integrates human aspects (such as leadership, customer focus and cultural change) and process aspects (such as process capability, process management and statistical thinking) for continuous improvement (Bhat et al, 2019;Antony, 2011). Integrating Lean principles of reducing waste with Six sigma's aim of reducing variation through value stream mapping and analysis and statistical process control can serve to improve patient satisfaction and outcomes.…”

Exploration and prioritization of just in time enablers for sustainable health care: an integrated GRA-Fuzzy TOPSIS application

“…The present work provides impetus for system wide application of JIT with through and contextual understanding among the different JIT enablers. According to a study conducted by Hussein and Zayed (2020) (Bhat et al, 2019;Vaishnavi and Suresh, 2020;Kaswan and Rathi, 2021). Naidoo and Fields (2019) also found that strategic leadership and organizational attitude and integration of Lean practices as key factors for successful deployment of Lean thinking in healthcare.…”