How do organizations implement an effective LSS initiative? A qualitative study

A balanced approach involving hard and soft factors for internalizing Lean Management and Six Sigma in hospitals

Purpose

This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

Design/methodology/approach

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

Findings

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

Research limitations/implications

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

Practical implications

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

Originality/value

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.

The moderating role of Lean Six Sigma practices on quality management practices and quality performance in medical device manufacturing industry

Purpose

The purpose of this paper is to explore the moderating role of Lean Six Sigma (LSS) practices in explaining the relationship between quality management practices (QMPs) and quality performance.

Design/methodology/approach

Partial least square-based structural equation modeling (PLS-SEM) was used to empirically examine the moderating effect of LSS practices on QMPs and quality performance in Malaysian medical device manufacturing companies.

Findings

Findings revealed that both QMPs and LSS practices have a significant and positive effect on quality performance. Furthermore, LSS practices served as a substitute for moderating the positive relationship between QMPs and quality performance in such a way that the relationship becomes weaker as LSS practices increase.

Originality/value

LSS is acknowledged as the most well-known hybrid methodology; however, due to its relative newness, it has not been studied in great detail. Unlike previous studies, this paper argued that Lean and Six Sigma practices are distinct from its predecessor TQM practices; moreover, both Lean and Six Sigma practices do not need to substitute QM/TQM practices instead of complimenting the QMPs. In addition, this study adds to the growing body of QM literature by empirically examine the effect of LSS practices in moderating the relationship between QMPs and quality performance.

Framework for zero-defect manufacturing in Indian industries – Voice of the customer

Purpose

The present paper proposes a framework for zero-defect manufacturing in Indian industries. Due to the current competitive market, there is a strong need to achieve zero defects from the customer's perspective. A survey questionnaire is analyzed based on the responses and a structured framework is drafted to implement zero defect manufacturing in the Indian industry.

Design/methodology/approach

To analyze zero-defect in Indian industries, a literature review and a survey questionnaire constituted a framework. This framework is independent of the type of process and product.

Findings

The findings of this study are based on a total of 925 responses received through survey questionnaires by different mediums. The framework has been tested in different manufacturing organizations to achieve zero-defect through the continuous improvement approach.

Practical implications

The study results aim to achieve zero-defect, help to improve customer satisfaction, reduce waste and rework in the manufacturing process. This framework is also used as a problem-solving approach to implement Six Sigma in the Indian industries.

Originality/value

Zero defect manufacturing is growing in India and globally. This framework helps to implement zero defect manufacturing in Indian industries. It is an essential tool to capture the voice of the customer.

Critical failure factors for continuous improvement methodologies in the Irish MedTech industry

Purpose

The main objective of this study is to investigate what are the critical success factors that exist for continuous improvement (CI) methodology deployment in the Irish medical technology (MedTech) industry. The research will, in particular, seek to establish if the highly regulated nature of the global MedTech industry is an additional critical failure factor (CFF) for the deployment of CI methodology. The study involves the analysis of the benefits, challenges, CFFs and tools most utilised for the application to the deployment of CI methodologies in the Irish medical device (MD) industry.

Design/methodology/approach

A quantitative survey was utilised in this study. The main participants were made up of senior quality professionals working in operational excellence, quality consultants, quality directors, quality engineers, quality managers and quality supervisors working in both manufacturing and service sectors from Irish MD companies. A total of 94 participants from the Irish MedTech industry responded to the survey.

Findings

The main finding of this study is that 42% of participants perceived that a highly regulated environment was a CFF to CI, whilst 79% of respondents utilised Lean Six Sigma in their organisations, and productivity and financial factors were found to be the highest reasons for CI deployment amongst the Irish MedTech industry. The top CFFs highlighted for CI in regulated industries were fear of extra validation activity, compliance versus quality culture and a regulatory culture of being “safe”. Another relevant finding presented in this paper is that just over 48% of participants felt that CI tools are very strongly integrated into the industries quality management systems (QMSs) such as the corrective and preventative action system, non-conformance and audit systems.

Research limitations/implications

All data collected in the survey came from professionals working for Irish indigenous and multinational MedTech companies. It is important to highlight that n = 94 is a low sample size, which is enough for a preliminary survey but reinforcing the limitation in terms of generalisation of the results. A further study on a wider European and global scale as well as a comparison with the highly regulated pharma industry would be informative.

Originality/value

The authors understand that this is the very first research focussed on the CFFs for CI in the MedTech/MD manufacturing industry with a specific focus on the highly regulated nature of the industry as a potential CFF. The results of this study represent an important first step towards a full understanding of the applicability and use of CI in the medical-device-manufacturing industries on a global scale.

Strategies for successful deployment and sustainment of Lean Six Sigma in healthcare sector in India: a multi-level perspective

Purpose

This study aims to present Lean Six Sigma (LSS) deployment and sustainment strategies for the healthcare sector from a multi-level perspective. The objective is to present LSS implementation insights to enable policymakers, practitioners and academicians to test and develop an LSS framework for healthcare sectors.

Design/methodology/approach

The strategies identified are the result of a multi-method research design involving literature review, action research (AR) and Delphi study. Further, the AR portion of the study involved more than 10 years of projects focused on the deployment of LSS in the healthcare sector.

Findings

The strategies include a holistic view from the multi-level perspective, considering the Top Management Level, Middle Management Level and Operational Level. The authors ascertained 27 strategies across the three levels of organizational structure for the effective deployment of LSS. Further, the authors present a customized LSS “pocket guide” from the healthcare perspective for quick reference.

Research limitations/implications

The strategies delineated in this study are based on the Indian healthcare section only; thus, further research in additional geographic contexts is needed. Also, further research is necessary to provide additional empirical validation of the effects of the identified strategies on LSS program outcomes and to verify that the strategies operate at the proposed organizational levels. Future research should also focus on identifying the interrelationships between strategies within and across levels, developing a “road map” for LSS implementation in hospitals and designing the LSS curriculum for medical schools and other medical training programs.

Practical implications

Observations of this study can contribute to developing a holistic framework for successful LSS implementation in the healthcare sector for academicians, practitioners and policymakers. This, in turn, ensures an enhanced value proposition, improved quality of life and reduced healthcare operational costs. Thus, it ensures a win-win situation among all the stakeholders of the healthcare sector.

Originality/value

The strategies put forth will enable the LSS researchers, academicians and, more particularly, practitioners to delve deeper into specific enablers and safeguard the LSS deployment from backlash. The research has two significant benefits. Firstly, it enhances the understanding of LSS from the healthcare perspective. Secondly, it provides direction for future studies with specific components for hospitals’ LSS framework, which can be further tested, refined and improved.

Digitization in the Design and Construction Industry—Remote Work in the Context of Sustainability: A Study from Poland

The article presents the results of research on the digitization of services provided by the design industry in the context of the implementation of sustainable development goals, especially environmental sustainability. First, a literature review has been done. These research goals were established in the publication: investigating the impact of remote work on the implementation of sustainable development goals (in particular, environmental), examining the essence of better perception of remote work and digitization of the design process by employees of the design and construction industry, and examining barriers and factors favoring the digitization of the design and construction industry in Poland. Both a survey and interviews were carried out. To analyze data obtained from the interviews, the Colaizzi’s methodology was performed. The data obtained as a result of the survey were subjected to a statistical analysis using a cluster analysis (Ward’s method). Groups (clusters) of strong and weak barriers, supporting factors, and sustainability factors were defined. The COVID-19 pandemic has perpetuated the digitization trend in this industry. Employees and owners of project offices prefer remote work due to the flexibility of working time, time savings, work comfort, safety, and savings. Industry employees recognize the advantages and benefits of remote work in terms of environmental sustainability. The environmental impact in the form in the reduction of electricity consumption by large office buildings and reduction of the emission of harmful substances contained in car exhaust fumes are the most frequently mentioned environmental advantages. The biggest barriers are legal aspects, and sometimes difficult cooperation with a client. The research results presented in this publication, as well as the methodology adopted, are a contribution to the literature on the perception and comfort of remote work, the social effects of the COVID-19 pandemic, and environmental sustainability.

A study into the pros and cons of ISO 18404: viewpoints from leading academics and practitioners

Purpose

This paper aims to present and summarise the arguments for and against the ISO 18404 standard and the perceived advantages and disadvantages of implementing it.

Design/methodology/approach

A qualitative interview approach was utilised by interviewing a panel of leading academics and practitioners familiar with Lean Six Sigma.

Findings

The results indicate that Lean Six Sigma professionals have conflicting opinions on ISO 18404. An overwhelming majority of the panel questioned the “quality” of the standard and whether it is “fit for purpose”, while others see the advantages of a common standard in helping continuous improvement deployment.

Research limitations/implications

As the standard has not been widely adopted, there were limited examples on ISO 18404 discussion in the literature. Much of the current literature focuses on the theoretical application of the standard, with sparse practical examples providing case study deployment. Also, the interviews were short and at a high level. There is an opportunity for further study and analysis. It was difficult to find qualified interviewees who were familiar with the standard. A very real constraint when conducting research into ISO 18404 is to obtain a balanced view of the standard from those who have a vested interest in its continuation and evolution, or not.

Originality/value

The paper provides a resource for people to obtain insight into the value or non-value add of a standard in Lean Six Sigma 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 to implement it or not.

Applying Lean Six Sigma Methodology to a Pharmaceutical Manufacturing Facility: A Case Study

This research examines a case study on the implementation of an effective approach to advanced Lean Six Sigma problem-solving within a pharmaceutical manufacturing site which manufactures acetaminophen (paracetamol containing pain relief) tablets. Though this study was completed in a single manufacturing company, the implementation of this study delivers important application and results that can be deployed in other such manufacturing companies. The manufacturing site faced backlogs in customer orders due to increased demand. Increased demand is due to brand popularity and recognition, product efficacy and a COVID 19 pandemic that intensified the demand for pain relief tablets in an already very busy site. With increased demand, to ensure timely deliveries, customer satisfaction and minimize delays, sources of site productivity losses and wastes needed to be analyzed and reduced or eliminated. Manufacturing Packaging line downtime was identified as one area of concern. The goal of the research was to introduce a problem-solving technique to reduce downtime within a manufacturing site without affecting the production required to fulfil customer demand while increasing product quality. The research utilized an integrated LSS methodology which identifies, stratifies and effectively eliminates non-value adding (waste) activities, by following a 7-step customized problem-solving methodology which resulted in complete elimination of the issue under investigation and savings of just under half a million dollars. The learnings are being deployed and leveraged worldwide across the pharmaceutical organizations parent site and sister sites. The presented results demonstrated that Lean Six Sigma methodology and tools are effective for accurate root causing of problems and enablers of implementation of continuous improvement.