5S – a quality improvement tool for sustainable performance: literature review and directions

The Impact and Challenges of the Implementation of 5S Methodology in Healthcare Settings: A Systematic Review

The 5S methodology, rooted in lean manufacturing principles, has been adopted in healthcare settings to improve organization, efficiency, and quality. This systematic review aimed to synthesize the literature on the implementation of the 5S methodology in healthcare, its impact, and factors influencing successful implementation. A comprehensive literature search was conducted in PubMed, Google Scholar, and Cochrane databases for original studies on the implementation of the 5S methodology in healthcare settings. Studies were screened based on inclusion and exclusion criteria, and data were extracted on study characteristics, implementation details, outcomes, and key findings. Six studies met the inclusion criteria, spanning various healthcare settings, including hospitals, clinics, and laboratories. The studies reported positive outcomes associated with implementing the 5S methodology, such as improved workplace organization and cleanliness, increased utilization of healthcare services, enhanced staff satisfaction and motivation, and reduced waste and non-conformities. Critical success factors included commitment from top management, staff involvement, continuous monitoring, and adequate training. However, challenges were noted, including limited resources, small sample sizes, and difficulty assessing long-term sustainability. The implementation of the 5S methodology in healthcare settings can lead to improved organization, efficiency, and quality. However, successful implementation requires addressing critical factors such as leadership commitment, staff engagement, continuous monitoring, and training. Future research should focus on larger-scale implementation studies, long-term assessments, quantitative and qualitative evaluations, and cost-effectiveness analyses to strengthen the evidence base and inform best practices.

Improving Efficiency in Hospital Pharmacy Services: An Integrated Strategy Using the OCTAGON-P Framework and Lean 5S Management Practices

Background Hospital pharmacy departments have a critical role in the healthcare system, as they aim to provide excellent patient services while also ensuring cost-effectiveness. Lean methodologies are well-known for improving efficiency and quality in various industries, but their impact on healthcare, particularly in hospital pharmacy settings, has not been thoroughly investigated. Aim This quality improvement (QI) study aimed to assess the impact of implementing the sort, set in order, shine, standardize, and sustain (5S) methodology using the innovative orientation, coordination, training, awareness, governance, observation, normalization, and promotion (OCTAGON-P) framework on the operations of Mediclinic Parkview Hospital (MPAR) Pharmacy in Dubai, UAE. Methods The QI project spanned a period of six weeks, from December 18th, 2023, to January 28th, 2024. Throughout this period, a new novel OCTAGON-P framework's eight crucial elements were methodically integrated. Simultaneously, an extensive preparation process encompassing the five stages of the 5S method was carried out. Results The findings indicated a notable enhancement in organization, orderliness, cleanliness, medication storage, and workspace standardization. The significant improvement of 217% in terms of organization highlighted the effectiveness of resource arrangement. The orderliness of the workspace saw an increase of 800%, indicating a transformation in the systematic organization. Additionally, cleanliness improved by 138%, demonstrating a significant advancement in maintaining a spotless environment. The standardization of processes experienced a boost of 300%, reflecting a solidified approach to consistent operational methods. These refinements resulted in an overall improvement of 90% from the initial baseline of 20% on the 5S checklist scores. Efficiency gains were observed, with outpatient medication retrieval times reduced by 50%, inpatient times by 40%, emergency prescription serving by 16.7%, and pediatric prescription serving by 11%. The inpatient medication return process saw a 67% improvement. Patient counseling time increased by 23.3%, indicating a more patient-centered approach. Prescription verification and medication expiry checks increased by 50% and 200%, respectively, enhancing the quality of care. Inventory management efficiency improved by 36%, and medication label printing time decreased by 70% with the additional label printers. Installing extra medication label printers was done through the OCTAGON-P framework, specifically in the "orientation" and "coordination" phases. These two initial phases focused on leadership's 5S orientation, management support, and securing additional resources. Therefore, the OCTAGON-P framework provided a structured approach that promoted continuous improvement and sustained lean practices. Conclusion This research study presented the remarkable effectiveness of the OCTAGON-P framework in structurally implementing the 5S methodology into hospital pharmacy operations. The findings underscored the potential of lean 5S to enhance and optimize operational efficiency and overall quality within the critical environment of hospital pharmacy settings. Consequently, these improvements can conclusively result in the provision of superior and enhanced patient care, which is truly fundamental and central to the mission and objectives of any healthcare institution.

A 5S Lean Strategy for a Sustainable Welding Process

The correct performance of the welding processes used to join metal parts or structural elements is considered to be of vital importance to guarantee the reliability of these products during their useful lives. Adequate workstation design ensures a safe environment in which an operator can perform these processes correctly. In order to guarantee the quality of welding seams, which are used to join metal parts and structural elements, a series of standards have been developed; these standards establish requirements to guarantee the correct performance of welding processes, and the inspection of the metal welds obtained. The 5S methodology has proven to be a valid tool for improving workplaces in industrial and service activities; it is a capstone methodology when companies implement lean production approaches. This work presents a framework for applying the 5S methodology in metal welding workplaces. It defines an index to evaluate the degree of implementation of the 5S methodology, and the application of the important performance analysis methodology (IPA). Fuzzy logic is used to treat the uncertainty in evaluating the different evaluation indicators proposed. This framework is applied to a real practical case, to provide an example of its use in establishing good manufacturing practices that guarantee compliance with the requirements of welding standards, and guaranteeing the correct handling and storage of the materials and tools used in welding processes for the manufacture of welded parts and structural elements.

Innovative ecosystem: the role of lean management auditing

The auditing of organizations’ activities plays a crucial role in ensuring the direction chosen by top management and identifying early signs of upcoming changes and threats. The audit assesses the efficient use of resources and processes and promotes corporate credibility, which is essential from investors’ perspectives, particularly in ecosystems of innovations. Meanwhile, little is known about lean auditing, which is crucial in achieving effective processes. This paper summarises the arguments and counterarguments within the scientific discussion on the issue of auditing. The research’s primary purpose is to identify types of waste in auditing and formulate the principles of lean auditing. The systematic literature review and approaches for solving the problem based on grounded theory and triangulation of methods enabled the resolving of research problems. This article analyses the internal auditing standards and guidelines and uses in-depth interviews with 19 internal auditors from different Polish public organizations from 2017 to 2020. The choice of a qualitative approach resulted from the research phenomenon’s open nature, with very few studies. It created a need for a reflective approach with respondents simultaneously being key informants and experts. The results of an empirical analysis showed that internal auditors little knew about the lean concept in audit processes. However, they noticed the benefits of using the lean concept in the audit. The research enabled the development of the model of lean auditing. It could help improve the audit process, which is particularly important from the innovation ecosystem perspective. Besides, one determined the waste of auditing and formulated the principles of lean auditing. The research results develop the audit theory and are helpful for practitioners. Improved internal audit better meets stakeholders’ expectations regarding the spending of funds and implementation of tasks.

Role of personal anxiety in individual kaizen behaviour and performance: evidence from Japan

Purpose

This study examines the role of anxiety in kaizen behaviour and performance by empirically testing the influence of personal anxiety (state and trait) on individual kaizen behaviours (rule adherence, initiative and perseverance of effort), which, in turn, affect individual kaizen performance.

Design/methodology/approach

The data were obtained from a survey of 552 employees of four companies in Japan and analysed using structural equation modelling.

Findings

The results show that state anxiety has a significantly positive effect on rule adherence and kaizen performance. Trait anxiety positively influences employees' initiative and perseverance but has a significant negative effect on kaizen performance.

Originality/value

This study contributes to kaizen and continuous improvement theory by focussing on individual kaizen, which is considered to be as important as organisation-level kaizen and investigating the relevance of personal anxiety in individual kaizen behaviours and kaizen performance.

Enhancing customer satisfaction using Kaizen: a case study of Imperial Tobacco Company (ITC)

Purpose

With rising income and changing lifestyle, increased disposable income along with rapid urbanization is boosting the country’s biscuit market. The purpose of this paper is to represent the implementation of Kaizen in a biscuit-manufacturing unit of Imperial Tobacco Company (ITC). Although the concept of Kaizen is not a standard practice in India, the company chosen for the case study has a prominence in the Indian market.

Design/methodology/approach

The methodologies that have been applied to implement Kaizen in the ITC are discussed. Why-Why techniques, fishbone diagram, failure modes and effects analysis, ABC analysis have been used to study cause and effects.

Findings

It was found that the yield was increased from 88.3 to 92.2 percent, which was a significant change, as far as the product line is concerned. The product complaints were reduced to zero with an added increased product quality rating system to 98.2 from the existing rating of 96.7. The product consistency was also improved as an application of Lean in the manufacturing process.

Research limitations/implications

This case study is restricted to the manufacturing sector, especially in the field of biscuit company.

Practical implications

The paper should assist those practitioners and consultants who have the desire to find a better way of Kaizen implementation in small-scale industries of India. The academia can also use this case study for a better understanding of the difference between the theoretical and application aspects of the concept.

Originality/value

This paper is an original contribution in the existing body of literature. It shows the application of Kaizen in the manufacturing sector in India.

Achieving better revenue and customers’ satisfaction with after-sales services

Purpose

Branded car dealerships with best revenue by serviced car also have the best after-sales customers’ satisfaction level. The purpose of this paper is to present the analysis of the after-sales quality management practices adopted by dealerships with the best performance in terms of customer’s satisfaction and revenue and how such practices contribute to these results.

Design/methodology/approach

A multiple case study was performed with nine leader branded car dealerships in an emerging country, considering the entrance car. The performance indicators to evaluate customers’ satisfaction, revenue and operational indicators related to product support, brand manifestation and relationship with customers were identified. Quality management practices that support the best results achievement were analyzed.

Findings

The three dealerships that represent Asiatic brands have best customers’ satisfaction and revenue performance. These dealerships typically have different processes comparing with dealerships that represent European and American brands concerning to: continuous improvement management; warranties and stock management; services scheduling; offer bonuses to customers; and customers service that emphasizes focus on technical and commercial expertise.

Originality/value

This research considered indicators performance and, based on that, analyzed the dealerships’ practices that support the best performance. Such aspect has room for academic literature since the quality management research related to car industry focuses mainly on manufacturer and generates managerial insights to the car industry and its dealerships.

An investigation into manufacturing performance achievements accrued by Indian manufacturing organization through strategic 5S practices

Purpose

The purpose of this paper is to evaluate the quantitative and qualitative benefits accrued by an Indian automotive parts industry through strategic 5S implementation initiatives.

Design/methodology/approach

The study involves evaluation of steps involved in systematic implementation of 5S program methodology in an automotive manufacturing organization and investigation of achievements accrued by the industry through the successful implementation of 5S program.

Findings

The empirical results of the study have revealed that effective practice of 5S program brings considerable level of improvements in the quality, production, cost optimizations, employee’s morale values and work culture in the manufacturing industry. The industry accrued both tangible and non-tangible benefits through the holistic adoption of 5S principals. 5S principals have been envisioned to further support other quality improvement programs like lean manufacturing initiatives of the organizations.

Research limitations/implications

The limitation of the study is that this research has been carried out in only manufacturing industry while similar study will be conducted in the service industry also.

Originality/value

Global competition in the manufacturing sector has provided necessary impetus for manufacturing organizations for affecting continuous improvements in manufacturing performance for achieving sustainability and profitability in the competitive market. 5S implementation is the fundamental tool for the overall achievements in both quantitative and qualitative performance enhancements in the manufacturing as well as service organizations.

Empirical investigation of contributions of 5S practice for realizing improved competitive dimensions

Purpose

The purpose of this paper is to evaluate the capabilities of 5S program to meliorate the different competitive dimensions of manufacturing organizations and extracts the various significant factors which influence its successful implementation.

Design/methodology/approach

The paper involves empirical study of responses collected from various manufacturing organizations to investigate the inter-relationships between various 5S implementation success factors and competitive dimensions parameters through different statistical techniques. The study deploys Bonferroni post hoc test to establish the statistical significance of competitive dimensions improvements, progressively accrued over a reasonable period of time, through holistic 5S implementation.

Findings

The study validates the contributions of 5S program toward realization of significant improvements of various competitive dimensions such as overall organizational achievements, production achievements, quality and continuous improvement achievements, cost optimization achievements, employee-related achievements, effective workplace utilization and safety enhancement achievements accrued by Indian manufacturing organizations. Finally the discriminant validity test has been used in the study for classifying highly successful and moderately successful organizations.

Originality/value

The research aims to empirically test the relationships among various 5S implementation constructs and competitive dimensions parameters constructs in manufacturing organizations. The research work establishes that 5S initiatives have effectively contributed for realization of significant competitive dimensions, progressively from introduction to maturity phases. The research highlights the key significant implications for manufacturing managers.