Barriers and Enablers for Continuous Improvement Methodologies within the Irish Pharmaceutical Industry

Pharma 4.0: A deep dive top management commitment to successful Lean 4.0 implementation in Ghanaian pharma manufacturing sector

The primary aim of this study is to assess the significance of top management commitment in the context of Lean 4.0 implementation within the pharmaceutical manufacturing industry in Ghana. The study seeks to understand and evaluate the overall effectiveness and achievements associated with adopting Lean 4.0. Employing a positivist mindset, the research utilizes an explanatory quantitative research design and a survey technique. Data collected from 181 employees of pharmaceutical companies in Ghana undergo analysis using SmartPLS (version 4) and IBM SPSS version 26. The study employs a combination of descriptive statistics to summarise data characteristics and inferential statistics to test various hypotheses related to Lean 4.0 adoption. The analysis reveals that the successful integration of lean methods and Industry 4.0 technologies requires meticulous management. Simultaneously, individual implementations of lean principles and Industry 4.0 technologies positively impact business performance. Surprisingly, the study does not observe a substantial positive influence of Lean 4.0 on corporate performance, suggesting that immediate improvements in efficiency or profitability may not result from the adoption of this framework. This research contributes to the field by highlighting the need for careful management in integrating lean methods and Industry 4.0 technologies. It also emphasizes the positive impacts of lean principles and Industry 4.0 technology on business performance. The unexpected finding regarding the lack of immediate improvements in corporate efficiency or profitability with Lean 4.0 adoption prompts considerations of initial implementation challenges or the organization's need for time to adapt to this integrated approach.

The Impact of Serialisation on Operational Efficiency and Productivity in Irish Pharmaceutical Sites

Technology enabling drug serialisation technology was introduced by regulators to enhance security in pharmaceutical supply chain and protect drugs from infiltration by falsified and substandard medicines. The introduction of systems for serialisation required huge financial outlays manufacturers of pharmaceuticals. This study investigated the impact of serialisation on the operational efficiency and productivity in Irish pharmaceutical sites. A qualitative study was conducted with 11 manufacturing sites in Ireland. The participating companies operated a total of 114 pack-lines, representing approximately 65% of the automated packing lines in the country. The study found that serialisation had a negative effect on packaging production line OEE and line availability and on the individuals cost per unit of packaged pharmaceuticals. The research results estimated that the capital costs of serialisation were four times greater than those estimated by the regulators. There was a 4.1 cents average cost per pack for serialisation with high volume sites reporting an annual cost of serialisation of up to €4.5 m per annum and a 2.7% increase in the average cost of goods sold. A pattern whereby where many pharmaceutical manufacturers are transitioning from smaller batch production and moving toward larger batch production sizes in order to increases efficiencies was identified. The research also proposed the use of a serialisation depreciation factor as a method to determine the impact of serialisation on the cost of goods sold. This is the first study of its kind into the cost of serialisation from a manufacturer's viewpoint and studying the effects of serialisation on productivity, line availability and operational efficiency.

The response of the Irish pharmaceutical manufacturing sector to the COVID-19 pandemic with a focus on Lean and JIT

Background

Just in Time (JIT) and Lean manufacturing are concepts that originated in the automotive industry and were then adopted by pharmaceutical and biopharmaceutical companies during the 1990s. However, the Covid-19 pandemic and the urgent demand for pharmaceutical treatment challenged JIT and Lean manufacturing processes. Production of Covid-19-related medicines increased, putting pressure on global supply chains and operations. This also hindered the production of medicines using the same or similar materials. Thus, questions are raised concerning JIT and Lean supply chains in the pharmaceutical industry.

Objectives

The present study aimed to explore (1) if material and supply constraints occurred due to the Covid-19 pandemic, (2) how companies were impacted and managed and (3) if changes are required to future proof the JIT supply chain approach for future global events.

Design

A mixed-method cross-sectional survey design was used and focused on material supply, qualification and validation in Irish pharmaceutical manufacturing sites.

Methods

Employees working in the Irish pharmaceutical manufacturing industry were recruited using convenience sampling through online advertisement using the social media platform 'LinkedIn'. Quantitative data was analysed using percentages and qualitative data from free-text responses were used to add context to the quantitative survey questions.

Results

A total of 41 participants were recruited. The results suggested that the pandemic had a negative effect on material availability according to 81% of participants. This translated to delays or stoppage of production activity and was mainly handled by sourcing new materials (70%). To cope with future global crises, 60% of participants recommended more flexibility in future validation processes while 78% of participants acknowledged the importance of validating additional suppliers. A hybrid model of manufacturing and supply chain management was also a preferred approach to exclusive Lean and JIT (42%).

Conclusions

The production of non-Covid-19 medicines was adversely affected by the Covid-19 pandemic, but the pharmaceutical industry in Ireland demonstrated resilience and collaboration in response to these challenges. This study suggests that the JIT and Lean manufacturing model should be adjusted to ensure medicine supply chains are not disrupted during future global events.

A total productive maintenance & reliability framework for an active pharmaceutical ingredient plant utilising design for Lean Six Sigma

This research investigates the requirement for and relationship and implementation of a total productive maintenance (TPM) and Reliability Centred Maintenance (RCM) strategy within an Active Pharmaceutical Ingredient (API) Plant. This research aimed to study the tools and techniques of TPM and Reliability Engineering and then deploy a designed model to an API plant. A case study involving Design for Lean Six Sigma phases of Define, Measure, Analyse, Design, and Verify was utilised to build an API site TPM pilot program. Data was collected using interviews across Company 'X's local and Global Engineering teams. Process runtime, downtime and plant availability metrics were compiled and a new design for Total Productive Maintenance and Reliability was proposed and verified. A maintenance framework was designed to optimally incorporate Total Productive Maintenance, Reliability and Operational Excellence with an emphasis on Overall Equipment Efficiency (OEE) realizing a 33 % reduction in planned maintenance activities, a 70 % reduction in Corrective Maintenance, Cleaning for Maintenance was reduced by 50 %, the pilot maintenance area of the centrifuge has its OEE increased by 20 % and plant availability increased by two hundred and 6 h. This research highlights the importance of Total Productive Maintenance as a key component of an effective maintenance strategy and its potential to transform maintenance practices. Based on this research and results, TPM is recommended to be applied to any API manufacturing organization. A limitation of the study is that it is a single-site case study. The novelty of this research is based upon the emphasis on Reliability Engineering to remove non-value add Maintenance time from the manufacturing schedule. The Total Productive Maintenance & Reliability model designed and implemented in this research is unique in the literature and can be leveraged by engineering professionals and academics to understand the benefits of TPM.

The Challenges for Manufacturers of the Increased Clinical Evaluation in the European Medical Device Regulations: A Quantitative Study

The European Union Medical Device Regulations 2017/745 entered into force on May 2021 with changes related to strengthening the clinical evaluation requirements, particularly for high-risk devices. This study investigates how the increased requirements on medical device manufacturers in relation to how clinical evaluation will challenge manufacturers. A quantitative survey study was utilized with responses from 68 senior or functional area subject matter experts working in medical device manufacturing Regulatory or Quality roles. The findings from the study demonstrated that the highest source of reactive Post-Market Surveillance data was customer complaints and proactive data were Post-Market Clinical Follow-Up. In contrast, the top 3 sources for generating clinical evaluation data for legacy devices under the new Medical Device Regulations were Post-Market Surveillance data, Scientific literature reviews, and Post-Market Clinical Follow-Up studies. Manufacturers' biggest challenge under the new Medical Device Regulations is determining the amount of data needed to generate sufficient clinical evidence, while over 60% of high-risk device manufacturers have outsourced the writing of their clinical evaluation reports. Manufacturers also reported a high investment in clinical evaluation training and highlighted inconsistencies in the requirements for clinical data by different notified bodies. These challenges may lead to a potential shortage of certain medical devices in the E.U. and a delay in access to new devices, negatively impacting patient quality of life (1). This study provides a unique insight into the challenges currently experienced by medical device manufacturers as they transition to the MDR clinical evaluation requirements and the subsequent impact on the continued availability of medical devices in the E.U.

Managing inpatient bed setup: an action-research approach using lean technical practices and lean social practices

PURPOSE

This article aims to introduce a guide to improving hospital bed setup by combining lean technical practices (LTPs), such as kaizen and value stream mapping (VSM) and lean social practices (LSPs), such as employee empowerment.

DESIGN/METHODOLOGY/APPROACH

Action research approach was employed to analyze the process of reconfiguration of bed setup management in a Brazilian public hospital.

FINDINGS

The study introduces three contributions: (1) presents the use of VSM focused specifically on bed setup, while the current literature presents studies mainly focused on patient flow management, (2) combines the use of LSPs and LTPs in the context of bed management, expanding current studies that are focused either on mathematical models or on social and human aspects of work, (3) introduces a practical guide based on six steps that combine LSPs and LSPs to improve bed setup management.

RESEARCH LIMITATIONS/IMPLICATIONS

The research focused on the analysis of patient beds. Surgical beds, delivery, emergency care and intensive care unit (ICU) were not considered in this study. In addition, the process indicators analyzed after the implementation of the improvements did not contemplate the moment of the COVID-19 pandemic. Finally, this research focused on the implementation of the improvement in the context of only one Brazilian public hospital.

PRACTICAL IMPLICATIONS

The combined use of LSPs and LTPs can generate considerable gains in bed setup efficiency and consequently increase the capacity of a hospital to admit new patients, without the ampliation of the physical space and workforce.

SOCIAL IMPLICATIONS

The improvement of bed setup has an important social character, whereas it can generate important social benefits such as the improvement of the admission service to patients, reducing the waiting time, reducing hospitalization costs and improving the hospital capacity without additional physical resources. All these results are crucial for populations, their countries and regions.

ORIGINALITY/VALUE

While the current literature on bed management is more focused on formal models or pure human and social perspectives, this article brings these two perspectives together in a single, holistic framework. As a result, this article points out that the complex bed management problem can be efficiently solved by combining LSPs and LTPs to present theoretical and practical contributions to the important social problem of hospital bed management.

Empirical analysis of Lean Six Sigma implementation barriers in healthcare sector using fuzzy DEMATEL approach: an Indian perspective

Purpose

The present study aims to explore the barriers to Lean Six Sigma (LSS) implementation in the healthcare sector and develop the ranking of finalized barriers using the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach under a fuzzy environment.

Design/methodology/approach

The LSS barriers are identified through the literature review and validated by the expert's opinion and statistical analysis. A total of 124 experts were identified through the purposive sampling method for conducting this study. A questionnaire survey method is used to collect the data related to identified LSS barriers in the healthcare sector. The screened barriers are ranked through the Fuzzy DEMATEL approach.

Findings

In this study, a total of 21 barriers were identified with the help of a systematic literature review and screened 13 significant barriers by the expert opinions of healthcare personnel. The result reveals that “Lack of top management commitment and support, lack of awareness about LSS”, “resistance to culture change and inadequate resources emerges as the most critical barriers”. The prioritization of barriers facilitates the managers to make effective policies and guidelines for LSS implementation in healthcare organizations.

Practical implications

To avoid LSS implementation failure, the practitioners and researchers need to focus on LSS barriers as per suggested ranking more conventionally and make plans and adoption policies accordingly.

Originality/value

This study is unique in terms of investigation and empirical analysis of LSS implementation barriers in the healthcare sector in the Indian context. The outcomes of the present study will help the managers of healthcare organizations to make the strategies and policies for LSS implementation as per the recommended LSS barriers.

The Effect of Medical Device Regulations on Deploying a Lean Six Sigma Project

This paper investigates the differences in timelines involved in Lean Six Sigma (LSS) project deployment in a regulated industry versus in an unregulated one. Two case studies utilising Lean Six Sigma methods—in order to compare the transfer of manual manufacturing lines within a medical device and electronics manufacturing site—are discussed and utilised. This research aims to show the effects of regulatory procedures on LSS project implementation and timelines. This study particularly highlights how a regulatory environment can be a barrier, or bottleneck, to project management, continuous improvement, and engineering changes in the MedTech or medical device manufacturing industry. The results of this study represent an important first step towards a full understanding of the influence of regulations on operations in medical devices and, by extension, on pharmaceutical manufacturing industries on a global scale. The research limitations are that the data collected were from two specific case study comparisons alone.

A Review of Lean Methodology Application and Its Integration in Medical Device New Product Introduction Processes

The purpose of this study is to review the Lean tool application and its utilisation in medical device design and the new product introduction process to establish the benefits and best practices for its integration with existing new product introduction processes. A review of the literature on the current state of medical device New Product Introduction (NPI) processes is completed along with a comprehensive review of the literature on the history and development of Lean NPI. The review indicates that Lean can be combined with the predominant NPI execution tools, Stage-Gate and Concurrent Engineering within the medical device industry to achieve a best-in-class continuous improvement methodology within the NPI process. This integration eliminates waste, focusses on customer value, and ultimately reduces cost and lead time to market. This review highlights for the first time the main challenges and issues with Lean in the medical device sector NPI processes, identifying possible future strands of research. Limitations of the current review are that despite the heavy emphasis placed on Lean manufacturing processes, comparatively little emphasis is placed on the use of Lean in the medical device NPI process. Future longitudinal case studies on case study application of Lean in medical device NPI processes would be useful. This study has implications for identifying best practices for Lean in NPI in the device industry, improving what is considered state-of-the-art for the introduction of devices into the public domain.

An empirical study into the use of 7 quality control tools in higher education institutions (HEIs)

Purpose

The main purpose of this study is to revisit Ishikawa's statement: “95% of problems in processes can be accomplished using the original 7 Quality Control (QC) tools”. The paper critically investigates the validity of this statement in higher education institutions (HEIs). It involves analysis of the usage of the 7 QC tools and identifying the barriers, benefits, challenges and critical success factors (CSFs) for the application of the 7 QC tools in a HEI setting.

Design/methodology/approach

An online survey instrument was developed, and as this is a global study, survey participants were contacted via social networks such as LinkedIn. Target respondents were HEIs educators or professionals who are knowledgeable about the 7 QC tools promulgated by Dr Ishikawa. Professionals who work in administrative sectors, such as libraries, information technology and human resources were included in the study. A number of academics who teach the 7 basic tools of QC were also included in the study. The survey link was sent to over 200 educators and professionals and 76 complete responses were obtained.

Findings

The primary finding of this study shows that the diffusion of seven QC tools is not widespread in the context of HEIs. Less than 8% of the respondents believe that more than 90% of process problems can be solved by applying the 7 QC tools. These numbers show that modern-quality problems may need more than the 7 basic QC basic tools and there may be a need to revisit the role and contribution of these tools to solve problems in the higher education sector. Tools such as Pareto chart and cause and effect diagram have been widely used in the context of HEIs. The most important barriers highlighted are related to the lack of knowledge about the benefits and about how and when to apply these tools. Among the challenges are the “lack of knowledge of the tools and their applications” and “lack of training in the use of the tools”. The main benefits mentioned by the respondents were “the identification of areas for improvement, problem definition, measurement, and analysis”. According to this study, the most important factors critical for the success of the initiative were “management support”, “widespread training” and “having a continuous improvement program in place”.

Research limitations/implications

The exploratory study provides an initial understanding about the 7 QC tools application in HEIs, and their benefits, challenges and critical success factors, which can act as guidelines for implementation in HEIs. Surveys alone cannot provide deeper insights into the status of the application of 7 QC tools in HEIs, and therefore qualitative studies in the form of semi-structured interviews should be carried out in the future.

Originality/value

This article contributes with an exploratory empirical study on the extent of the use of 7 QC tools in the university processes. The authors claim that this is the first empirical study looking into the use of the 7 QC tools in the university sector.

The Lack of Ireland’s Assisted Human Reproduction (AHR) Regulation Viewed under the Lens of the Patient’s Experience

Assisted Human Reproduction (AHR) treatment is unregulated in Ireland, although it is practised there. Within Europe, Ireland is one of the only European countries without any form of AHR-specific regulation. This study aims to investigate the experiences and viewpoints of Irish women undergoing AHR treatments and establish if the lack of legislation is affecting these experiences. A quantitative survey was carried out on women undergoing AHR treatment in Irish clinics. Patients highlighted a lack of information in terms of end-to-end care and poor information around treatments and success rates. Key issues highlighted included unanticipated high treatment costs and add-on treatment costs, lack of financial support from the government, no redress process in the event of dissatisfaction, and generally an overall feeling of a lack of support both from the AHR clinics and the Irish government. This study offers a real-time view of the Irish AHR system from the patient’s experience of AHR and under the lens of the lack of a legislative system. In early 2022, the Irish government announced that it would adopt its bill around AHR treatment and that subsidies for AHR treatment are to come into effect, which will alleviate some financial pressures on patients. Further studies of the legislation carried out post implementation will provide more information about the impact of having a legislated AHR process on the patients.

The evolution and future of lean Six Sigma 4.0

Purpose

This purpose of this study is to provide an overview of the current state of research on Lean Six Sigma (LSS) and Industry 4.0 and the key aspects of the relationships between them. The research analyses LSS's evolution and discusses the future role of LSS 4.0 in an increasingly digitalized world. We present the benefits and motivations of integrating LSS and Industry 4.0 as well as the critical success factors and challenges within this emerging area of research.

Design/methodology/approach

A systematic literature review methodology was established to identify, select and evaluate published research.

Findings

There is a synergistic nature between LSS and Industry 4.0. Companies having a strong LSS culture can ease the transition to Industry 4.0 while Industry 4.0 technologies can provide superior performance for companies who are using LSS methodology.

Research limitations/implications

One limitation of this research was that as this area is a nascent area, the researchers were limited in their literature review and research. A more comprehensive longitudinal study would yield more data. There is an opportunity for further study and analysis.

Practical implications

This study reviews the evolution of LSS and its integration with Industry 4.0. Organisations can use this study to understand the benefits and motivating factors for integrating LSS and Industry 4.0, the Critical Success Factors and challenges to such integration.

Originality/value

This is the first systematic literature review on LSS 4.0 and can provide insight for practitioners, organisations and future research directions.

A Lean Manufacturing Progress Model and Implementation for SMEs in the Metal Products Industry

The manufacturing industry faces the challenge of small and diversified customer orders. To meet this challenge, strong internal production capabilities are required. A lean manufacturing process that uses fewer resources and offers greater process improvement will help SMEs to continue to contribute to the global economy. Though SMEs provide most employment opportunities, previous studies have focused on large companies in auto-manufacturing-related industries. With the commitment and support of the management, and the application of a value stream map (VSM) and related improvement tools, we produced a practical process improvement model for a lean manufacturing system in an SME. With the commitment and support of the management and the joint efforts of the project improvement staff, the 10 improvement projects over a six-month period all achieved their goals: reduction in lead time from 26 days to 19.5 days, improvement of welding per people per hour (PPH) efficiency by 28.3%, improvement of packaging PPH efficiency by 64.1%, improvement of working in process (WIP) efficiency at the production site by 83.84%, and improvement of raw material storage by 83.84%. The efficiency of the raw material warehouse inventory was improved by 58.63%, and the efficiency of the shipment completion rate was improved by 14.5%.

A Review of Lean Adoption in the Irish MedTech Industry

There have been many literature reviews carried out on Lean implementation in larger organisations with specific focus on the automobile industry. Lean implementation in the medical device industry has not been extensively investigated. Thus, this research endeavored to analyse the benefits of Lean, tools utilised and challenges and results of Lean implementation in Medtech companies. This article aims to bridge a gap in the literature by reviewing the literature that discusses Lean implementation in MedTech companies in Ireland with a perspective of identifying the benefits and challenges faced. The quantitative methodology allows us to review the comprehensive numbers and data which were collected from 20 Enterprise Ireland MedTech case studies. There are very few published case studies in the literature on Lean due to the highly regulated nature of MedTech sector and the vast array of medical devices, which are often under privacy and confidentiality constraints. The results showed that integration of Lean has brought benefits to companies by increasing productivity and product quality, optimised cost, and time. An inclusive discussion of Lean tools for Lean implementation within MedTech was established and suggestions for future research orientations are thus provided.