PurposeThe purpose of this work is to gain insights about Lean Six Sigma (LSS) in the Indian context by reviewing the related literature for one decade based on various perspectives, such as author profile, year of publication, type of firm, type of methodology used, type of industry for which the research work is carried out and the key findings from the research.Design/methodology/approachThis study reviews the research related to LSS from the articles published in the reputed journals. The literature used for reviewing is derived from the sources, including Science direct, Google scholar, IEEE, Taylor and Francis Group, Emerald Insight, Springer, Inderscience and Elsevier during the period between 2010 and 2021. Totally, the authors have included 141 LSS-related research articles that are published in the Indian context. The keywords used are Lean Six Sigma, Lean Six Sigma in the Indian context, Lean Sigma and LSS to identify and consolidate the research papers published during this timeframe.FindingsThe research papers collected from various reputed journals, including Scopus and non- Scopus enlisted, are classified and grouped under various categories to identify the class of author who publishes more in this field, research trend over the years, the type of firm which implements LSS, the research methodology which is commonly used in LSS and related research and also the key takeaway from these articles are highlighted. Further, the authors have also identified the major contributions of researchers in various sectors during this period in India.Originality/valueThis classification framework and the systematic review help in identifying the research gap and in giving directions for future researchers. It will be useful for researchers and practitioners working on the area of LSS, rural and urban entrepreneurs, start-up managers, professionals working in micro, small and medium enterprises (MSMEs) and executives of the Make in India Project to make India as Aatmanirbhar Bharat Abhiyan. Further, the clear direction of progress over the current decade in manufacturing industries, service sectors and processing industries can help the professionals working in these sectors.

The implementation of Lean Six Sigma framework in the Indian context: a review and suggestions for future research

PurposeThis research aims to examine the relationships among leadership and culture, human resources and process improvement in lean hospitals from the socio-technical perspective.Design/methodology/approachThe survey instrument was developed from literature reviews, verified by experts and confirmatory factor analysis. Multiple responses were used to collect data from 473 care providers in 220 outpatient departments of Thai hospitals to improve reliability of the obtained data. Path analysis of structural equation modeling was applied to analyze the hypotheses.FindingsIt was found that human resources has a significant positive direct effect on process improvement. Leadership and culture not only has significant direct positive impacts on human resources and process improvement but also has a significant indirect positive impact on process improvement through human resources.Originality/valueThis is one of the first examples of research to present insights into the links between soft and hard factors of lean hospitals at strategic and operational levels.

Relationships between leadership and culture, human resources and process improvement in lean healthcare

PurposeRecently, several areas are successfully applying the Lean Six Sigma methodology, specifically in healthcare, public services, higher education institutions and manufacturing industries. This study aims to present an extensive literature review involving Lean Six Sigma practical applications in the last five years, described in a case studies format.Design/methodology/approachA systematic literature review was conducted, and 39 articles were selected and analyzed.FindingsAn increase in Lean Six Sigma applications in healthcare and higher education institutions was identified. Furthermore, Lean Six Sigma is effectively applied in several areas and is continuously used in traditional industries. The main critical success factor identified was leadership and management involvement, project management and organizational infrastructure, as well as training and education. Also, the main difficulties found are related to the organization's culture and developing communication with leaders and managers.Research limitations/implicationsThe main difficulties found in this research are related to the lack of data presented in some articles analyzed, where only information about how the Lean Six Sigma application was conducted is shown, not mentioning difficulties or success factors identified.Originality/valueCase studies are fundamental to help popularize Lean Six Sigma applications, showing a real-life scenario of how the methodology is implemented, the main difficulties encountered and critical success factors found. Thus, the value of this study is promoting and developing research involving Lean Six Sigma case study applications to guide new researchers and practitioners on the subject.

Lean Six Sigma case studies literature overview: critical success factors and difficulties

PurposeThis paper aims to characterize a sample of Lean Six Sigma (LSS) projects in healthcare settings and discuss some specificities of operational excellence (OPEX) initiatives in hospitals and healthcare organizations in the USA.Design/methodology/approachA content analysis involving a sample of 23 documents shared by US hospitals was performed in order to achieve the research objectives. Such analysis was based on a conceptual framework developed from the literature review. It was also applied to a quantitative approach, including descriptive statistics, hypothesis testing and correspondence analysis that supported the research.FindingsMost LSSH projects were focused on business transformation and strategic improvements. Simple techniques and tools were predominant such as descriptive statistics, process mapping, 5S and spaghetti charts, usually implemented by Green Belts and Black Belts through the define, measure, analyze, improve and control (DMAIC) method. In addition to the expressive findings reported, these projects' results have been aligned with lead time and operational cost reduction, quality improvement and capacity increase.Research limitations/implicationsThe study adds knowledge to the OPEX literature by analyzing the Lean Six Sigma healthcare (LSSH) in hospitals and healthcare institutions in the USA. It also demonstrates that different approaches, such as the kaizen event and DMAIC project show different results according to some techniques and tools applied in the hospital environment.Originality/valueThe empirical evidence presented in this study provides scenery of the LSS practices in the healthcare settings, highlighting the implementation areas, outcomes, tools and techniques mostly used in the North American healthcare institutions.

Characterization of Lean Six Sigma projects in healthcare settings: empirical research

Summary Introduction Lean is largely applied to the health sector and on the healthcare-associated infections (HAI). However, a few results on the improvement of the outcome have been reported in literature. The purpose of this study is to analyze if the lean application can reduce the HAI rate. Methods A comprehensive search was performed on PubMed/Medline, Scopus, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the following keywords: “lean” and “infection”. Inclusion criteria were: 1) research articles with quantitative data and relevant information on lean methodology and its impact on healthcare infections; 2) prospective studies. The risk of bias and the study quality was independently assessed by two researchers using the “The National Institutes of Health (NIH) quality assessment tool for before-after (Pre-Post) study with no control group”. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines has been used. 22 studies were included in the present meta-analysis. Results Lean application demonstrated a significant protective role on healthcare-associated infections rate (RR 0.50; 95% C.I.: 0.38-0.66) with significant impact on central line-associated bloodstream infections (CLABSIs) (RR 0.47; 95% C.I.: 0.28-0.82). Conclusions Lean has a positive impact on the decreasing of HAIs and on the improvement of compliance and satisfaction of the staff.

Mohd Shadab

Papers

Lean six sigma in the healthcare sector: A systematic literature review