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Journal ArticleDOI

Reducing medication errors using LSS Methodology: A systematic literature review and key findings

TL;DR: Increased interest in the application of process excellence methodologies such as Lean, Six Sigma and LSS to reduce medication errors especially from the developed countries was found.
Abstract: The paper aims to systematically review the literature on Lean, Six Sigma, Lean Six Sigma (LSS) intervention and its tools and techniques to reduce the medication errors in hospitals. Subject-speci...

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TL;DR: In this article, the authors present a detailed review for benefits and challenges about implementation of Lean Six Sigma (LSS) in business organization and spread of LSS literature in term of various sectors wise, research methodology wise and journal wise.
Abstract: The purpose of present study is to expose the detailed review for benefits and challenges about implementation of Lean Six Sigma (LSS) in business organization and spread of LSS literature in term of various sectors wise, research methodology wise and journal wise.,This paper covers the literature on LSS from 2000 to 2018. The authors have selected a large number of research papers using the keywords as Lean Six Sigma implementation in automotive, micro small medium enterprises, health care, education, financial sectors and many more. A total of 216 research papers have been reviewed on LSS distribution of sector wise, research methodology adopted, active countries, year of publication and critical barriers in implementation of LSS.,The present literature classifies the spread of LSS in four important sectors of manufacturing, health care, human resource, financial and education. It presents the critical barriers and benefits of LSS implementation in various sectors mentioned above and an important research gap, where practitioner/researcher can focus more during their research on LSS.,It is important for industry, researchers and LSS practitioners to be aware about challenges and success factor during LSS implementation in various sectors such as manufacturing, education, financial, human resource and health care. Hence, this paper could provide significant and valuable insights to industry and practitioners for successful implementation of LSS projects.,LSS results in reduced waste, defects and improve process, which in turn provide high-quality products at minimum cost, and this leads to customer delight, which ultimately raises the societal living standard. The results encourage LSS practices without fear because there is a huge discussion of near about all success and failure parameters about LSS.,To the authors’ best knowledge, no studies have still covered the literature review of LSS implementation in three different sectors: manufacturing, service and process. The present study was mainly focused on presenting a systematic review of literature in said sectors and found the gap between current status and future direction for the implementation of LSS in different areas.

71 citations

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TL;DR: The study finds that the implementation of L SS in the Norwegian public health-care context is still in its infancy, amidst several challenges faced by Norwegian hospitals such as the lack of top-management support, lack of LSS training and coaching and a lack of awareness around the benefits of Lss in health care.
Abstract: Purpose: Medication errors are a significant cause of injury in Norwegian hospitals. The purpose of this study is to explore how Lean Six Sigma (LSS) has been used in the Norwegian public health-care context to reduce medication errors. Design/methodology/approach: A mixed method approach was used to gather data from participants working in the four regions served by the Norway health authorities. A survey questionnaire was distributed to 38 health-care practitioners and semi-structured interviews were conducted with 12 health-care practitioners. Findings: The study finds that the implementation of LSS in the Norwegian public health-care context is still in its infancy. This is amidst several challenges faced by Norwegian hospitals such as the lack of top-management support, lack of LSS training and coaching and a lack of awareness around the benefits of LSS in health care. Research limitations/implications: Because of the large geographical area, it was difficult to reach participants from all health regions in Norway. However, the study managed to assess the current status of LSS implementation through the participants’ perspectives. This is a fruitful area for future research whereby an action research methodology could be used. Originality/value: To the best of the authors’ knowledge, this is the first empirical study into the use of LSS methodology in reducing medication errors. In addition, this study is valuable for health-care practitioners and professionals as a guideline to achieve the optimal benefit of LSS implementation to reduce medication errors.

17 citations

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TL;DR: This study characterizes the literature by evaluating and classifying 22 reviews, based on year of publication, country, taxonomy, health care setting, outcome, tools, and enabling factors, in order to identify gaps in the literature and set new directions for research.
Abstract: Background and objectives Health care is a complex industry in which professionals are facing the challenge of balancing lower costs with better health and quality of care. To remain competitive, health care organizations have promoted the use of Lean and Six Sigma in various settings. More than 300 refereed English-language articles about Lean and/or Six Sigma in health care are found in the literature, and many reviews have been published on this subject. Methods This article characterizes the literature by evaluating and classifying 22 reviews, based on year of publication, country, taxonomy, health care setting, outcome, tools, and enabling factors, in order to identify gaps in the literature and set new directions for research. Results Findings indicate that 90% of reviews are characterized by restrictive inclusion criteria that result in the inclusion of only 3% to 66% of the literature at the corresponding time. Furthermore, there is no full comprehensive literature review available on Lean and Six Sigma in health care. Other gaps in the literature include more studies with better research design, broader applications in various health care settings and various countries, sustainability assessment and long-term effects, and evidence of failed Lean and Six Sigma implementations. Conclusion This study provides an updated starting point for future research to researchers and practitioners in the field.

12 citations

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TL;DR: In this paper , the authors identify, study, model and analyze green lean six sigma (GLSS) success factors for the Indian health-care facility, and suggest a direction for practitioners to execute the GLSS approach through a systematic understanding of classification and structural relationships among different enablers.
Abstract: Purpose Green lean six sigma (GLSS) is a sustainable development approach that leads to improved patient care with improved safety and quality of service to patients. This study aims to identify, study, model and analyze GLSS success factors for the Indian health-care facility. Design/methodology/approach Interpretive structural modeling (ISM) and Impact Matrix Cross-Reference Multiplication Applied to a Classification analyses have been used to understand the hierarchical structure among the GLSS success factors. This enabled the development of dependency relationships between success factors, in particular, which factors support the development of other factors. Findings Specifically, this study found that the success factors “commitment of management” and “financial availability” are the most critical to GLSS implementation success, as they support the development of all other success factors. Meanwhile “embedding sustainable measures at each stage of the service”; “the capability and effectiveness of real-time data collection”; and “feedback and corrective actions” most directly support the GLSS implementation in the health-care facility and serve as the final indicators of implementation progress. Research limitations/implications The major implication of this research work lies in suggesting a direction for practitioners to execute the GLSS approach through a systematic understanding of classification and structural relationships among different enablers. This study also facilitates health-care managers to explore different GL wastes in hospitals and challenges to sustainability pursuits in health-care that assist in an organization’s efforts toward sustainable development. Originality/value This research work is the first of its kind that deals with the identification and analysis of the prominent factors that foster the inclusive implementation of GLSS within the health-care facility.

12 citations

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TL;DR: A new framework of Sigma metric in statistical quality control (SQC) is developed which is able to capture economic, environmental, and social impact of defect and is expected to be suitable for sustainable manufacturing.
Abstract: Number of defects is a simple way to determine the quality of a product. Quality of a process can also be determined on the basis of number of defects being produced by the process. This paper is an attempt to shift the focus from number of defects to the severity of defects. This also unlocks important concept of integration of sustainability with quality management (QM). QM is one of the areas of research which is equally dependent on quantitative and qualitative measures. As far as quantitative measures are concerned, Six Sigma is the most used metric to define the quality of a system. The ‘Sigma’ is a measure based only on the number of defects which does not involve severity of impact due to defect. Existing literature about sustainability from Six Sigma takes ecological foot print as a defect. Authors argue that different types of defects may result in different level of impact and consequently affect the sustainability of the system under investigation. In this paper, authors are discriminating defects on the basis of severity of their end impacts. Allocation of appropriate weight to each defect develops a new framework of Sigma metric in statistical quality control (SQC). This framework is able to capture economic, environmental, and social impact of defect. It is expected that practitioners and academicians will find using this new sigma metric to be suitable for sustainable manufacturing. This paper also presents an industrial case study as an evidence of achieving higher sustainability for competitiveness by classifying defects on the basis of their end impact.

11 citations

References
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TL;DR: The extent to which the process of systematic review can be applied to the management field in order to produce a reliable knowledge stock and enhanced practice by developing context-sensitive research is evaluated.
Abstract: Undertaking a review of the literature is an important part of any research project. The researcher both maps and assesses the relevant intellectual territory in order to specify a research question which will further develop the knowledge base. However, traditional 'narrative' reviews frequently lack thoroughness, and in many cases are not undertaken as genuine pieces of investigatory science. Consequently they can lack a means for making sense of what the collection of studies is saying. These reviews can be biased by the researcher and often lack rigour. Furthermore, the use of reviews of the available evidence to provide insights and guidance for intervention into operational needs of practitioners and policymakers has largely been of secondary importance. For practitioners, making sense of a mass of often-contradictory evidence has become progressively harder. The quality of evidence underpinning decision-making and action has been questioned, for inadequate or incomplete evidence seriously impedes policy formulation and implementation. In exploring ways in which evidence-informed management reviews might be achieved, the authors evaluate the process of systematic review used in the medical sciences. Over the last fifteen years, medical science has attempted to improve the review process by synthesizing research in a systematic, transparent, and reproducible manner with the twin aims of enhancing the knowledge base and informing policymaking and practice. This paper evaluates the extent to which the process of systematic review can be applied to the management field in order to produce a reliable knowledge stock and enhanced practice by developing context-sensitive research. The paper highlights the challenges in developing an appropriate methodology.

5,444 citations


"Reducing medication errors using LS..." refers methods in this paper

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Journal ArticleDOI

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TL;DR: In this article, the authors evaluate the process of systematic review used in the medical sciences to produce a reliable knowledge stock and enhanced practice by developing context-sensitive research and highlight the challenges in developing an appropriate methodology.
Abstract: Undertaking a review of the literature is an important part of any research project. The researcher both maps and assesses the relevant intellectual territory in order to specify a research question which will further develop the knowledge hase. However, traditional 'narrative' reviews frequently lack thoroughness, and in many cases are not undertaken as genuine pieces of investigatory science. Consequently they can lack a means for making sense of what the collection of studies is saying. These reviews can he hiased by the researcher and often lack rigour. Furthermore, the use of reviews of the available evidence to provide insights and guidance for intervention into operational needs of practitioners and policymakers has largely been of secondary importance. For practitioners, making sense of a mass of often-contrad ictory evidence has hecome progressively harder. The quality of evidence underpinning decision-making and action has heen questioned, for inadequate or incomplete evidence seriously impedes policy formulation and implementation. In exploring ways in which evidence-informed management reviews might be achieved, the authors evaluate the process of systematic review used in the medical sciences. Over the last fifteen years, medical science has attempted to improve the review process hy synthesizing research in a systematic, transparent, and reproducihie manner with the twin aims of enhancing the knowledge hase and informing policymaking and practice. This paper evaluates the extent to which the process of systematic review can be applied to the management field in order to produce a reliable knowledge stock and enhanced practice by developing context-sensitive research. The paper highlights the challenges in developing an appropriate methodology.

4,989 citations

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01 Jan 2009

1,102 citations


"Reducing medication errors using LS..." refers methods in this paper

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Book

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01 Jan 2000
TL;DR: This book presents an Executive Overview of Six Sigma, a Powerful Strategy for Sustained Success, and some of the key concepts of the Six Sigma System as well as tools used in expanding & Integrating the six Sigma System.
Abstract: Part I: An Executive Overview of Six Sigma. Chapter 1: A Powerful Strategy for Sustained Success. Chapter 2: Key Concepts of the Six Sigma System. Chapter 3: Why Is Six Sigma Succeeding Where Total Quality "Failed"? Chapter 4: Applying Six Sigma to Service and Manufacturing. Chapter 5: The Six Sigma Roadmap. Part II: Gearing Up and Adapting Six Sigma to Your Organization. Chapter 6: Is Six Sigma Right for Us Now? Chapter 7: How and Where Should We Start Our Efforts? Chapter 8: The Politics of Six Sigma: Preparing Leaders to Launch and Guide the Effort. Chapter 9: Preparing Black Belts and Other Key Roles. Chapter 10: Training the Organization for Six Sigma. Part III: Implementing Six Sigma: The Roadmap and Tools. Chapter 12: Identifying Core Processes and Key Customers (Roadmap Step 1). Chapter 13: Defining Customer Requirements (Roadmap Step 2). Chapter 14: Measuring Current Performance (Roadmap Step 3). Chapter 15: Six Sigma Process Improvement (Roadmap Step 4). Chapter 16: Six Sigma Process Improvement (Roadmap Step 4A). Chapter 17: Expanding & Integrating the Six Sigma System (Roadmap Step 5). Chapter 18: Advanced Six Sigma Tools: An Overview. Conclusion: Twelve Keys to Success.

1,001 citations

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TL;DR: This paper presents the key ingredients, which are essential for Six Sigma implementation, generated from a pilot survey conducted in the UK manufacturing and service organisations.
Abstract: Six Sigma is a business strategy and a systematic methodology, use of which leads to breakthrough in profitability through quantum gains in product/service quality, customer satisfaction and productivity. The concept of implementing Six Sigma processes was pioneered at Motorola in the 1980s and the objective was to reduce the number of defects to as low as 3.4 parts per million opportunities. For the effective implementation of Six Sigma projects in organisations, one must understand the critical success factors that will make the application successful. This paper presents the key ingredients, which are essential for Six Sigma implementation. These ingredients are generated from a pilot survey conducted in the UK manufacturing and service organisations.

663 citations


"Reducing medication errors using LS..." refers background in this paper

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