Purpose – The purpose of this paper is to study the scope of Lean Six Sigma (LSS) strategy and to explore its successful deployment in the Indian healthcare sector. Design/methodology/approach – The research reported in this paper is based on a case study carried out using the LSS DMAIC (Define-Measure-Analyze-Control) approach and its application in improving the registration process in the Health Information Department (HID) of a Medical College hospital in India. Findings – The study describes improvements in the HID through the power of LSS. Cycle time of the process was reduced from three to 1.5 minutes and the SD was reduced to 21.2 from 61 seconds. The project has shown a 94 per cent reduction in patients’ average waiting time. The study also reported a 91 per cent reduction in queue length and 48 per cent reduction in percentage of scheduled utilization of staff for the process. Research limitations/implications – The paper is based on a single case study executed in a hospital and hence there is limitation in generalizing the specific results from the study. But the approach adopted and the learning from this study can be generalized. The study is of use to healthcare practitioners seeking to implement or develop LSS further in their organizations. Originality/value – Although LSS being extremely successful in the last two decades, the application of LSS to the healthcare industry in general and HID in particular has been limited. This study illustrates how its application can improve the performance of the process and thus productivity in the department.
Purpose The purpose of this paper is to provide lean and six sigma professionals and researchers of tomorrow with Ten Commandments of Lean Six Sigma (LSS). Design/methodology/approach The Ten Commandments of LSS are based on several years’ experience of four authors who act as researchers, LSS Master Black Belts, consultants, practitioners and trainers on various topics of Lean, Six Sigma and general quality management and continuous improvement. Findings The Ten Commandments in our opinion include: alignment of LSS initiative with organisational strategy, LSS project selection and prioritisation, selection of top talent for the project execution, leadership for LSS, effective training and design of appropriate curriculum for different LSS roles, development of reward and recognition system, LSS sustainability, Linking LSS with Organisational Learning and Innovation, Linking LSS with Environmental Management System Standards and finally LSS and Big Data. Research limitations/implications The key features outlined in this paper are based on the practitioners of LSS. The authors of this article are planning to pursue a global study to critically evaluate these commandments by various practitioners of LSS. Originality/value The senior managers and executives of various businesses can use these commandments of LSS as a guide to achieve and sustain competitive advantage.
Purpose The purpose of this paper is to explore the voice of the customer, key performance indicators, critical to quality characteristics, critical success factors, and commonly used tools and techniques for deploying the Lean Six Sigma (LSS) strategy in Indian private hospitals, with special attention to the medical records. Design/methodology/approach The study utilizes the action research methodology to obtain a greater understanding of the use of LSS in the Indian healthcare sector. Multiple case studies were designed and successfully deployed to understand and ascertain challenges in LSS implementation. Five case studies were carried out in the Medical Records Departments (MRD) of four private hospitals in India. Findings Patients perceive that waiting in queue harms their health, which can be rectified by addressing the cycle time of the system. The research also found that effective leadership, availability of data, involvement of cross-functional team and effective communication are critical to the success of LSS projects. In addition, control charts, cause and effect diagram, 5S, gemba, two-sample t-test, standardization, waste analysis and value stream mapping are some of the common tools used to improve healthcare systems. Research limitations/implications The research was restricted to studying the impact of LSS on the workflow and resource consumption of the MRD in Indian allopathic hospitals only. The validity of the results can be improved by including more hospitals and more case studies from the healthcare sector in different countries. Originality/value The findings will enable researchers, academicians and practitioners to incorporate the results of the study in LSS implementation within the healthcare system to increase the likelihood of successful deployment. This will provide greater stimulus across other departments in the hospital sector for wider and broader application of LSS for creating and sustaining process improvements.
This article addresses the issue of longer patient waiting time in the outpatient department (OPD) of a super specialty hospital attached to a manufacturing company in India. Due to longer waiting times at OPD, employees need to be away from the workplace for a longer duration. This problem was addressed through the Lean Six Sigma (LSS) methodology. The process, starting from registration of a patient to dispensing of medicine, was included in the project. The non-value added steps in the process were identified, and actions were initiated. A cause and effect diagram was prepared for high patient waiting time, and causes were validated with the help of data collected from the process. Statistical tools such as Kruskal-Wallis test, Box -Cox transformation, Control charts, normality test, etc., were used within the LSS methodology not only to identify the causes but also to sustain the improvements. As a result of this project, the average waiting time reduced from 57 min to 24.5 min and the standard deviation was reduced to 9.27 from 31.15 min. This will help the hospital to serve patients better and faster, which, in turn, will lead to a reduction in delay of treatment and a faster recovery of patients. The productivity loss due to absenteeism of employees from the workplace could be reduced. Generally, in an Indian health care scenario, most of the activities were dependent on individual doctors rather than processes. This project has helped the clinicians and the hospital management to identify the weak areas in the process for improvement. Because of the implemented solutions, understanding the history of past treatments and medications of the patients was easy for the doctors. Also, the practical validity of deploying LSS in a healthcare scenario was justified with this study.
Purpose – The purpose of this paper is to illustrate how Lean Six Sigma (LSS) methodology was applied to a medical records department (MRD) of a hospital in India to reduce the Turn-Around-Time (TAT) of medical records preparation process and thus to improve the productivity and performance of the department. Design/methodology/approach – The research reported in this paper is based on a case study carried out using LSS approach and in improving the medical records preparation process. Findings – The root causes for the problem were identified and validated through data-based analysis from LSS tool box, at different stages in the project. As a result of this project, the TAT was reduced from average 19 minutes to eight minutes and the standard deviation was reduced by one-tenth, which was a remarkable achievement for department under study. This was resulted in the reduction in the work-in-process inventory of medical records from 40 units to 0 at the end of the day. Project in-turn reduced the staffing level from the earlier level of six to a current level of four. Research limitations/implications – The paper is based on a single case study executed in IP-MRD of a single hospital and hence there is limitation in generalizing the specific results from the study. But the approach adopted and the learning from this study can be generalized. Originality/value – This paper will be helpful for those professionals who are interested in implementing LSS to healthcare organization to improve the productivity and performance.
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