Purpose -The authors analyze the principles and results of lean production and compare the lean production philosophy with the six sigma quality process and the principles of total quality management (TQM). At the end of the paper, it is discussed how to build the necessary company culture for having success with these principles/management philosophies. Design/methodology/approach -Literature search and comparative analysis complemented with a Danish case on wastage in a core process. Findings -It is shown that the lean production philosophy and the six sigma steps are essentially the same and both have developed from the same root -the Japanese TQM practices. The improvement process from six sigma, the DMAIC process, can be regarded as a short version of the Quality Story, which was developed in Japan in the 1960s as a standard for QC-circle presentations. We conclude that the roadmaps of lean production and six sigma quality are examples of new alternative TQM roadmaps. We also conclude that especially with lean production and six sigma quality there seems to be too much focus on training people intools and techniques and at the same time too little focus on understanding the human factor, i.e. how to build the right company culture. Originality/value -The detailed and historical analysis of six sigma quality, lean production and TQM combined with a focus on the human factor and the needed corporate culture.

ISO 14000 is based on the concept that better environmental performance can be achieved when environmental aspects are systematically identified and managed. Despite the growing interest in voluntary environmental management standards, little empirical information exists and only a few survey studies have been made. This paper contains an evaluation of results from a survey on ISO 14000 and ISO 9000 companies. The study presents experiences from the standards implementation processes in Sweden. It focuses on motives for implementation, perceived benefits and key implementation factors. Further, comparisons are made between ISO 14000 and ISO 9000 systems. Swedish companies mainly use the standard to demonstrate their commitment to environmental protection. Most benefits are also perceived in the improved relations with stakeholders and in marketing advantages. Since the standard requires companies to set their environmental policy and objectives themselves, the identification of environmental aspects was stated as most important and also as the factor requiring most effort. Organizations require their suppliers to implement ISO 9000 to a greater extent than ISO 14000.

PurposeThe purpose of this paper is to discuss how a performance measurement system called “the flow model” is designed to measure changes towards lean thinking in health care services.Design/methodology/approachThe paper integrates literature from the health care sector and the lean production movement in order to understand whether lean thinking is applicable in healthcare and thereby identify key performance indicators that measure changes towards lean thinking in health care. The flow model is discussed in relation to this measurement framework.FindingsThe paper finds that lean thinking is applicable in health care settings, and that the flow model is a suitable tool for following up these initiatives. However, it is argued that the flow model needs to be balanced with other measurements in order to receive a complete picture of lean performance.Research limitations/implicationsThe paper shows that the framework of measurements may be used in empirical research of assessing changes towards lean thinking in health care settings.Practical implicationsThe paper shows that health care practitioners may use the findings to develop measurements of the outcome of lean initiatives on existing care processes.Originality/valueThe paper shows analysis and discussion of the application of an industrial concept – Lean Production – in health care services.

No abstract

No abstract