REDUCING HOSPITAL OUTPATIENT WAITING TIME USING LEAN SIX SIGMA: A SYSTEMATIC REVIEW

Background: Lean Six Sigma (LSS) is a beneficial data-driven tool for quality improvement. Literature regarding the use of LSS to reduce hospital outpatient waiting time is scarce despite numerous problems encountered in many countries. Aims: This systematic review aims to evaluate the causes of long outpatient waiting time, demonstrate the effectiveness of LSS and the improvement strategies applied to reduce outpatient waiting time. Methods: Literature search was performed on eight databases: Proquest, Wiley, Science Direct, Taylor and Francis, Oxford Journal, Sage Publication, Scopus, and Pubmed. Inclusion criteria were peer-reviewed English articles published from January 1, 2003, to May 25, 2021, and studies conducted in hospital settings. Results: Nine relevant articles were included. Inefficient clinic processes, inappropriate scheduling, human resources problems, workplace factors, patient communication problems, and patient characteristics are root causes found for long outpatient waiting time. All studies revealed a reduction in outpatient waiting time (5.2% to 97%) after implementation of LSS. Process redesign, improvement in appointment scheduling, patient communication, and improvement in workplace design, were strategies used to reduce outpatient waiting time. These strategies increase the number of patients seen and hospital gross revenue, as well as patient satisfaction. Conclusion: LSS is beneficial to reduce outpatient waiting time. Process redesign provide advantageous results. Keywords: hospital, lean six sigma, outpatient waiting time, process redesig

Levantamento sobre a evolução da abordagem lean e six sigma / Survey on the evolution of the lean and six sigma approach

Este artigo traz um levantamento bibliométrico referente ao desenvolvimento científico realizado sobre a utilização do lean six sigma (L6σ) pelas organizações. Em relação à abordagem metodológica esta pesquisa é bibliográfica e exploratória. A revisão teórica foi realizada em artigos internacionais no idioma inglês. Inicialmente, objetivou-se conhecer os periódicos, o total de artigos disponíveis revisado por pares, o ano de publicação dos artigos, a classificação Qualis-Capes dos periódicos e seus autores, sobre o tema L6σ. Os resultados mostram a metodologia L6σ destacada em seis bases de dados que integram o portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) entre os anos de 2009 e 2017. A principal contribuição está na constatação do que parece estar faltando na literatura, à necessidade de uma abordagem mais sistêmica e de gestão, em detrimento dos parâmetros com ênfase estatística referente às mudanças nos processos e impactos organizacionais

ارزیابی عملکرد بیمارستان های خصوصی و دولتی بر مبنای فاکتورهای مهندسی مقاومت پذیری و ایمنی با رویکرد ترکیبی شبیه سازی و تصمیم گیری

زمینه و هدف: سیستم های سلامت به ویژه بیمارستان ها، با ریسک های متعددی در محیط مواجه می شوند که روی عملکرد سیستم تأثیر می گذارد و کارایی را ضعیف تر می کند. شاخصهای مهندسی مقاومت پذیری و ایمنی، قادرند سیستم های پرخطر را در مقابل مواجهه با تغییرات ناگهانی پایدار نگه دارند و یا تأثیرات منفی ناشی از این تغییرات را در سیستم به حداقل رسانند. مواد و روش ها: این مطالعه، مفهومی جدید از ترکیب شاخصهای مهندسی مقاومت پذیری و ایمنی و مدت زمان انتظار را در کنار هم به عنوان شاخص کارایی در ارزیابی عملکرد بیمارستان ها در نظر گرفته است و به مقایسه عملکرد بیمارستان های دولتی و خصوصی می پردازد. به منظور ارزیابی عملکرد از یک روش ترکیبی شبیه سازی و روش تصمیم گیری چند معیاره استفاده شده است. در روش تصمیم گیری چند معیاره، از روش خروجی محور تحلیل پوششی داده ها استفاده شده است. نتایج: نتایج نشان می دهد که شاخصهای مهندسی مقاومت پذیری و ایمنی نقش مهمی در تعیین کارایی بیمارستان ها ایفا می کنند، همچنین نتایج خروجی از تحلیل داده های جمع آوری شده نشان می دهد که عملکرد بیمارستان های خصوصی به مراتب بهتر از بیمارستان های دولتی می باشد. نتیجه گیری: نتایج نشان می دهد که شاخص کارگروهی نسبت به سایر شاخصهای کارایی در نظر گرفته شده، تأثیر بیشتری در تعیین سطح عملکرد بیمارستان ها داشته است. مدیران اجرایی سیستم های سلامت و درمان می بایست با اتخاذ سیاست های بهبود کارایی و عملکرد در کنار شاخص کارگروهی به سایر شاخصهای مهندسی مقاومت پذیری توجه بیشتری داشته باشند

Measuring Lean Six Sigma and quality performance for healthcare organizations

Purpose – This study investigates applications of lean six sigma approaches and quality performance in Malaysian hospitals. It identifies five dimensions of lean six sigma conformance (i.e., continuous quality improvement, lean management initiatives, six sigma initiatives, patient safety and teamwork) and quality performance of the hospitals based on demographics such as gender, types of hospital and working experience. Design/methodology/approach – This study distributed 1007 self-administered survey questionnaires to hospital staff resulting in 438 useful responses with 43.5% response rate. Research data were analysed based on reliability analysis, exploratory factor analysis (EFA), independent samples t-tests and one-way ANOVA using SPSS version 23. Findings – Research findings indicate that there are significant differences between public and private hospital staff on lean management initiatives, six sigma initiatives, patient safety and teamwork. Private hospital staff perceives lean management initiatives, six sigma initiatives, patient safety and teamwork more favourably compared to public hospital staff. The present study findings also indicate that senior hospital staff (more than 10 years working experience) perceives patient safety and teamwork more favourably compared to other working experience groups. Research limitations/implications – Our research focused solely on the Malaysian health sector and thus the results might not be applicable to other countries. Originality/value – This research provides theoretical, methodological, and practical contributions for the lean six sigma approach and the research findings are expected to provide guidelines to enhance the level of quality performance in healthcare organisations in Malaysia as well as other countries

Application of Lean Six Sigma to Improve Service in Healthcare Facilities Management: A Case Study

abstract: The purpose of this paper is to present a case study on the application of the Lean Six Sigma (LSS) quality improvement methodology and tools to study the analysis and improvement of facilities management (FM) services at a healthcare organization. Research literature was reviewed concerning whether or not LSS has been applied in healthcare-based FM, but no such studies have been published. This paper aims to address the lack of an applicable methodology for LSS intervention within the context of healthcare-based FM. The Define, Measure, Analyze, Improve, and Control (DMAIC) framework was followed to test the hypothesis that LSS can improve the service provided by an FM department responsible for the maintenance and repair of furniture and finishes at a large healthcare organization in the southwest United States of America. Quality improvement curricula and resources offered by the case study organization equipped the FM department to apply LSS over the course of a five-month period. Qualitative data were gathered from pre- and post-intervention surveys while quantitative data were gathered with the Organization’s computerized maintenance management system (CMMS) software. Overall, LSS application proved to be useful for the intended purpose. The author proposes that application of LSS by other FM departments to improve their services could also be successful, which is noteworthy and deserving of continued research.Dissertation/ThesisMasters Thesis Construction 201

An integrated approach for lean production using simulation and data envelopment analysis

According to the extant literature, improving the leanness of a production system boosts a company’s productivity and competitiveness. However, such an endeavor usually involves managing multiple, potentially conflicting objectives. This study proposes a framework that analyzes lean production methods using simulation and data envelopment analysis (DEA) to accommodate the underlying multi-objective decision-making problem. The proposed framework can help identify the most efficient solution alternative by (i) considering the most common lean production methods for assembly line balancing, such as single minute exchange of dies (SMED) and multi-machine set-up reduction (MMSUR), (ii) creating and simulating various alternative assembly line configuration options via discrete-event simulation modeling, and (iii) formulating and applying DEA to identify the best alternative assembly system configuration for the multi-objective decision making. In this study, we demonstrate the viability and superiority of the proposed framework with an application case on an automotive spare parts production system. The results show that the suggested framework substantially improves the existing system by increasing efficiency while concurrently decreasing work-in-process (WIP).Q10006980682000012-s2.0-8511520297

The Revolution Lean Six Sigma 4.0

Industry 4.0 makes a factory smart by applying advanced information systems and future-oriented technologies. Today, thanks to the application of the most innovative digital technologies offered by the new Industry 4.0 paradigm, in this Fourth Industrial Revolution, there is a significant "evolution" of many methodologies of Continuous Improvement, such as, e.g., Lean Six Sigma (LSS). Most of the tools of Lean Six Sigma relies on data to know in depth problems: data is necessary to drive any process improvement. The key issue is based on data integrity and on real time data. The aim of this paper consists of proving the efficiency of the so called "Lean Six Sigma 4.0". This paper deals with engineering approaches, here applied in HealthCare environment, in order to optimise the services supply process and to reduce the waste of resources (human and/or material), while improving the Quality of Experience (QoE) of the patients. Indeed, it has been proved that the huge growth in the HealthCare costs is due to inefficient use of available resources and not-optimised service processes. Applying Lean Six Sigma 4.0 it is possible to reduce HealthCare costs, improving at the same time the QoE perceived by the patient