Healthcare is an industry where mistakes are not tolerated. Various Improvement
methodologies such as Total Quality Management (TQM), Lean and Six Sigma intend to
improve the performance of processes and impact organisational performance. Lean Six
Sigma (LSS) combines approaches for flow and quality with the intent to reduce waste,
variation and defects in processes. There have been many attempts to implement LSS.
However, there is a lack of academic research on the extent of implementation or whether
it leads to improvement. Generic lists of Critical Success Factors (CSFs) have been
created, but they have not yet been explored in more dynamic settings such as healthcare
in developing countries. The purpose of this study was to examine LSS implementation
in UAE hospitals being a multi-cultured, professional and high labour turnover
environment. The study also examined whether Strategic, Tactical and Operational (STO)
CSFs are positively correlated with LSS successful implementation measured by hospital
performance.
A mixed-method approach was adopted to explore the study aim and objectives also
enhancing the study quality in terms of reliability and validity. A conceptual model was
developed from a review of the literature and existing improvement frameworks
identifying three distinct CSFs themes (Strategic, Tactical and Operational) and eight
hospital performance indicators. The study analysed the findings from a survey,
interviews and a brainstorming session using SPSS, thematic analysis, Partial Least
Squares Structural Equation Modelling (PLS-SEM) and Interpretive Structural Modelling
(ISM). The study revealed that CSFs in healthcare should be sequenced in clusters,
therefore creating a new framework for deploying LSS. Workforce stability and job
security emerged as two new CSFs. Moreover, the empirical results showed that LSS
CSFs have a positive effect on the performance of the UAE hospitals confirming previous
research in other sectors. While the results confirmed that the UAE healthcare sector
shares many common LSS CSFs and barriers identified in previous research, the study
revealed three new barriers, namely lack of sustainability of LSS, lack of a holistic
approach to deploy LSS and lack of advertising LSS success stories. This study
contributes to academics and practitioners by providing a deployment framework for LSS
in healthcare, offering better insights on the current status of LSS in UAE healthcare to
enhance LSS deployment towards better organisational performance
