A systematic literature review of empirical research in Lean and Six Sigma in healthcare

The purpose of this paper is to review the existing literature on empirical research in Lean, Six Sigma and Lean Six Sigma in healthcare. The approach for the critical review of the 118 papers found is based on the empirical research approach given by Flynn, Sakakibara, Schroeder, Bates, and Flynn (Empirical research methods in operations management. Journal of Operations Management, 9(2), 250–284). It is concluded from the analysis of the results that the number of empirical research articles in Lean, Six Sigma and Lean Six Sigma in healthcare is increasing in a very fast way. Despite this fact, it is still needed studies describing: (i) how to create a continuous improvement culture in practice; (ii) the main aspects and lessons learned on how to sustain the improvements implemented and (iii) the specific barriers for conducting improvements in the healthcare sector. To the best knowledge of the authors, this paper is the first to attempt to critically review the empirical research articles in Lean, Six Sigma and Lean Six Sigma in healthcare.

[1]  Elizabeth A. Cudney,et al.  The application of Kano model in the healthcare industry: a systematic literature review , 2019 .

[2]  V. Nabelsi,et al.  Information technology strategy for a patient-oriented, lean, and agile integration of hospital pharmacy and medical equipment supply chains , 2017, Int. J. Prod. Res..

[3]  Rosanna Fornasiero,et al.  Supply chain configurations: a model to evaluate performance in customised productions , 2017, Int. J. Prod. Res..

[4]  Jochen Bergs,et al.  The effects of a lean transition on process times, patients and employees. , 2017, International journal of health care quality assurance.

[5]  Chinweike I. Eseonu,et al.  What drives continuous improvement project success in healthcare? , 2017, International journal of health care quality assurance.

[6]  Mehmet A. Begen,et al.  Supply and demand uncertainty reduction efforts and cost comparison , 2016 .

[7]  Greg J. Bamber,et al.  Process redesign for time-based emergency admission targets. , 2016, Journal of health organization and management.

[8]  Jingshan Li,et al.  Continuous improvement in manufacturing and service systems , 2016 .

[9]  Changhyun Kwon,et al.  Integrated supply chain management for perishable products: Dynamics and oligopolistic competition perspectives with application to pharmaceuticals , 2016 .

[10]  J. Hardman,et al.  Improving the diagnostic stage of the suspected colorectal cancer pathway: A quality improvement project. , 2016, Healthcare.

[11]  Antonio Freitas Rentes,et al.  A new value stream mapping approach for healthcare environments , 2016 .

[12]  Dan Zrymiak.  Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition , 2016 .

[13]  Chris Hicks,et al.  Applying lean principles to the design of healthcare facilities , 2015 .

[14]  V. G. Aguilar-Escobar,et al.  HOSPITAL KANBAN SYSTEM IMPLEMENTATION: EVALUATING SATISFACTION OF NURSING PERSONNEL / IMPLANTACIÓN DEL SISTEMA KANBAN EN HOSPITALES: EVALUACIÓN DE LA SATISFACCIÓN DE ENFERMERÍA , 2015 .

[15]  Christopher M. McDermott,et al.  Implementing lean in knowledge work: Implications from a study of the hospital discharge planning process , 2015 .

[16]  Brecht Cardoen,et al.  On the design of custom packs: grouping of medical disposable items for surgeries , 2015 .

[17]  Dorothy Y. Hung,et al.  Implementing a Lean Management System in Primary Care: Facilitators and Barriers From the Front Lines , 2015, Quality management in health care.

[18]  Antonio Freitas Rentes,et al.  Improving Hospital Performance by Use of Lean Techniques: An Action Research Project in Brazil , 2015 .

[19]  Annemie Vlayen,et al.  Does lean management improve patient safety culture? An extensive evaluation of safety culture in a radiotherapy institute. , 2015, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[20]  Jiju Antony,et al.  Reducing Patient Waiting Time in Outpatient Department Using Lean Six Sigma Methodology , 2014, Qual. Reliab. Eng. Int..

[21]  Rambabu Kodali,et al.  A literature review of empirical research methodology in lean manufacturing , 2014 .

[22]  G. Rees.  Organisational readiness and Lean Thinking implementation: Findings from three emergency department case studies in New Zealand , 2014, Health services management research.

[23]  Rafat Mohebbifar,et al.  Outpatient Waiting Time in Health Services and Teaching Hospitals: A Case Study in Iran , 2013, Global journal of health science.

[24]  G. Svensson.  Processes of substantiations and contributions through theory building towards theory in business research , 2013 .

[25]  Nick Rich,et al.  Losing patients: a systems view on healthcare improvement , 2013 .

[26]  Mark Stevenson,et al.  Workload control: Successful implementation taking a contingency‐based view of production planning and control , 2013 .

[27]  J. Antony,et al.  LEAN AND SIX SIGMA METHODOLOGIES IN NHS SCOTLAND: AN EMPIRICAL STUDY AND DIRECTIONS FOR FUTURE RESEARCH , 2012 .

[28]  K. Seidl,et al.  The Intersection of Evidence-Based Practice With 5 Quality Improvement Methodologies , 2012, The Journal of nursing administration.

[29]  Antonio Costa,et al.  Linking Six Sigma to simulation: a new roadmap to improve the quality of patient care. , 2012, International journal of health care quality assurance.

[30]  Majed Alsmadi,et al.  A comparative analysis of Lean practices and performance in the UK manufacturing and service sector firms , 2012 .

[31]  M. Holweg,et al.  Lean in healthcare: the unfilled promise? , 2012, Social science & medicine.

[32]  Pamela Mazzocato,et al.  How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden , 2012, BMC Health Services Research.

[33]  M. Graban.  Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Second Edition , 2011 .

[34]  Jens J. Dahlgaard,et al.  Quality and lean health care: A system for assessing and improving the health of healthcare organisations , 2011 .

[35]  Gunjan Soni,et al.  A critical analysis of supply chain management content in empirical research , 2011, Bus. Process. Manag. J..

[36]  Jay Arthur,et al.  Lean Six Sigma for Hospitals: Simple Steps to Fast, Affordable, and Flawless Healthcare , 2011 .

[37]  Pat Hagan,et al.  Waste not, want not: Leading the lean health‐care journey at Seattle Children's Hospital , 2011 .

[38]  Bin Jiang,et al.  How relevant is OM research to managerial practice? An empirical study of top executives' perceptions , 2011 .

[39]  P. Kaboli,et al.  Guiding inpatient quality improvement: a systematic review of Lean and Six Sigma. , 2010, Joint Commission journal on quality and patient safety.

[40]  C. Pocha.  Lean Six Sigma in Health Care and the Challenge of Implementation of Six Sigma Methodologies at a Veterans Affairs Medical Center , 2010, Quality management in health care.

[41]  Patrick R Axon,et al.  The use of Lean Thinking techniques in implementing the Department of Health, UK, 18-week waiting time directive for cochlear implantation. , 2009, Cochlear implants international.

[42]  Luciano Brandão de Souza,et al.  Trends and approaches in lean healthcare , 2009 .

[43]  S I McClean,et al.  A critical look at Lean Thinking in healthcare , 2008, Quality & Safety in Health Care.

[44]  S. R. Devadasan,et al.  The origin, history and definition of Six Sigma: a literature review , 2008 .

[45]  C. Moorman,et al.  Cross-Sectional versus Longitudinal Survey Research: Concepts, Findings, and Guidelines , 2008 .

[46]  S. Boyages,et al.  Implementing and sustaining transformational change in health care: lessons learnt about clinical process redesign , 2008, The Medical journal of Australia.

[47]  Claire Moxham,et al.  Lessons for Lean in Healthcare from Using Six Sigma in the NHS , 2007 .

[48]  R. B. Johnson,et al.  Educational Research: Quantitative, Qualitative, and Mixed Approaches , 2007 .

[49]  D. Fillingham.  Can lean save lives? , 2007, Leadership in health services.

[50]  Aleda V. Roth,et al.  Applications of Empirical Science in Manufacturing and Service Operations , 2007, Manuf. Serv. Oper. Manag..

[51]  Matthias Holweg,et al.  The genealogy of lean production , 2007 .

[52]  Mahesh S. Raisinghani,et al.  Six Sigma: concepts, tools, and applications , 2005, Ind. Manag. Data Syst..

[53]  P. Hines,et al.  Learning to evolve: A review of contemporary lean thinking , 2004 .

[54]  D. Tranfield,et al.  Towards a Methodology for Developing Evidence-Informed Management Knowledge by Means of Systematic Review , 2003 .

[55]  T. N. GOH,et al.  A strategic assessment of six sigma , 2002 .

[56]  D. Coghlan,et al.  Action research for operations management , 2002 .

[57]  S. Lynham.  Theory building in the human resource development profession , 2000 .

[58]  Jack R. Meredith,et al.  Building operations management theory through case and field research , 1998 .

[59]  R. Westbrook.  Action research: a new paradigm for research in production andoperations management , 1995 .

[60]  Barbara B. Flynn,et al.  Empirical research methods in operations management , 1990 .

[61]  Moacir Godinho Filho,et al.  Lean healthcare in developing countries: evidence from Brazilian hospitals , 2017, The International journal of health planning and management.

[62]  Philipp Nadel.  The Machine That Changed The World , 2016 .

[63]  Anuj Saraogi,et al.  Assessing the evidence of Six Sigma and Lean in the health care industry. , 2011, Quality management in health care.