Operationalising lean in healthcare: the impact of professionalism

Abstract

Lean is endorsed as policy in practice in the UK but the challenges and complexities affecting Lean in healthcare are still to be adequately assessed. Through a qualitative single case study of an NHS organisation implementing Lean, 43 interviews with multi-disciplinary team members involved in Lean were conducted. The progress of Lean is found to be inhibited as medical professionals have failed to engage or provide clinical leadership in supporting the trajectory of Lean. This resulted in limited outcomes, sustainability implications, and failed projects. Lean is challenged by complexity and this is evident in conflicts between professional identity, corresponding status and clinical/managerial relationships. Medical professionals as a group have received a limited focus in papers assessing the progress of Lean in Healthcare from an operational perspective. Going forward, strategies for mitigating the negative impact of this can be developed to support operational managers in the healthcare domain.     

A Lean Six Sigma framework for the reduction of ship loading commercial time in the iron ore pelletising industry

Evidence suggests that specifically designed frameworks to implement Lean Six Sigma (LSS) projects to tackle particular problems are more effective than ‘generic’ versions. This paper proposes an implementation framework to effectively deploy LSS to improve a key operation and performance indicator, i.e. ship loading commercial time, of one of the largest world producer of iron ore. This article therefore contributes with a refined framework to effectively implement LSS, and documents its successful application and effectiveness within the context of the case organisation. The LSS framework and project contributed in helping the studied organisation to improve both the capability of its ship loading process and commercial time by more than 30%, resulting in operational savings in the range of $300,000 USD per year. The systematic nature of the framework proposed also helped the organisation to establish a standardised routine to improve its operations. Managerial implications exposing the challenges faced during the implementation of LSS are also discussed to serve as lessons learnt to be considered in other LSS projects. Managers and engineers incharge of improving operations and processes can benefit from this paper as it can be used as a guide to direct the conduction of LSS projects and the empirical application of its principles and tools.     

Implementing lean sigma framework in an Indian automotive valves manufacturing organisation: a case study

The manufacturing organisations have been witnessing a key transition to lean manufacturing paradigm so as to eliminate waste. Concurrently, six sigma methodology has been widely used for reducing the defects. In order to attain the combined benefits of these two approaches, the amalgamated lean sigma framework has originated. Lean sigma framework proves drawbacks, such as lack of systematic and scientific management and feeble lean anchorage. In order to overcome these deficiencies, this article contributes a refined lean sigma framework, and its effectiveness has been test implemented in an Indian automotive valves manufacturing organisation. The implementation benefits are described in this article.     

Measuring impact of Lean implementation on construction safety performance: a structural equation model

Abstract

The construction industry is a risky endeavour. Therefore, it is essential to develop significant safety measures for lowering risks and ensuring safety during projects. However, current safety applications are yet to be developed given the increasing number of workplace accidents. Among these, Lean applications have the potential to improve safety standards and enhance safety performance. Within this context, this study develops components for Lean implementation and construction safety performance, and it presents a conceptual framework to study the relationship between them. A questionnaire was designed and given to Lean practitioners to quantify the impact of the components. Structural Equation Modelling was used to analyse the framework and validate the relationship between Lean implementation and safety performance. The results of the study indicate that there is a significant relationship between Lean implementation and safety performance. The findings also imply that firms that perform well in implementing Lean practices achieve better safety performance. The primary contribution of this research is to prove that Lean practices are closely related to safety performance, with the aim of encouraging construction practitioners to work in a safer environment by using well-established Lean practices. Moreover, the study aims to expand the use of Lean practices to achieve better safety performance by revealing the strong ties between safety and Lean. Finally, this study can guide construction practitioners to adopt Lean techniques and apply them in their projects to enhance safety performance.     

Using Lean Six Sigma to improve mobile order fulfilment process in a telecom service sector

This study proposes and follows a specific and systematic framework for implementing Lean Six Sigma (LSS) methodology in a telecom company in order to improve customer satisfaction by minimizing the company’s response time to customer requirements. The goal of this study was achieved by utilizing several LSS tools under five phases of the DMAIC methodology. Unlike previous studies in the telecom sector that used only qualitative method, in this study, both qualitative and quantitative methods were utilized to draw meaningful conclusions. As a result of the implementation of the LSS methodology, the average order fulfilment lead time for sales orders (SO) and value-added service (VAS) orders was reduced from 10.3 to 5.9 days and from 1.5 to 0.5 days, respectively. The reduction in lead time resulted in an increase in the sigma level for SO and VAS orders from 0.44 to 1.26 and from 0.73 to 2.66, respectively. These improvements were expected to lead to a financial benefit in savings of over $600,000 per year in operational costs, enhancements to customer experience and an increase in revenue generating opportunities. Moreover, this article enriches the existing literature on the application of LSS concept in the service industry, and helps the company to speed up the response to customer requirements.     

Implementation of Lean Six Sigma framework with environmental considerations in an Indian automotive component manufacturing firm: a case study

Lean Six Sigma is a systematic data driven methodology that integrates two powerful business improvement strategies Lean Manufacturing and Six Sigma with the goal of removing wastes and reducing process variation. Lean Six Sigma has a positive effect on environmental performance as defect reduction and reducing process variation leads to reduction in raw material consumption, energy consumption and reduced scrap which in turn reduces the overall environmental impacts. In this context, this study uses a Lean Six Sigma framework with environmental considerations to reduce overall defects and environmental impacts concurrently to improve the firm’s operational and environmental performance. The framework is based on Define Measure Analyze Improve Control methodology where traditional Lean Six Sigma and environmental impact assessment tools are integrated to systematically deploy LSS strategies with environmental considerations. The framework is validated with an industrial case study conducted in an Indian automotive component manufacturing organisation and the inferences are derived. On successful deployment of the framework, the internal defects was brought down to 6000 ppm from 16,000 ppm and environmental impacts was reduced to 33 Pt from 42 Pt. Deployment of the developed framework helped in improving the firm’s sigma level and also reduced the overall environmental impacts.     

Benefits of adopting lean production on green performance of SMEs: a case study

Abstract

Small- and medium-sized enterprises (SMEs) are widely recommended to strive, not only for their performance in operational side, but they need to integrate the environmental dimension. To do that, the literature widely indicates a positive impact of lean practices on green performance. However, very few studies have been carried out in SMEs context. In this view, this paper aims at providing through a practical case study of lean implementation in a real-life small manufacturing company, the information to confirm this synergy between lean and green performance. To achieve this aim, a proposed framework of lean and green integration has been implemented in a SME producing different types of pumps. The results achieved shows that there is a strong correlation between operational metrics improvement and green metrics improvement. Moreover, the benefits of lean practices such as 5S, Kanban, SMED, AM, cellular manufacturing and quality control on green performance are widely demonstrated. Future work could study other processes and explore other case-specific supporting tools and techniques.     

Synergies and misalignments in lean and green practices: a logistics industry perspective

Abstract

This paper conducts an exploratory case study-based research in three companies to identify the main synergies and misalignments between Lean and Green in the context of a range of distribution networks operating globally, regionally and domestically. The research strategy applied by this study is exploratory multiple case studies in three companies, particularly in the road transport and logistics sector. Semi-structured interviews with 15 executives from three companies were conducted to identify activities within logistics operations leading to synergies and misalignment between Lean and Green practices. The outcome of the three cases shows that several improvements can be achieved by the simultaneous adoption of Lean and Green. The study contributes to the literature by extending the research in the logistics sector and providing examples from a wide variety of logistics operations on synergies and misalignments between Lean and Green practices. The findings and outcome of this study are a starting point for further research in the logistics sector.     

An integrated lean and green approach for improving sustainability performance: a case study of a packaging manufacturing SME in the U.K.

Abstract

Competitive landscape, informed consumers and stringent regulations have forced many manufacturing small- and medium-sized enterprises (SMEs) to focus on operational efficiency along with sustainability issues in recent years. While many manufacturing organisations have been taking lean initiatives for the past few years for operational excellence, an impulsive rush to adopt lean without a strategic deployment vision has led to scattered implementation of lean tools and projects without desired success. Many researchers and practitioners prescribe value stream mapping as a foundation for lean transformation initiatives; however, little empirical work is available on the symbiosis of lean and green paradigms to reap maximum benefits. This research, through a systematic methodology and a novel tool called Green Integrated Value Stream Mapping (GIVSM), integrates both paradigms in a case study on a U.K. packaging-manufacturing SME. Applying the GIVSM demonstrates that simultaneous deployment of lean and green paradigms have synergistic effect for improving both operational efficiency and environmental performance. In addition, continuous improvement framework with sustainable procurement is proposed to overcome the lean-green misalignments. This study also provides a guiding reference for practitioners to undertake similar improvement projects and identifies opportunities to expand this academic research on integrated lean-green approach into other industry sectors.     

Sensitisation of SMEs towards the implementation of Lean Six Sigma – an initialisation in a cylinder frames manufacturing Indian SME

This article suggests the adoption of a model on Lean Six Sigma for successfully implementing it in small and medium engineering enterprises (SMEs). This model is given the name Deficiency Overcoming Lean Anchorage Define Measure Analyse Improve Control Stabilise (DOLADMAICS). The DOLADMAICS model has been designed to lift up an SME through the implementation of Lean Six Sigma in five levels. The implementation study on first level of DOLADMAICS model conducted in an Indian SME, manufacturing a component called ‘cylinder frames’, has been reported in this article. After conducting this implementation study, it was found that the first level of DOLADMAICS model would act as a catalyst and guide for sensitising the management of SMEs to successfully implement Lean Six Sigma.     

Lean practices and their effect on performance: a literature review

This paper introduces a literature review of 83 studies dealing with the degree of adoption of lean manufacturing practices around the world, and the links between those practices and organisation performance. The results of this study revealed that lean practices application still occurs in a fragmented way, disregarding the systemic linkage that is essential to lean manufacturing. Forty-one articles have suggested a positive effect of lean practices in at least one operational, financial and/or environmental performance metric. Nevertheless, five studies indicated that some lean practices had a negative effect on operational or financial performance. High demand variability, a perceived result of long-term lean manufacturing implementation, a country/company’s organisational culture and the difficulty of traditional costing production systems to measure and compare investments and economic gains from adopting lean manufacturing over time are some of the reasons to explain that negative effect of lean practice on performance.     

Understanding dynamism and complexity factors in engineer-to-order and their influence on lean implementation strategy

Complexity and dynamism are considered intrinsic features of engineer-to-order (ETO) business environment; it is, therefore, important to understand and manage them better. Based on empirical investigation into two case companies, this paper expands the existing literature on how and why complexity and dynamism context factors constitute not only external business environment issues but also subfactors within the boundary of the firm. It argues that most of the subfactors for complexity and dynamism identified for repetitive manufacturing are relevant for the high uncertainty capital goods manufacturing ETO with some exceptions such as short product life cycle and technological turbulence. A framework of configuration (on implementation of lean practices), and moderation (on the lean-operations performance relation) forms of influence from dynamism and complexity is proposed. Further arguments to be verified in future large-scale research include: (1) dynamism bears challenges, and complexity provides opportunities to foster implementation of relevant lean practices in ETO, (2) both complexity and dynamism positively mediate better operations performance and enriched value from implemented lean practices.     

Values and behaviors of effective lean managers: Mixed-methods exploratory research

Lean Management is a managerial approach focused on enhancing customer value through the elimination of non-value adding steps from work processes. Lean Management is also enjoying a resurgence, largely because its ‘do more with less’ philosophy is particularly well-suited for the austere conditions of a 'Great Recession' recovery. Despite this resurgence with practitioners, however, academic research of Lean Management, in particular research on the leadership of lean initiatives, remains limited. In this study, we identify a constellation of lean values and behaviors of effective lean managers, based on extant research and the views of expert practitioners, and a field study of lean managers. In the first of two empirical studies, we produce an initial list of values and behaviors, derived from both the lean and leadership literature, and from three Delphi rounds with 19 expert lean practitioners. In study 2, we corroborate and refine the list with a sample of effective lean middle managers, through 18 interviews; a survey (N = 43); and fine-grained video-analyses of their in situ behaviors during meetings with subordinates. The values identified include: honesty, candor, participation and teamwork, and continuous improvement—all indicative of self-transcendence and openness to change. Regarding behaviors, we find that the effective lean middle managers of our sample, compared to other middle managers, engage significantly more in positive relations-oriented “active listening” and “agreeing” behaviors, and significantly less in “task monitoring” and counterproductive work behaviors (such as “providing negative feedback” and “defending one's own position”). To conclude, we put forward five new propositions intended to guide future research and a more successful practice of ‘lean leadership.’     

Implementing lean sigma in an Indian rotary switches manufacturing organisation

The manufacturing organisations have been witnessing a transformation in the manufacturing paradigm. Lean sigma and six sigma are the two business process improvement strategies widely employed by organisations to enhance their manufacturing performance. To achieve dramatic result in cost, quality and time, best strategies need to be applied to enhance the process performance. Lean sigma and six sigma are two powerful and effective strategies, enabling the organisation to overcome their weakness and for retaining their improvement. Lean sigma combines the variability reduction tools and techniques drawn from six sigma with the waste and non-value added elimination tools and techniques from lean manufacturing to achieve savings in the organisations. This study uses an integrated lean sigma framework to reduce the defects occurring in the final product, thereby contributing savings to the organisation. The proposed framework integrates lean tools within six sigma methodology to enhance the bottom-line results and to win customer loyalty. The implementation of the proposed framework shows dramatic improvement in key metrics and substantial financial savings to be generated by the organisation.     

精益改善活动的实现过程研究

由丰田生产方式（TPS）发展而来的精益生产（Lean）已经被越来越多的中国企业所接受,并引入实际工作当中。但是各企业的实施效果却相差甚远。究其原因,很重要的一点,就是企业对“持续改善”的实践效果不同.大多数实现精益生产效果不佳的企业．都没能很好的进行改善活动,反之亦然。本文分析了精益改善活动在企业中的作用,并对其实现过程中的几个关键因素进行了研究。     

Barriers in Green Lean implementation: a combined systematic literature review and interpretive structural modelling approach

Green Lean has recently emerged as an alternative strategy for organisations to pursue both operational and sustainability excellence. The interest on this approach has rapidly risen in both academic and industry circles. However, despite this interest, very limited research has focused on its implementation, and no research has investigated the barriers that hinder the success of such activity. This study investigates the Green Lean implementation barriers and their contextual relationships and effects on the integration and deployment of this approach. A Systematic Literature Review (SLR), Interpretative Structural Modelling and fuzzy Matriced’ Impacts Croise’s Multiplication Appliqée a UN Classement (MICMAC) analyses were carried out. Fifteen barriers were extracted from the SLR and then validated in consultation with industry and academic experts. The Interpretive Structural Modelling (ISM) method was used to understand the relationship between the fifteen barriers and to develop a hierarchical model of these. The different barriers were classified into ‘linkage’ and ‘dependent’ barriers by using MICMAC analysis. The results suggested that all the identified barriers play an important role, and hence can equally act as a significant hurdle to the implementation of Green Lean projects. This study can help managers and policy-makers in better understanding these barriers. Thus, they can be assisted in managing and prioritising barriers towards the successful implementation of Green Lean initiatives for better financial and environmental performance.     

Fuzzy integrated QFD,FMEA framework for the selection of lean tools in a manufacturing organisation

Lean Manufacturing (LM) is a well-established system to improve performance of any manufacturing industry by eliminating wastes through globally accepted tools and techniques. Industries are trying to adapt lean principles in order to optimise the resources like people, equipment, material and schedule for being efficient in the competitive market. This paper proposes an integrated approach for selecting appropriate lean tools in reliable lean perspective to enhance these critical resources. The approach exercise a hybrid model which uses fuzzy QFD to prioritise the critical resources in relation with identified wastes and fuzzy FMEA to assess the risk associated with each sub elements to address lean implementation. For waste identification, plant layout and Value Stream Mapping are considered. The model is demonstrated based on the data collected from a manufacturing industry to illustrate the application. Significant improvements are quantified with the help of future state map and plant layout.     

Lean thinking in the highways construction sector: motivation,implementation and barriers

The interest in lean thinking in the UK’s civil construction industry is on the rise. The research presented in the paper evaluates the adoption of lean thinking in the highways construction sector by investigating 7 motivation factors, 20 lean techniques and 16 barriers through in-depth interviews with 20 sector managers and a questionnaire survey of 110 responses. The findings show the existence of strong external motivational factors for lean thinking such as clients’ push and companies’ expectation of winning more contracts alongside lean’s operational benefits. Limited adoptions of the lean techniques, mostly in the stepwise process improvement cycle, the Last Planner System and Visual Management, were determined. This raises concerns about ‘pseudo-lean’ practices in the sector. Lack of standardisation, insufficient benefit capturing, insufficient know-how, insufficient control of the entire value stream and limited view to the techniques were found as the top barriers.     

几种精益生产方式的混合应用

精益思想已逐渐被国内许多企业所接受,5S、均衡化生产、看板管理和价值流管理等精益生产方法均已被广泛使用。企业在实施精益生产过程中．如果孤立的使用某些精益生产方法,往往顾此失彼,导致实施效果不佳。本文通过某公司的实际案例,研究这几种精益生产方式的应用,并分析它们之间的相互关联和影响     

Decision support tool for lean product and process development

Lean and concurrent engineering (CE) are widely acknowledged business process improvement strategies. These strategies can improve processes, reduce costs, and cut waste enabling organisations to remain competitive. Lean manufacturing offers an enterprise-wide methodology that improves reliability and flexibility while reducing lead-times and inventory carrying costs. Companies in manufacturing and service sectors are focusing on integrating lean manufacturing methodology with other applications, so that, all their systems and processes are aligned. This article proposes a CE framework based on application of information technology and object-oriented methodology for lean manufacturing. This approach expected to give manufacturing companies an extra edge in today's competitive market. A case study is presented in this article to demonstrate the effectiveness of CE framework in a machine tool manufacturing company. CE practice was adopted for new products, to align the systems and processes of the company. Product development lead-time was found to decrease by more than 50% compared to similar development projects carried out by the company. The need for rework was found to be negligible and the development cost was reduced considerably.