Exploring the impact of the adoption of Green Lean Six Sigma practices on healthcare performance

PurposeThis study aims to investigate the mediating role of lean management on the relationship between workforce management and value-added time in private hospitals. This study also investigates the direct influences of workforce management and lean management on the value-added time of the hospitals.Design/methodology/approachThis study applied a quantitative approach to obtain data from the private hospitals’ staff in Peninsular Malaysia. A self-administered survey questionnaire was used to collect data from 287 hospital staff using a stratified random sampling method. The partial least squares structural equation modeling (PLS-SEM) approach was used to determine the internal consistency, reliability, validity of the constructs. The PLS-SEM method was also used to test the hypothesised research model via SmartPLS 3.3.4 version.FindingsThe findings of the study indicate that lean management has a direct and significant effect on the value-added time of private hospitals. The findings also revealed that lean management significantly mediates the relationship between workforce management and value-added time in private hospitals. The analysis of the results indicates that both workforce and lean management have a significant impact on the value-added time of the hospitals.Practical implicationsThis study provides empirical contributions to enhance the quality of workforce management, lean management and value-added time. The findings of this study provide valuable insights into how effectively managing the workforce and providing guidelines to augment the lean management practices can ensure value-added time in Malaysian hospitals and the overall health-care industry. The lean management framework provides useful insights for the policymakers to understand the significance of workforce management, lean management on ensuring value-added time through reducing waiting times, unnecessary delays, generating a higher degree of patient safety, satisfaction and loyalty.Originality/valueThe research findings provide some essential indications for the health-care service providers to understand how the lean management approach can be implemented to enhance value-added time and how lean management can play a mediating role in creating a link between workforce management and value-added time in hospitals. This study also contributes to the theoretical and practical perspectives. The present study contributes to a better understanding of workforce management and lean management in health-care sectors from theoretical and practical perspectives.

Purpose The present study examines the influence of leadership, employee involvement and Green Lean Six Sigma (GLSS) on the quality improvement of patient safety in specialised hospitals. This study also investigates the mediating roles of GLSS and employee involvement in the relationship between leadership and the improvement in patient safety quality. Design/methodology/approach In this study, a stratified random sampling technique was applied to collect data from 384 respondents of specialised hospitals in Bangladesh. SmartPLS 4 was employed to assess construct reliability and validity and to test mediation effects via bootstrapping. Furthermore, hypotheses were tested via partial least squares structural equation modelling (PLS-SEM). Findings The study’s findings indicate that leadership, employee involvement and GLSS have a positive and significant influence on the quality of patient safety. Based on the results, employee involvement has the greatest impact on quality and patient safety improvement compared to leadership and GLSS. However, the research findings also indicate that leadership does not directly influence the quality improvement of patient safety but does so indirectly through the mediating effects of GLSS and employee involvement. Practical implications This study provides important insights into how healthcare practitioners can enhance patient safety outcomes through effective leadership and operational activities. The results are informative regarding the management of specialised hospitals. The findings may serve as a reference point for the evaluation of GLSS and for the ecological sustainability of hospital management practices in developed and developing countries. Originality/value This study offers theoretical and practical contributions, and it is anticipated that the research findings will generate ideas to improve patient safety and quality in healthcare organisations.

Introduction: The healthcare sector significantly contributes to environmental degradation, highlighting the need for sustainable practices. Green Lean Six Sigma (GLSS) offers a relevant and impactful approach to reduce healthcare’s environmental footprint while improving efficiency. By incorporating environmental considerations into Lean Six Sigma, GLSS has the potential to mitigate healthcare’s environmental impact and promote environmental sustainability. This study aims to gain insight into healthcare professionals’ experiences with GLSS at their workplace. Materials and Methods: This qualitative exploratory study employed semi-structured surveys based on theory of training evaluation from Kirkpatrick with Dutch healthcare professionals in the first six to eight months after completing GLSS training. Results: Even though 76% (N = 16) of trained healthcare professionals applied GLSS at their workplace and 43% of them (N = 9) completed a project within the first six to eight months after training, they all experienced one or more barriers. The most frequently reported barriers were lack of time, difficulties with project selection and a lack of management support. GLSS project results included reduction of products, energy, costs and travel, green choices in procurement and sustainable food choices. GLSS also helped to create awareness on the environmental impact of healthcare and to optimize processes by reducing costs, waiting time, workload and defects. Discussion: This is the first study to report experiences from applying GLSS in healthcare. Furthermore, it is the first study presenting GLSS training evaluation results in terms of participant behaviour and organizational outcomes. Conclusions: Results of this study can be used to enhance GLSS deployment programs and to optimize organizational settings for successful GLSS implementation in healthcare.

Recently, increasing competition pressure and severe environmental situations have posed significant challenges to organizations in the industrial and service sectors. In this context, Green Lean Six Sigma (GLSS) is an important approach for helping industrial and service organizations achieve sustainability. The main objective of this study was to clarify the specific content of GLSS practices in the industrial and service sectors, including frameworks, tools, necessities, barriers, effects, and other aspects, through a systematic literature review (SLR). A statistical analysis was conducted to examine the main characteristics of these GLSS elements and the gaps in their implementation between the two sectors. Based on this analysis, an integration diagram of GLSS key elements is proposed, and it showcases core ideas and processes for implementing GLSS in the industrial and service sectors. The findings demonstrate that GLSS practices bring comprehensive improvements to enterprises in multiple dimensions and exhibit differentiated characteristics in the two sectors. Most GLSS frameworks are primarily designed for the industrial sector, and service organizations have yet to systematically grasp the application of GLSS tools. The findings have reference value for practitioners and researchers in the industrial and service sectors regarding GLSS practices.

Green-lean-six sigma practices and supporting factors for transitioning towards circular economy: A natural resource and intellectual capital-based view

Owing to global warming and changing environmental factors, the world has been experiencing negative and major changes. Society is showing a strong reaction to these environmental problems through marches, protests, and political initiatives, which also demonstrate the need for a new understanding of leadership. In this respect, green transformational leadership emerges as a potential solution. The current study aims to determine the mediating role of green innovation and environmental performance in the effect of green transformational leadership on sustainable competitive advantage. With this aim, a model was formed by utilizing the Natural Resource-Based View (NRBV) theory. To test the model, data were collected through a survey answered by 412 people working in SMEs in Istanbul and analyzed via the Smart-PLS program. The results indicate that green innovation had a moderate mediating role, and environmental performance had a low mediating role in the effect of green transformational leadership on sustainable competitive advantage. In light of these results, the sustainable competitive advantage predicted by the NRBV theory was found to have been achieved.

PurposeDespite differing strategies towards environmental sustainability in developed and developing nations, the manufacturing sector in these regional domains faces substantial environmental issues. The purpose of this study is to examine the green-lean-six sigma (GLSS) enablers and outcomes for enhancing environmental sustainability of manufacturing firms in both, a developed and developing country context by using an environment-centric natural resource-based view (NRBV).Design/methodology/approachFirst, a framework of GLSS enablers and outcomes aligned with the NRBV strategic capabilities is proposed through a systematic literature review. Second, this framework is used to empirically investigate the GLSS enablers and outcomes of manufacturing firms through in-depth interviews with lean six sigma and environmental consultants from New Zealand (NZ) and Pakistan (PK) (developed and developing nations).FindingsAnalysis from both regional domains highlights the use of GLSS enablers and outcomes under different NRBV capabilities of pollution prevention, product stewardship and sustainable development. A comparison reveals that NZ firms practice GLSS to comply with environmental regulatory requirements, avoid penalties and maintain their clean-green image. Conversely, Pakistani firms execute GLSS to reduce energy use, satisfy international customers and create a green image.Practical implicationsThis paper provides new insights on GLSS for environmental sustainability which can assist industrial experts and academia for future strategies and research.Originality/valueThis is one of the early comparative studies that has used the NRBV to investigate GLSS enablers and outcomes in manufacturing firms for enhancing environmental performance comparing developed and developing nations

PurposeThis paper attempts to explore the green-lean-six sigma (GLSS) practices in the continuous process industry particularly in the flexible packaging (FP) industry in an emerging economy for addressing environmental sustainability issues.Design/methodology/approachThe authors have employed a qualitative multiple-case approach to examine managerial perspectives on GLSS adoption in the flexible packaging industry. Semi-structured interviews with senior corporate managers in two large FP organizations in Pakistan were conducted as the primary source of data collection.FindingsDrawing on the natural resource-based view (NRBV), the analysis revealed that organizations are implementing key GLSS practices such as environmental management system (ISO 14001), cause–effect analysis, renewable energy sources, total productive maintenance, and statistical process control to effectively manage waste, conserve resources, control air emissions, and improve environmental and workplace safety.Originality/valueThe authors argue that this is one of the first research studies that has utilized NRBV to investigate the application of the GLSS approach in the process industry, specifically in the FP industry in an emerging economy.

Purpose This study aims to address the link between green transformational leadership (GTL) and green management practices (GMPs) to achieve environmental stewardship (ES) in modern organizations while exploring the mediating role of digital transformation readiness (DTR) and moderating roles of eco-friendly technology adoption (ETA) and tacit knowledge (TK). Design/methodology/approach An empirical study comprising of a sample data of 354 professionals was analysed on partial least squares structural equation modelling (PLS-SEM) 4.0 software. The hypotheses were developed using the perspectives from natural resource-based view theory and tested using a three-wave design. Findings The major findings showed that GTL significantly impacted ES. The direct effect of GMP on ES is substantial. DTR serves as an important mediator in the link between GTL and GMP. The moderator variable ETA has a considerable impact on the link between GMP and ES. Furthermore, TK also acts as a substantial moderator in the link between GMP and ES. Practical implications Encouraging ES may ultimately help organizations enhance corporate reputation and increase operational efficiency and cost savings. It would help enrich employee engagement and improve retention by fostering innovation. Originality/value This study is a unique attempt to explore the complex interrelationships leading towards ES with a three-wave design including the interplay of the technology evolution in the organizational culture with DTR and ETA and knowledge management with TK.

In recent years, we have observed a decline in environmental conditions. Both governments and societies have increasingly focused on this issue, seeing entrepreneurship as a key approach to achieving sustainable development. Drawing on the natural resource-based view theory and stakeholder theory, this study explores the central role of sustainable business model innovation (SBMI) in new ventures’ efforts to become more sustainable. Using data from 1,172 new ventures gathered from a survey, we tested the hypothesized framework with the partial least squares structural equation modeling (PLS-SEM) method. Our findings show that the results of SBMI mediate the relationship between the strategic orientations (toward entrepreneurship and sustainability) and support from different stakeholder types (family, society, and government) and their sustainable performance. Our study offers insights for entrepreneurs and managers of new ventures who pursue sustainability as a cornerstone of their business.

This study aims to examine the interrelationships among environmental strategy, environmental management accounting (EMA), environmental performance, and financial performance within manufacturing firms in Vietnam, a topic rarely addressed in previous research. Specifically, the research investigates the role of EMA use and environmental performance in mediating the relationship between environmental strategy and financial performance. Drawing on stakeholder theory, contingency theory, and the natural resource-based view theory, this study develops and tests a serial mediation model to explain how EMA use and environmental performance link environmental strategy to improved financial performance Data were collected from 198 manufacturing firms in Vietnam. The research employed partial least squares structural equation modeling (PLS-SEM) with SmartPLS software for data analysis. The findings reveal that environmental strategy positively influences both EMA use and environmental performance. Moreover, EMA and environmental performance act as significant mediators, positively influencing financial performance. This study focuses on manufacturing firms in Vietnam, an emerging market, which may limit the generalizability of the findings to other geographic contexts. Cultural differences, variations in environmental standards, and different levels of economic development across countries may influence the relationship between environmental strategies and performance outcomes, suggesting that the results may not be universally applicable. This research is the first to explore the interconnections between environmental strategy, EMA use, environmental performance, and financial performance in manufacturing firms in Vietnam. It provides valuable theoretical and practical insights for managers and policymakers, highlighting the importance of integrating environmental strategies into business operations.

This study investigates the critical enablers influencing the implementation of Green Lean Six Sigma (GLSS) in Malaysia's wastewater treatment industry. Through an extensive literature review and insights from the industry, 30 distinct enablers were identified and categorized based on their characteristics within wastewater treatment plant (WWTP) organizations, aimed at ensuring successful GLSS execution. Structural equation modelling was employed to validate the research model, utilizing data from 296 certified professionals in Malaysia. The analysis revealed five significant enablers, indicating moderate to high levels of GLSS adoption within the industry, with the ‘strategic’ and ‘resource’ enablers emerging as particularly influential factors. Subsequent confirmatory factor analysis further affirmed the validity and reliability of these enablers. Moreover, the findings demonstrated both convergent and discriminant validity, reinforcing the efficacy of these factors in measuring GLSS implementation in Malaysian WWTPs. The study highlights the critical importance of strategic planning and resource allocation while emphasizing the need to address cultural and environmental factors for successful GLSS adoption in the industry. However, enablers based on linkages, particularly those pertaining to supplier relationships and customer satisfaction, garnered the least consensus among respondents, indicating areas necessitating further attention and improvement.

Purpose This study aims to identify critical success factors and formulate strategies for implementing Green Lean Six Sigma (GLSS) integrated with Industry 4.0 technology inclusively, to improve process efficiency, product quality and sustainability in the manufacturing sector, including the manufacturing industry. Design/methodology/approach This study used a Systematic Literature Review (SLR) approach with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Findings The study’s results show that the success of GLSS is strongly influenced by technological readiness and a supportive organizational culture. However, the full automation approach is still difficult to be adopted by labor-intensive industries. Therefore, a hybrid Lean-Internet of Things (IoT) model that maintains the role of humans and is supported by real-time sensor systems and cloud-based dashboards is a strategic alternative. This approach enables early detection of production defects, increased efficiency and reduced defect rates. The Human–Cyber–Physical Systems (HCPS) concept proves to be relevant in integrating human and technological capabilities collaboratively. Research limitations/implications This study is limited to the literature in the last 15 years and has not tested direct empirical implementation in specific industries. Further studies can be conducted through longitudinal studies or trials in real manufacturing environments. Practical implications The findings provide strategic guidance for operational managers and policy makers in designing a GLSS implementation roadmap that not only focuses on digitization but also considers the readiness of human resources and organizational structures in industries that are not yet fully digitized. Originality/value The main contribution of this research is in introducing a more inclusive and applicable hybrid Lean-IoT based on GLSS model, and aligning sustainability principles with human engagement through HCPS-based production systems.

Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM)In view of its essential role in knowledge creation, multivariate data analysis prevails in the social sciences literature. The field of tourism is not an exception, specifically in the widely adoption of structural equation modeling (SEM), a multivariate technique, by tourism researchers over the past decade. While there are two major types of SEM including covariance-based SEM (CB-SEM) and variance-based SEM (PLS-SEM), the former dominated previous tourism research. However, increasing use of PLS-SEM in tourism research has been witnessed in recent years. This upward trend is likely to persist in the near future given the growing popularity of PLS-SEM in other social sciences domains like marketing, strategic management, and management information system, as specified in the preface of the book. Indeed, PLS-SEM, in relative to CB- SEM, provides more flexibility in handling of data. For instance, PLS-SEM is well-suited for accommodating small sample sizes and complex model, fortesting a model containing both formative and reflective constructs, and for handling single-item measures. To this end, the timely introduction of the book A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) helps tourism researchers stand at the front edge of the SEM technique and make effective use of the PLS-SEM in data analysis. Additionally, the book illustrates the application of PLS-SEM with a free downloadable software namely SmartPLS which is essential to extend the application of PLS-SEM in tourism research.Authored by Hair, Hult, Ringo, and Sarstedt, the book consists of eight chapters. To equip the readers with the basic knowledge of PLS- SEM, Chapter 1 delineates the meaning of SEM and its relationship with multivariate data analysis, followed by a description of the major elements in multivariate data analysis. Then the basic elements of PLS-SEM are explained. Finally, PLS-SEM is distinguished from its counterpart namely CB-SEM while the major characteristics of PLS-SEM and the conditions where the PLS-SEM are more adequate than CB-SEM and vice versa are discussed. To step in the application of PLS- SEM, Chapter 2 firstly explicates the concepts in structural model specification including mediation, moderation, and higher-order models. Then specification of measurement model is explained with a special focus on the differences between reflective and formative measures. After that, the issues that need to be addressed after data collection are discussed. The chapter ends by creating the model in the SmartPLS is illustrated. With an established model, Chapter 3 focuses on model estimation. The chapter explains the algorithm underpinning the estimation and the statistical properties of the PLS-SEM method, as well as the options and parameter settings for running the algorithm. Following that, the issues about interpretation of results are explained. The final section illustrates the execution of model estimation in the SmartPLS.Based on the model estimation, empirical measures of the measurement and structural models are derived, where evaluation of the models takes place. Chapter 4 exhibits the major steps in model evaluation in the beginning. Thereafter, the chapter explains the evaluation of reflective measurement models according to three major criteria including internal consistency reliability, convergent validity, and discriminant validity, followed by an illustration with the SmartPLS. Chapter 5 explains the assessment of formative measurement models with respect to the criteria of convergent validity, collinearity, and significance and relevance of the formative indicators. The chapter also elucidates the basic concepts of bootstrapping which is used to examine the statistical significance of estimates in PLS- SEM. An illustration of the assessment of formative measurement model in the SmartPLS follows. Chapter 6 continues the topic on model evaluation by focusing on the assessment of structural model. …

Increasingly, companies are embracing the green‐lean‐six sigma (GLSS) approach to managing their environmental impacts. Nevertheless, there is a paucity of studies that examined the underlying motivations behind GLSS deployment in manufacturing organizations. Accordingly, this study investigates the GLSS motivators in a developed and developing economy context through multiple case studies in which semi‐structured interviews are conducted with senior corporate managers in the flexible packaging manufacturing industry. Drawing on the natural resource‐based view (NRBV) and institutional theory‐based view (ITBV), our analysis revealed various operational, organizational, and environmental factors as internal motivators and factors related to the state, society, and market as external motivators. To the best of our knowledge, it is one of the early comparative studies investigating the GLSS motivators in both developed and developing economies, which can guide future researchers, practitioners, and policymakers in understanding the salient factors influencing the GLSS adoption for environmental sustainability.