Lean Improvement Research Articles

Inventory diagnosis for flow improvement—A design science approach

AbstractImproving flow is a core Operations Management theme that is set to become even more important following contemporary developments in manufacturing, such as smart products and digital encapsulation that enable new control concepts such as multi‐agent holonic control. But, companies often struggle to realize flow improvements in practice, both with and without new technologies. While the literature agrees on the importance of flow, a structured and independent process that supports managers in identifying the root causes of why flow items wait in inventories instead of being processed is missing. Managers often use a single production management concept, such as lean production or the theory of constraints, when they seek to understand the reasons for a flow problem, which may lead to misdirected and unsuccessful interventions. In response, we use design science to develop a comprehensive approach to diagnosing flow problems that is independent from any production management concept. This diagnosis process results from successive iterations with five companies and supports the selection of appropriate analytical models and flow improvement solutions. It enables an organization to widen the focus of its flow improvement actions beyond the scope of a singular production management concept and complements the application of recent advances in technology, allowing smart products to quickly interpret what is happening in a location without first simulating and analyzing the whole system. Furthermore, the study expands buffer theories by showing that buffers have an internal hierarchy and can be absorbed by other buffers, while enhancing other theories related to coordination, material flow control, and lean improvement.

Capacity building of logistics enterprises’ reverse inventory technology management based on value chain

In the process of the continuous development of e-commerce, the main body of e-commerce activities gradually formed the value chain through a variety of ways, and the e-commerce ecosystem was born. The e-commerce ecosystem model based on value chain is established, and the subject members are divided into core population, key population, assistant population and dependent population, and the hierarchical structure. And related characteristics of the ecosystem are studied. The evolution mechanism of e-commerce ecosystem based on value chain and the role of value chain in the evolution of e-commerce ecosystem are analyzed. This paper summarizes the evolution path of e-commerce ecosystem based on value chain, including the characteristics of each evolution stage and the countermeasures that core e-commerce enterprises should take. In this paper, based on the whole value chain theory of lean management, by implementing the lean logistics improvement of the whole value chain, implementing fine management and control could be over the whole process of inventory formation, highlighting the planning, implementation and assessment of inventory. The results indicates in the whole value chain, through the effective building of internal and external supply chains, the inventory turnover rate continues to rise, which effectively improves the pressure drop level of the company’s “two funds”. And it can promote the sustainable and healthy development of the company.

Six-Sigma And Lean Thinking in Healthcare: A Comprehensive Literature Review And Critical Assessment

Six-Sigma And Lean Thinking in Healthcare: A Comprehensive Literature Review And Critical Assessment Eisenhower C. Etienne, Ph.D; Mineke E. Etienne, MD, FACFP Abstract Purpose: This paper undertakes a comprehensive review of the literature on six-sigma and lean thinking in healthcare as the basis for critically evaluating current success in their deployment in the healthcare industry. Design/methodology/approach: A reasonably exhaustive search of the literature was undertaken. This search targeted both research on six-sigma and lean thinking and specific research on six-sigma and lean thinking in healthcare. Findings: Five conclusions emerge from the review. First, the measurable impact of six-sigma and lean thinking on the quality, cost, responsiveness and efficiency of healthcare organizations as evidenced by the results reported for improvement projects is modest, at best. Second, six-sigma and lean thinking improvement projects have targeted a very limited range of areas. There is no evidence of attempt to evaluate the extent to which these improvement were long lasting or permanent. Third, the improvement projects uncovered by our literature review generally leave untouched the core technologies, practices and methods of medical practice and delivery of healthcare. This means that none of the cases reported targeted or achieved the deep and permanent culture change that is the sine qua non of six-sigma and lean thinking implementation. Fourth, we uncovered no case of a healthcare organization that can be said to be prototypical six-sigma or lean thinking one of the calibre of Toyota Production System (TPS) or GE Capital. Finally, our research found no systematic attempt to build a theory of healthcare service delivery processes/operations. Such a theory is a pre-requisite to the systematic adaptation of six-sigma and lean thinking in these organizations. Originality/value: First, this research has documented the state-of-the-art on the deployment of six-sigma and lean thinking in healthcare. Such documentation is the first step in any systematic effort to identify areas where progress has been made as well as avenues for further research. The review demonstrates that very little systematic deployment of six-sigma and lean thinking in healthcare has been achieved and that the field of research is fundamentally wide open. Second, the review provides rather conclusive evidence that pronouncements to the contrary, the broad applicability of six-sigma and lean thinking, as these paradigms were originally conceived of and as they are currently used to guide research in healthcare, is far from established. Third, the very weak results of research undertaken thus far speak rather forcefully to the need to make radical change in the six-sigma and lean thinking paradigms to make them applicable to healthcare organizations. Fourth, the identification of a need for a theory of healthcare organizations may prove to be significant for the deployment of six-sigma and lean thinking in healthcare. Full Text: PDF DOI: 10.15640/rcbr.v9n1-2a2

NO WAIT: new organised well-adapted immediate triage: a lean improvement project

Long waiting times in the emergency department (ED) are associated with decreased patient satisfaction and increased morbidity and mortality. Triage may be a contributing factor to prolonged wait times in...

Teaching Lean Principles in Nonmanufacturing Settings Using a Computer Equipment Order Quotation Administrative Process

ABSTRACTAs organizations continue to expand their implementation of Lean practices, business schools and corporate training organizations have developed numerous games and simulations aimed at teaching Lean concepts in manufacturing settings. However, simulations have lagged behind the most recent adaptations of Lean outside of the factory in services, and more specifically, in office settings. In this article, we present a Lean simulation game, referred to as “Computer Solutions, Inc.” that provides participants with hands‐on experience in applying Lean principles in a nonmanufacturing setting.The simulation takes place in the order‐quote department at “Computer Solutions, Inc.,” a company that specializes in designing customized computer solutions for small businesses. The order‐quote process is purely office‐based and involves such activities as collecting information, processing information, filling out documents, and forwarding those documents to different parts of the organization. This simulation is implemented as a “pencil‐and‐paper” exercise that can be performed by students in the classroom.Our simulation brings some unique benefits that are often missing from current Lean manufacturing‐based simulations. It involves multiple rounds of Lean improvements that can span several weeks, providing students a chance to identify wastes and to make a thoughtful application of Lean tools and techniques. Students also get to experience the challenges of group dynamics that are often present in team‐based improvement efforts.

Applying Trade-off Curve to Support Set-Based Design application at an Aerospace Company

Companies compete greatly with each other today, so they need to focus on innovation to develop their products and make them competitive. Lean product development is the ideal way to develop product, foster innovation, maximize value, and reduce time. Set-Based Concurrent Engineering (SBCE) is an approved lean product improvement mechanism that builds on the creation of a number of alternative designs at the subsystem level. These designs are simultaneously improved and tested, and the weaker choices are removed gradually until the optimum solution is reached finally. SBCE implementations have been extensively performed in the automotive industry and there are a few case studies in the aerospace industry. This research describe the use of trade-off curve as a lean tool to support SBCE process model in CONGA project, using NASA simulation software version 1.7c and CONGA demonstration program (DEMO program) to help designers and engineers to extract the design solution where it exists according to the customer requirement and to extract alternative nearest solutions from the previous project that meet customer requirement to achieve low noise engine at an aerospace company and also extract the infeasible region where the designers cannot make any prototype in this region before manufacturing process begin, that will lead to reducing rework, time and cost.

Implementing Lean Quality Improvement in Primary Care: Impact on Efficiency in Performing Common Clinical Tasks.

Many primary care practices have adopted Lean techniques to reduce the amount of time spent completing routine tasks. Few studies have evaluated both immediate and sustained impacts of Lean to improve this aspect of primary care work efficiency. To examine 3-year impacts of Lean implementation on the amount of time taken for physicians to complete common clinical tasks. Non-randomized stepped wedge with segmented regression and interrupted time series analysis (January 2011-December 2016). A total of 317 physician-led teams in 46 primary care departments in a large ambulatory care delivery system. Lean redesign was initiated in one pilot site followed by system-wide spread across all primary care departments. Redesigns included standardization of exam room equipment and supplies, streamlining of call management processes, care team co-location, and team management of the electronic inbox. Time-stamped EHR tracking of physicians' completion time for 4 common tasks: (1) office visit documentation and closure of patient charts; (2) telephone call resolution; (3) prescription refill renewal; and (4) response to electronic patient messages. After Lean implementation, we found decreases in the amount of time to complete: office visit documentation (- 29.2% [95% CI: - 44.2, - 10.1]), telephone resolution (- 22.2% [95% CI: - 38.1, - 2.27]), and renewal of prescription refills (- 2.96% per month [95% CI: - 4.21, - 1.78]). These decreases were sustained over several years. Response time to electronic patient messages did not change significantly. Lean redesigns led to improvements in timely completion of 3 out of 4 common clinical tasks. Our findings support the use of Lean techniques to engage teams in routine aspects of patient care. More research is warranted to understand the mechanisms by which Lean promotes quality improvement and effectiveness of care team workflows.

Implementation of Lean in a Health System: Lessons Learned From a Meta-Analysis of Rapid Improvement Events, 2013-2017.

Recent data suggest that a majority of hospitals now engage in some form of Lean process improvement in an attempt to reduce costs and/or improve quality. The literature on Lean healthcare has evolved from describing theoretical benefits, implementation barriers, and best practices to studies describing where implementations have occurred and their outcomes. Nevertheless, previous studies are mostly limited to case studies in which Lean was implemented on a limited basis in a healthcare facility. In this article, we present lessons learned from the largest implementation of Lean in a single healthcare system composed of 16 hospitals, a health plan, and many outpatient clinics. Our analysis of 1,144 rapid improvement events (RIEs) over a 5-year period revealed that 45% were associated with some organizational benefit in several categories, including cost reductions, time savings, a reduction in clinical and nonclinical defects, and a reduction in workflow steps. As the organization became more experienced with RIEs, the benefits realized changed from mostly cost reductions to a more diverse mix of benefits, with time savings becoming the most common. RIEs implemented in certain settings and/or by certain types of employees were associated with the likelihood of realizing a benefit. Based on these analyses, we provide recommendations to hospital and health system leaders interested in optimizing their Lean implementations-especially on a large enterprise-wide scale.

COMPLEMENTS OR CONFLICTS: R&D AND LEAN INNOVATION APPROACHES

The purpose of this research is to explore the relationship between research and development (R&D)-funded innovation efforts and operational-level lean improvement efforts through the lens of the Resource-Based View (RBV), with a focus on the relationship between them. Does the “leaning” of a firm’s operations create barriers to change and inhibit the success of R&D-led innovation investment? Or, does the “leaning” of operations help organisations focus on priorities and simplify routines so that new R&D efforts are more effective? Our analysis of more than 850 firm-years’ worth of data showed that the relationship between lean and R&D productivity is nonlinear, specifically an inverted U-shape (concave). Leanness provides some early R&D productivity improvement benefits, but R&D productivity levelled then declined over time. In a follow-up industry-level analysis, we found that the effects of leanness on firm-level R&D productivity differed by industry, with some industries seeing evidence of positive effects from lean practices and others experiencing negative effects on R&D productivity from lean.

The Effect of Normobaric Hypoxia on Resistance Training Adaptations in Older Adults.

Allsopp, GL, Hoffmann, SM, Feros, SA, Pasco, JA, Russell, AP, and Wright, CR. The effect of normobaric hypoxia on resistance training adaptations in older adults. J Strength Cond Res 36(8): 2306-2312, 2022-The effect of normobaric hypoxia on strength, body composition, and cardiovascular fitness was investigated after a resistance training intervention in older adults. A single-blinded, randomized control trial recruited 20 healthy adults aged 60-75 years for an 8-week resistance training intervention in normoxia ( n = 10) or normobaric hypoxia (14.4% O 2 ; n = 10). Subjects performed 2 sessions per week of upper-body and lower-body exercises at 70% of 1 repetition maximum (1RM). Pretraining and post-training, maximal oxygen uptake (V̇O 2 max), muscular endurance (30 maximal knee flexions/extensions), and 5RM were assessed, with 5RM used to calculate 1RM. Subjects underwent whole-body dual-energy x-ray absorptiometry (DXA) at pretraining and post-training for fat and lean mass quantification. Significance was set at p < 0.05. Subjects in both groups substantially improved their calculated 1RM strength for leg extension, pectoral fly, row, and squat (normoxia; 30, 38, 27, and 29%, hypoxia; 43, 50, 28, and 64%, respectively); however, hypoxia did not augment this response. Hypoxia did not enhance V̇O 2 max or muscular endurance responses after the training intervention, with no improvements seen in either group. Fat mass and lean mass remained unchanged in both groups after the intervention. In summary, 8 weeks of resistance training in hypoxia was well tolerated in healthy older adults and increased upper-body and lower-body strength. However, the magnitude of strength and lean muscle improvements in hypoxia was no greater than normoxia; therefore, there is currently no evidence to support the use of hypoxic resistance training in older adults.

Green lean operationalisation of the circular economy concept on production shop floor level

Addressing today’s general requirements on sustainability, as captured by for example the UN sustainability goals, is a necessity within production operations. It means that production managers need to find and manage new working procedures and methods on the shop floor to increase resource efficiency and overall sustainability. Utilizing a green lean environmental improvement tool called Green Performance Map in manufacturing and pharma industry has proven successful results in engaging shop floor managers and operators in green kaizen and demonstrated the value of integrating the waste hierarchy model, hence operationalising the concept of circular economy. This paper presents results of eight industrial cases of pilot trials of the Green Performance Map, demonstrating how the waste hierarchy model was used as an operationalisation mechanism for increasing the circularity on the shop floor. This was made by prioritizing and executing environmental improvements identified by the shop floor team that implied moving up one or more steps in the waste hierarchy. By this action, resource efficiency was improved as well as the overall environmental behaviour. The research presented contributes to the green lean theory and its integration with circular economy in a production context. On managerial level, the research demonstrates a concrete way of how the circularity could be improved on the shop floor.

Integrated lean concepts and continuous/discrete-event simulation to examine productivity improvement in door assembly-line for residential buildings

Efforts within the construction-manufacturing domain to improve assembly-line operations have benefited from paradigms emerging in the late-1990s such as lean manufacturing. This study investigates lean concept solutions to enhance productivity prior to capital investments. The investigation is carried on a case study of a single-door assembly line for residential buildings. Lean improvements are examined through an integrated continuous/discrete-event simulation approach, aiming to increase the productivity of the assembly line. The proposed simulation model incorporates factors representing the system reliability. Continuous simulation modelling, using state variable technique, is implemented to facilitate the observation of door unites in targeted sections to track the accumulation levels in these particular sections of the assembly line. In addition, proposed solutions for productivity improvements are implemented within the simulation model, such as introducing advanced alternatives for the automated stations and adding parallel stations. The effect on the productivity of the assembly line was successfully evaluated after the implantation of the proposed improvements in the simulation model. Relevant approaches can be implemented to evaluate and improve modular construction assembly lines prior to incurring capital investment.

An actor–network theory perspective for “Lean” interventions in manufacturing firms

PurposeThis paper tracks the network of actors participating in the initial implementation of a “Lean management” system, in order to identify associations between human and non-human participants conducive to successful adoption of the system.Design/methodology/approachThe perspective of actor–network theory (ANT) helps reveal the complex dynamics at play in a “Lean” intervention at a manufacturing firm. It allows to identify key actors (human and non-human), as well as the possible associations between them, and helps produce network diagrams to track the changes in actors' roles and in network coherence over time.FindingsThrough a network analysis, the study charts the complexity of the process of Lean intervention, by accounting for the distinct possibility that actors' roles may shift over time, as they engage and disengage with the proposed intervention, until they fully cohere into a new system. Based on this, it derives a conceptual model to describe relevant factors for successful implementation of Lean improvement projects.Originality/valueThe ANT perspective affords new insights into Lean Management systems implementation, by highlighting associations between human and non–human actors. This novel focus suggests corresponding management guidelines and reflective practices for successful intervention.

Evaluation of Lean Business Process Improvement Methodology

AbstractIndustry trends such as lean manufacturing have proven to work effectively in removing waste and improving the efficiency and effectiveness of production processes in manufacturing companies. The business processes within some manufacturing companies tend to lack the same attention as the production processes, however. This research explored the value of using the GKN lean business process improvement (BPI) methodology for improving business processes at GKN Aerospace Norway (GAN), an aerospace manufacturing company located in Norway. The method aims to identify and reduce waste by mapping the current state of a selected process, suggest a future state with less waste, generate an action list for changes, and a plan for implementation of the proposals made. During this study, the method showed to be successful at improving the efficiency in 7 out of 8 of the processes adopted. The research also found that employees at GAN respond favorably to BPI initiatives but that better preparation prior to each BPI workshop could further improve the effectiveness of the method.

Lean improvement of the stage shows in theme park based on consumer preferences correlation deep mining

Online comments provide a new and convenient way to understand consumer preference, but these comments for stage shows in theme park are usually incomplete, which can seriously affect the accuracy of existing mining models. In order to overcome the dilemma of missing information, we propose the consumer preferences correlation deep mining model, which precisely mines user preferences from two aspects: comment semantic deep mining and attribute emotion correlation mining. Furthermore, the Kano-IPA model is proposed to comprehensively excavate the user satisfaction and the importance of product attributes to give a lean improvement strategy for stage shows. Specifically, firstly, correlation deep mining model is constructed to deeply mine the missing attribute emotional polarity based on the emotional correlation sequence, emotional vector and Senti2vec + Gated Recurrent Unit model. Secondly, correlation width mining model is developed to excavate the user preferences for the stage shows attribute. In the correlation width mining model, the partial regression equation is used to describe the influence of the user emotional polarity on the user satisfaction level. Based on the emotion correlated attribute sequences, the correlation Kano mapping rules are proposed, and then the priority of user preferences for product attributes is given. Thirdly, the Kano-IPA model is designed for the lean improvement of products to achieve higher benefits at a lower cost. Finally, the experimental results on Shanghai Disneyland confirm the effectiveness and application value of the proposed model. Consequently, this study provides an accurate decision support model driven by big data for product improvement.

Countervailing Risk Management Through Knowledge Transfer

This investigation seeks to understand the relationship between the identification and handling of countervailing risks that arise during value stream analysis projects and knowledge obtained from other value stream analysis projects. Eight hypotheses were formulated. Data were collected from 73 continuous improvement projects that performed value stream analysis of an organization within the Department of the Navy in the U.S. The results support a relationship between knowledge transfer across projects and the management of countervailing risks. These results suggest that practitioners using knowledge transfer methods and tools can promote better Lean Thinking value stream analysis continuous improvement projects.

Developing optimal scaffolding erection through the integration of lean and work posture analysis

PurposeFacility structures in liquefied natural gas (LNG) plants require tremendous amounts of scaffolding to facilitate relevant industrial operation and maintenance. As such, the productivity of scaffolding operations in turnaround maintenance (TAM) has attracted much attention in recent years. In addition, health and safety issues have been recognised as a key contributor along with productivity improvement in the LNG industry. This study aims to integrate work posture analysis into value stream mapping to achieve an optimised and balanced improvement in both productivity and health and safety.Design/methodology/approachA case study approach is adopted to integrate lean and work posture analysis in a TAM site. The lean improvement is conducted through value stream mapping, and the work posture analysis is conducted through the Ovako Working Posture Analysis System method. A three-step optimisation strategy is then developed for achieving optimised performance in waste reduction and work posture improvement.FindingsIt is found that the implementation of value stream mapping can help eliminate waste in the installation process, therefore eliminating potential health and safety risks. However, health and safety of onsite workers does not always improve as lean implementation intensifies. There is an optimised erection schedule that has the lowest health and safety risk within a waste reduction target.Originality/valueIn contradiction to previous studies, which rely on qualitative assessment to identify the a positive correlation between lean and health and safety, this study reveals the distinct difference between lean attributes and health and safety attributes through a quantitative assessment and is more readily to be implemented at the site level for simultaneous improvement in lean and health and safety.

MON-LB301 Application of Lean Six-Sigma DMAIC Tool for Improvement and Sustainability of Diabetes Management in Outpatient Clinics

DMAIC: Define, Measure, Analyze, Improve, Control. LSL: Lower specified limit. USL: Upper specified limit.Lean Six Sigma DMAIC is quality improvement methodology used for strategic business management. Frequent applications of this methodology in healthcare include improvement of patient satisfaction, reduction of emergency department waiting times, prescription error reduction and monetary recovery by reducing waste.Patients with a HgbA1c testing frequency of >6 months have poorer glycemic control. The American Diabetes Association recommends HgbA1c test quarterly in patients whose therapy has changed or who are not meeting glycemic goals and at least two times a year in patients who are meeting treatment goals.We hypothesized that the Lean Six-Sigma DMAIC tools can be used in the outpatient clinic setting to improve frequency of HgbA1c testing in patients with diabetes mellitus.At baseline, 19% of our patients with diabetes mellitus had HgbA1c tested infrequently, defined as more than 6 months. This high percentage is a concern as it could lead to poor diabetes control. The aim was to increase percentage of patients having an HgbA1c tested between 3 to 6 months before an appointment in our clinic, to a goal of 90%. Target population included all patients with diabetes mellitus seen in outpatient endocrinology clinic.A baseline analysis of existing processes was done through brainstorming with the clinic staff using a fish bone diagram. Lack of follow up and HgbA1c testing orders were some of the modifiable factors identified. The new processes implemented include nurse driven standing medical orders for HgbA1c testing and pre-visit planning. Control phase included regular audits to sustain the improvements.The percentage of patients with a HgbA1c testing within 3-6 months of appointment improved from a baseline of 76.7% (LSL:70%, USL:94%) to 92.2% (LSL:88%, USL:93.7%). The improvement was noticeable within 1 month of new process implementation and continues to sustain. The mean had an absolute improvement of 15.5%. The variation from the mean decreased from 25% at baseline to 6% at the end of the control phase. The reduction in variation made our future results more predictable.The use of Lean Six-Sigma DMAIC quality improvement tools are an effective method to improve quality of care in the outpatient setting. These strategies can be replicated for other clinical quality outcomes.

Towards the Control and Prevention of Waste in IT Service Operation Using Fuzzy Logic: Focus in Incident Management Process

All production lines are continuously confronted with the phenomenon of waste, especially in IT operations. A waste is assessed in terms of the required resources and the cost employed to solve the problem behind it. Eliminating the waste in daily operations is essential to improve IT service management. This article aims to provide an estimation of the level of potential waste, where waste generation trends are provoked by the activities of IT service management processes. We are going to focus particularly on the possibility of applying a Lean improvement process to IT services processes when using fuzzy logic method. We specifically demonstrate our contribution through the application of fuzzy analysis to the incident management process. This approach also aims at developing a theoretical and pragmatic model and promoting the knowledge of IT experts. In order to make our framework as generic as possible, concepts of IT operations, including the incident management, are inspired by the Information Technology Infrastructure Library (ITIL), the most prominent framework for IT service governance according to the current literature.

Defining and Developing Measures of Lean Sustainability for Manufacturing Sector

Toyota Manufacturing Company revival after World War II and its survival during 1973 global oil crisis had inspired many manufacturing organisations around the world to initiate lean transformation. However, due to lack of clear understanding of the lean sustainability concept, many manufacturers are unable to fully transform into a true lean organisation like Toyota. In fact, without a proper measurement, the organisation’s transformation progress will be unknown and the specific gains made from lean improvement cannot be monitored. Hence, it will result in wrong strategy deployment in the lean transformation program. This paper therefore aims to theoretically define Lean Transformation Sustainability and propose set of indicators for measuring this concept. A myriad of literature related to theory and practices of lean manufacturing was studied to better understand this concept. The methodology adopted to better understand Lean Transformation Sustainability concept was based on steps to success in writing literature review by Machi and McEvoy. Apparently, Lean Transformation Sustainability can be measured in three dimensions; (1) lean elements momentum, (2) lean culture adaptation, and (3) enduring success. At the end of this article, the authors recommend several opportunities for future research that can be used for adding literature to lean body of knowledge.