Lean Initiatives Research Articles

Relationship between lean six sigma, environmental management systems, and organizational performance in the Malaysian automotive industry

In the globalization era, lean initiatives and environmental management systems are increasingly implemented in the automotive industry. The aim of this report is to investigate and perform structural analysis of Lean Six Sigma (LSS) and Organizational Performance (OP). Data were obtained from 252 top management leaders in the Malaysian automotive industry. This report presents the results of the Exploratory Factor Analyses (EFA), Confirmatory Factor Analysis (CFA), and reliability analysis, which are empirically verified and validated. A set of assessment measurements of LSS and OP is expected to be suitable for their characteristics and improve their competitiveness. Thus, the main objective of the analysis was to provide additional insight into the relationship between LSS and OP by examining the effects of ISO 14001 certification as a moderator. The results indicate that ISO 14001 certification does not significantly moderate the relationship between LSS and OP in the Malaysian automotive industry. However, the OP values for ISO 14001 certified companies are higher than those without ISO 14001 certification.

Making progress towards more sustainable societies through lean and green initiatives

Making progress towards more sustainable societies through lean and green initiatives

Contrasting continuous quality improvement, Six Sigma, and lean management for enhanced outcomes in US hospitals

PurposeRapidly rising healthcare costs, partially due to preventable medical errors, have led hospitals to redouble their process improvement (PI) efforts. The purpose of this paper is to examine how PI initiatives mediate the effect of medical error sources to enhance three hospital outcomes (patient safety, operational effectiveness, and competitiveness).Design/methodology/approachDrawing from Dynamic Capabilities Theory, the authors develop a framework to explore three PI initiatives: Continuous Quality Improvement (CQI), Six Sigma Initiatives (SSI), and Lean Management Initiatives (LMI). Hierarchical regression analysis is employed to test the proposed model, using data from a nationwide survey of 210 US hospitals.FindingsFor enhancing patient safety outcomes, it was found that CQI and LMI were significant in mediating hospital error sources; however, SSI was not significant after accounting for the other two PI types. For improving organizational effectiveness, CQI and SSI were significant; whereas LMI was not significant over and above the other two PI types. Finally, only SSI was significant for superior sustainable competitive advantage.Research limitations/implicationsThe paper provides insight into which PI initiatives were most effective for various hospital outcomes. The findings can benefit healthcare practitioners as they select among different PI programs for enhancing healthcare results. Limitations of the study include the use of perceptual measures, relatively small sample size, and potential alternate relationships relevant to the outcome variables.Originality/valueThis is the first study to explore the mediating effects of three PI programs for the impact of medical errors on each of three hospital outcomes.

1750 Implementing Developmental Screening Recommendations in a Family Medicine Residency Training Program: Barriers, Solutions and Recommendations for Practice

Background and AimsThe American Academy of Pediatrics recommends that all children, as part of well child care, have validated developmental screening in the medical home. Testing increases the early identification...

Lean Construction Conformance among Construction Contractors in Turkey

Lean construction is the term that corresponds to the reflection of the production system developed at the Toyota Corporation (automotive industry) on the construction industry. Turkish contractors constitute a large portion of the local economy and are important global actors in contracting business. Lean construction–based research and practice, as a production management–based approach for increasing the effectiveness and efficiency of the construction industry, are scarce among Turkish contractors. This paper presents the results of a questionnaire prepared to predict the lean conformance levels of Turkish contractors and discusses the results. The comparative strengths and weaknesses of Turkish contractors for a lean construction initiative are highlighted. The findings that are presented in this paper can be used as a starting point to disseminate the research and practice in lean construction among Turkish contractors in the future. A similar kind of research can be repeated to compare the lean conformance levels in different countries and to evaluate the lean construction programs at different companies after the introduction of lean construction.

Establishing Baseline Electrical Energy Consumption in Wood Processing Sawmills for Lean Energy Initiatives: A Model Based on Energy Analysis and Diagnostics

ABSTRACT This research focuses on the benchmarking of electrical energy use at sawmills. Lean energy (a programmatic concept similar to lean manufacturing) is facilitated by this research, which furthers the understanding of energy intensity at sawmills, leading to reductions in operating costs and increases in profitability. A user-friendly interactive model, Baseline Electrical Energy Consumption in Wood Processing Sawmills (BEECWPS), was developed to enable the user to create an energy profile based on sawmill process dynamics and to provide information about product, process, and system parameters. These parameters were gathered by visiting six sawmill facilities in West Virginia. A detailed methodology was developed to collect the field data and determine an energy intensity. The proposed model has the capability of developing the energy benchmark for a facility under consideration, upon successful submission of required data, and will aid lean energy initiatives within the organization. Manufacturin...

From Toyota to the Bedside

The advent of health care reform means new pressures on American hospitals, which will be forced to do more with less. In the next decade, increased use of "Lean" principles and practices in hospitals can create real value by reducing waste and improving productivity, costs, quality, and the timely delivery of patient care services. In 2010, the Institute of Medicine recommended that nurses lead collaborative quality improvement efforts and assume a major role in redesigning health care in the United States. In this article, we provide an overview of the use of Lean techniques in health care and 2 case studies of successful, nurse-directed Lean initiatives at the Robert Wood Johnson University Hospital. The article concludes with some lessons we have learned and implications for nursing education in the future that must include the concepts, tools, and skills required for adapting Lean to the patient care environment.

An ISA-95-based manufacturing intelligence system in support of lean initiatives

Increasingly, lean manufacturing is being applied by leading manufacturers throughout the world. As continuous improvement cycles of many lean initiatives focus on cost control and improving quality of product, turbulence in world markets demand more agility and responsiveness without compromising cost and quality. In order to attain more agility, information and communication technologies are utilized by many manufacturers, both at shop floor systems and enterprise resource planning (ERP) layer. This increasing trend created a disconnect that presents an opportunity for manufacturing intelligence (MI) systems. Bridging this gap, MI can enhance responsiveness by providing visibility into operations and improve quality by tracking long-term data, hence support the continuous improvement philosophy of lean manufacturing. This paper presents an ISA-95-based MI framework that can support lean manufacturing by contextualizing low-level shop floor data using production operation information from ERP systems. Processed data is presented on dashboards via Key Performance Indicators, which managers can use to determine appropriate action for their lean initiatives, timely and effectively.

Managing lean capabilities through flexible workforce development: a process and framework

Many firms today are employing temporary contractual workers in order to help them to stay lean and flexible. The benefit of this approach is that the process of layoff is much easier. Thus, an emerging issue arises here, on how can firms manage and train temporary workers effectively? The core of lean adoption is through people, to have workers buy into the ideas and be part of the overall initiative. There is very little guidance available on how to deal with contractual workers who have less motivation and commitment to the firm given that they are only employed on a temporary basis. This article proposes a framework and process to assist firms in managing and training temporary workers to improve the efficiency and effectiveness of the implementation of lean improvement initiatives.

A comparative analysis of management accounting systems' impact on lean implementation

Lean principles and practices have been widely adopted by many companies since the early 1990s. These companies are now beginning to realise that traditional costing and accounting methods may hinder the lean initiatives that they are implementing. This raises an important question: “Which cost management and accounting approaches best support the newly implemented lean principles and practices?” This paper examines the relative impact of three different management accounting systems on lean manufacturing implementation through simulation modelling with a single performance metric – net income. Three management accounting alternatives included in this study: traditional management accounting (TMA), activity-based costing (ABC), and value stream costing (VSC). This study compares these three management accounting alternatives using process simulation and statistically designed experimental methods. The results demonstrate that VSC appears to provide a bridge between operational views and financial views of lean, which enhances the transfer of information from shop level to management level.

Book Review: Build Lean: Transforming construction using Lean Thinking by Adrian Terry & Stuart Smith

Presented as a narrative like Goldratt’s The Goal, Build Lean: Transforming Construction Using Lean Thinking2 traces the lean journey of one company led by Steve, a senior officer. It begins when he is confronted by some dismal results on one project and a significant success, attributed to Lean, on another. Three sections –  Lean in a Construction Context  Implementing Lean in a Construction Organization  Using Lean to Maintain an Edge frame the story and speak to issues important to every organization adopting Lean Construction. This is not a book about adopting Lean Construction or applying it on a project. By “Lean” here I mean the principles and practices drawn from Toyota and popularized by Womack & Jones (2003) — Value, Value Stream, Flow, Pull, Perfection. Lean Construction3 is defined by fundamental concepts, basic practices and a common vocabulary. Together these create a new paradigm for managing work in projects from concept to completion. While the book may be useful to some, I found it disappointing for a variety of reasons. Even so, I recommend it for designers and contractors trying to establish a lean initiative and to their clients hiring organizations implementing lean principles and practices. More on that along the way.

Application of Lean principles to improve early cardiac care in the emergency department

To achieve our goal of excellent emergency cardiac care, our institution embarked on a Lean process improvement initiative. We sought to examine and quantify the outcome of this project on the care of suspected acute coronary syndrome (ACS) patients in our emergency department (ED). Front-line ED staff participated in several rapid improvement events, using Lean principles and techniques such as waste elimination, supply chain streamlining, and standard work to increase the value of the early care provided to patients with suspected ACS. A chart review was also conducted. To evaluate our success, proportions of care milestones (first electrocardiogram [ECG], ECG interpretation, physician assessment, and acetylsalicylic acid [ASA] administration) meeting target times were chosen as outcome metrics in this before-and-after study. The proportion of cases with 12-lead ECGs completed within 10 minutes of patient triage increased by 37.4% (p < 0.0001). The proportion of cases with physician assessment initiated within 60 minutes increased by 12.1% (p = 0.0251). Times to ECG, physician assessment, and ASA administration also continued to improve significantly over time (p values < 0.0001). Post-Lean, the median time from ECG performance to physician interpretation was 3 minutes. All of these improvements were achieved using existing staff and resources. The application of Lean principles can significantly improve attainment of early diagnostic and therapeutic milestones of emergency cardiac care in the ED.

The role of the physical layout in the implementation of lean management initiatives

PurposeThe purpose of this paper is to investigate the impact of layout configurations in a hospital on the implementation of lean management initiatives, to include different units of care. The research concentrated on the impact, the physical distance between dependent units could have on staff perception, use of staff time, time spent in the system by patients, and performance.Design/methodology/approachThe research examined the relationship between clinical units allocated within Northampton General Hospital and their internal providers. In addition, an adapted version of the SERVPERF questionnaire was used to measure the quality perception of staff.FindingsThe transit distances from each clinical unit to their internal providers have: a negative relationship with the staff quality provision of care; a positive relationship with the time the patient spends in the system; and no discernable direct correlation with performance.Practical implicationsThese findings will help hospital managers to understand the impact of the layout of a hospital on the implementation of service improvement activities, and will assist them in planning improved relocation of clinical units. This facilitates future service improvements whilst optimising the use of available and constrained resources within the present hospital facilities.Originality/valueThe ideas and results presented in this study are original and valuable to the study of hospital layouts, services improvements and the implementation of lean operation initiatives and quality improvement programmes in hospitals. The study also successfully tested the application of SERVPERF in a hospital setting.

Complementarity and lean manufacturing bundles: an empirical analysis

PurposeThe paper aims to test and validate the complementarity effects on operational performance of two of the main lean manufacturing bundles, just‐in‐time (JIT) and total quality management (TQM). The paper also explores the role played by the human resource management (HRM) bundle as an enhancer of the complementarity between JIT and TQM.Design/methodology/approachThe paper is based on statistical analysis on the high performance manufacturing round III database, a survey that involves 266 plants in nine countries across three different industries (electronics, machinery and transportation components).FindingsThe paper proves the existence of complementarity between JIT and TQM and shows the enabling role of HRM on such complementarity.Research limitations/implicationsThe paper provides analytical and empirical argumentations showing that JIT and TQM mutually reinforce each other's marginal returns on operational performance. The study also indicates that only those plants characterized by a significant implementation of HRM practices enjoy the complementarity effects of TQM and JIT on operational performance.Practical implicationsThe research suggests a pattern of improvements where JIT and TQM have to be implemented hand‐in‐hand to take full advantage of their complementarity. HRM, the soft part of lean initiatives, provides the ground over which complementarity originates, spreading its benefits throughout the organization.Originality/valueThe study represents one of the few attempts trying to operationalize and empirically validate the concept of complementarity. The study also provides original suggestions to practitioners on how to make the most out of lean initiatives.

Lean: More than a Shop-Floor Fad

When most business or IT executives hear the term "Lean," they immediately think of shop-floor centric initiatives limited to manufacturing. However, a deeper look at Lean principles reveals opportunities for organizations to optimize their operations, including IT. At its most basic form, Lean focuses on processes in an organization that add value for which a customer will pay. It advocates removing all extraneous processes that don't directly contribute to that value stream. The author recently met with Larry Miller, author of Lean Culture: A Leadership Guide (LM Miller Publishing, 2011), to discuss not only how IT can support Lean efforts but also how the Lean philosophy can help CIOs optimize IT operations. Although executives and business leaders are Miller's target audience, IT analysts, relation ship managers, business liaisons, change-management teams, and other IT players will quickly spot how the described approach fits in with IT practices. Given that today's CIOs have evolved from simple service providers into partners in business-strategy definition and execution, these processes should be useful with or without a formal Lean initiative.

Approaches and practices of lean manufacturing: the case of electrical and electronics companies

Lean manufacturing is now one of the most powerful manufacturing systems in the world. Numerous plants around the world have attempted to implement or adopt it to enhance their efficiency. However, little studies regarding lean manufacturing have been done in Malaysia especially in the electrical and electronics industry. The purpose of this study is to investigate the approach of adopting lean, the tools and techniques implemented, the changes in the organizations, the problems encountered as well as the lessons learnt. This paper describes the results and findings of four industrial case studies conducted in different electrical and electronics companies in Malaysia. Interviews were conducted with the key personnel to answer some issues which were crucial in this study. Comparisons and discussion were made among the case companies. One of the key findings obtained is that people in the organization should possess the lean mindset and act in the lean way in order to make a lean initiative successful. This is perhaps the first study that investigates the actual implementation of lean manufacturing in the Malaysian electrical and electronics industry. The information presented in this paper can be used or emulated by other companies in the same industry to improve their operational performance. Key words: Lean manufacturing, implementation, case studies, electrical and electronics, Malaysia.

84 LEAN TECHNOLOGY IMPROVES EFFICIENCY IN OUTPATIENT ACADEMIC URO-ONCOLOGY CLINICS

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness1 Apr 201184 LEAN TECHNOLOGY IMPROVES EFFICIENCY IN OUTPATIENT ACADEMIC URO-ONCOLOGY CLINICS Sean Skeldon, Andrea Simmons, Bob Broach, Karen Hersey, Michael Jewett, Antonio Finelli, Alexandre Zlotta, and Neil Fleshner Sean SkeldonSean Skeldon Toronto, Canada More articles by this author , Andrea SimmonsAndrea Simmons Toronto, Canada More articles by this author , Bob BroachBob Broach Zionsville, IN More articles by this author , Karen HerseyKaren Hersey Toronto, Canada More articles by this author , Michael JewettMichael Jewett Toronto, Canada More articles by this author , Antonio FinelliAntonio Finelli Toronto, Canada More articles by this author , Alexandre ZlottaAlexandre Zlotta Toronto, Canada More articles by this author , and Neil FleshnerNeil Fleshner Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.148AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Due to high clinic volumes and variability among patient needs, conducting an efficient and streamlined uro-oncology clinic can be challenging. Academic urology clinics pose additional challenges including: teaching (medical students, residents and fellows), clinical trial coordination and formalized biobanking. Lean technology is an industrial engineering tool developed to optimize manufacturing efficiency and has been successfully applied in the health care setting. We set out to determine if Lean methods could improve efficiencies and quality of care among a hospital-based high volume uro-oncology clinic. METHODS Prior to the Lean initiative, baseline data were collected around patient volumes, wait times, cycle times (patient arrival to discharge), nursing assessment time, patient teaching and physician ergonomics (via spaghetti diagram). Value stream analysis (VSA) and a Rapid Improvement Event (RIE) were carried out and significant changes were made to patient check in, work areas and nursing face time. Follow-up data were obtained at 30, 60 and 90 days. Changes from baseline were compared to baseline with probability values less than 0.05 deemed significant. RESULTS Table 1 demonstrates the improvements seen following the VSA and RIE. Figures 1 and 2 show spaghetti diagrams depicting physician and nurse flow prior to and after the RIE. Table 1. Improvement from baseline following Rapid Improvement Event Baseline 30 days 60 days 90 days Average Number of Patients per Clinic 30.4 32.1 32.6 31.2 Median Cycle Time (min) 46 43 31⁎ n/a Wait Time for Initial Assessment (min) 23 5⁎ 10⁎ 5⁎ RN Quick Assessment (min) 0.5 15⁎ 5⁎ 5⁎ RN Teaching (min) 2 n/a 15⁎ 10⁎ Wait Time for Clinical Trial Coordinators (min) 26 18⁎ 6⁎ n/a ⁎ p < 0.05 compared to baseline CONCLUSIONS Using Lean methodology we were able to significantly shorten the patient cycle time and time to initial assessment as well as integrate both an initial RN assessment and RN teaching to each visit. Lean Technology can effectively be applied to improve efficiency and patient care in an academic outpatient uro-oncology clinic setting. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e36-e37 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sean Skeldon Toronto, Canada More articles by this author Andrea Simmons Toronto, Canada More articles by this author Bob Broach Zionsville, IN More articles by this author Karen Hersey Toronto, Canada More articles by this author Michael Jewett Toronto, Canada More articles by this author Antonio Finelli Toronto, Canada More articles by this author Alexandre Zlotta Toronto, Canada More articles by this author Neil Fleshner Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Improving performance through Lean

Ostensibly, less than 10% of UK organizations accomplish successful Lean implementations. Nonetheless, an appropriate implementation results in tangible success for the organization. Consequently, a refined system to the Balanced Scorecard was utilized. A robust procedure is proposed that focuses on both the intangible and intellectual assets but also embraces various time horizons and the interests of multiple stakeholders. The methodology utilized ensured both validity and credibility were secured. Predominantly, the data was collected through meticulous Survey questionnaires undertaken in sixty-eight organizations. This was coupled with seven Case Studies; the quintessential characteristic of Case Studies enables them towards a holistic understanding of interrelated activities engaged in by the actors in a social situation. At least eight informants were questioned in each case study which included questionnaires and interview schedules. The Survey questionnaire analysis was performed with the aid of the software SPSS version 13.0 for Windows. The overwhelming evidence dictates that Lean results in better performance levels. Nonetheless, considerable variations were found which reflected how Lean was embraced by the company. Fifteen organizations excelled but had also demonstrated a greater commitment towards becoming Lean. We are always directed towards the low numbers of successful Lean initiatives; this research demonstrates the importance of embracing Lean as a total ideology. When this happens, Lean proves successful for the organization provided its principles are adhered to closely. Despite the popularity of the Balanced Scorecard it has recently proven inadequate in certain circumstances. The proposal enables managers to bridge the gap between the real and aspired performance. The adapted scorecard acts as a bespoke measurement for any Lean initiative.

Lean principles, learning, and knowledge work: Evidence from a software services provider

In this paper, we examine the applicability of lean production to knowledge work by investigating the implementation of a lean production system at an Indian software services firm. We first discuss specific aspects of knowledge work—task uncertainty, process invisibility, and architectural ambiguity—that call into question the relevance of lean production in this setting. Then, combining a detailed case study and empirical analysis, we find that lean software projects perform better than non-lean software projects at the company for most performance outcomes. We document the influence of the lean initiative on internal processes and examine how the techniques affect learning by improving both problem identification and problem resolution. Finally, we extend the lean production framework by highlighting the need to (1) identify problems early in the process and (2) keep problems and solutions together in time, space, and person.

Survey‐based spreadsheet model on lean implementation

PurposeThis research was conducted to study benefits of a concept, known as lean manufacturing, which elicits organizations to do more with less effort, time, space, and equipment by eliminating waste. Because lean implementation involves finances, dedication, and cultural change in business, there is a need to assess a company's lean initiative.Design/methodology/approachA comprehensive lean assessment tool is designed targeted for use by manufacturing companies. Research of lean principles and practices was conducted through lean organizations, trade publications, manufacturing web sites, professional articles, textbooks, lean exhibitions, and non‐profit lean organizations.FindingsThis led to the development of a lean survey questionnaire delivered to 143 lean companies and lean consultants for authentic input. Based on the response, survey participation met a goal of 95 percent accuracy with 15 percent error. Completed surveys were compiled and analyzed for fundamental practices of lean organizations. Answers to the survey were assigned numerical values based on lean significance, and a lean assessment model was developed based on Excel. The lean assessment model was fine‐tuned and programmed to output a numerical and descriptive lean assessment grade. It was tested for soundness by inputting mock lean and traditional company answers into the model. Output results from the model correlated with the input.Originality/valueLean thinking philosophy and lean manufacturing methods and principles were exhaustively researched to make a successful lean organization. The research led to the development of a visual indicator, the Lean Thinking Management Wheel. This model to assess lean thinking manufacturing initiatives unique and has a great potential to use industry wide.