Lean Management Principles Research Articles

Barriers to Effective Implementation of Lean Management Principles - Empirical Exemplification in the Industry of Agricultural Machinery

Barriers to Effective Implementation of Lean Management Principles - Empirical Exemplification in the Industry of Agricultural Machinery

Implementing Lean Management Techniques at a Radiation Oncology Department.

Lean management (LM) principles were first developed by a Japanese manufacturing company to maximise value and minimise waste in the automotive industry. However, these principles can also be applied in the healthcare sector. This study aimed to illustrate the process of implementing LM principles in a radiation oncology department to streamline workflow and identify and reduce waste. This study took place in the Department of Radiation Oncology, Royal Hospital, Muscat, Oman, in December 2016. A value stream map (VSM) was created for the chain of processes followed in the department. A waste analysis was conducted to determine which processes did not add value for the patient or healthcare provider. Based on the VSM analysis, only six out of 13 steps were found to be of value. Necessary and unnecessary non-value-adding activities were identified. Sources of waste included parking and registration. In addition, variabilities in workload were noted. Overall, LM principles improve workflow, reduce waste and enhance patient and staff satisfaction. In the current study, the application of LM principles helped to improve value in a radiation oncology department.

Lean Energy: Turning Sustainable Development into Organizational Renewal

The potential for integrating principles of lean management and sustainability initiatives has been recognized in earlier research. The present study argues for the need to focus on how this should be implemented and to acknowledge the criticality of developing individuals’ competencies to support such integration. The purpose of this paper is to explore the integration of lean and energy efficiency practices and provide practical examples of such integration. This study is explorative in nature and based on a qualitative research approach. Primary evidence was collected through an interview study of 19 participants in a lean energy course, and through a participant observation at a company workshop following up the program results. Secondary evidence was collected on the development and evaluation of this course. By operationalizing sustainability through energy efficiency and combining with lean principles, organizations can exploit continuous improvement efforts for sustainable development. This paper focuses on professional education as a component for integrating improvement initiatives and sustainable development. Whilst professional education enables individual learning, organization-wide efforts are needed to follow up on the educational program and support a scaling-up of lean energy. The scaling-up means that the organization itself encourages the use of principles and tools to identify and remove energy waste and support a move from local practices to shared experience.

Implementation of modern tools in autopsy practice-the way towards contemporary postmortal diagnostics.

Medical, legal, and socioeconomic issues have contributed to the decline of autopsy rates. Pathology-related factors, however, with changing clinical duties on the one hand and decreasing interest and lack of substantial technical developments in this field on the other, may have contributed to this condition as well. We present our experience of a restructuring project that culminated in the introduction of a modernized postmortal diagnostic (PMD) unit: Workflows of PMD procedures and space organization were restructured according to LEAN management principles method. Classical autopsy suites were transformed into postmortal operating rooms. A PMD pathologist staff was designated to perform postmortal operative diagnostics (i.e., using laparotomy and thoracotomy approaches) with the intention of gradually replacing classical autopsy procedures. Postmortal minimal invasive diagnostics (PMID) using laparoscopy and thoracoscopy were successfully implemented with the expertise of clinical colleagues. Reorganization of workflow reduced turn-around times for PMD reports from a median of 33days to 15days. Short-term analysis revealed that this combined effort leads to a slight increase in the number of adult postmortal examinations 1year after the introduction of this project. A change of culture in postmortal diagnostics may contribute to a better reputation of postmortal examinations from the perspective of clinicians, the general public, and affected relatives of the deceased. It may also serve to demonstrate that the pathology community is keen not only to preserve but also to further develop this valuable tool for medical quality control and education.

Continuity of Care Unit (CCU): an organizational model based on Lean Management principles.

Continuity of Care Unit (CCU): an organizational model based on Lean Management principles.

20An Audit of Door-To-Needle Times and Implementation of LEAN Management Principles in a University Hospital in Ireland

20An Audit of Door-To-Needle Times and Implementation of LEAN Management Principles in a University Hospital in Ireland

Design of a Conceptual Model for Improving Company Performance Based on Lean Management Applying the Viable System Model (VSM)

Abstract Designing, changing and adapting organizations to secure viability is challenging for companies. Researchers often fail to holistically design or transform organizations. Thus, the aim of this study is to propose a holistic approach how organizations can be designed, changed or managed considering also its implications to production management following lean management principles. Hereby the Viable System Model was applied. This structure can be applied to any kind of structured organization and for its management with goals to be achieved in modern society; however focus of the research is the cluster of manufacturing and assembly companies. Goal of the developed organizational model is to be able to react to all potential company environments by taking decisions regarding organization and production management functions correctly and in the right moment based on the needed information. To ensure this, standardized communication channels were defined. In conclusion this proposed approach enables companies to have internal mechanisms to secure viability and also in production to reduce necessary stocks, lead times, manpower allocation and leads to an increase of the service level to the final customer.

MAPEAMENTO DO PROGRESSO DE MOLDES – UMA FERRAMENTA DE GESTÃO VISUAL PARA A INDÚSTRIA 4.0

The planning of injection molds production is a complex task where the classic planning approaches has proven limitations because of the following particular characteristics: the mold expands in a myriad of components for production; the “one-of-a-kind” type of production and recurrent mold design changes asked by the customer. To overcome this challenge a methodology to Molds Production progress Mapping is proposed (MPM). The methodology was built on the authors experience in collaborating with mold making companies, on the principles of lean manufacturing and visual management (VM) and also have in mind the trend towards production digitalization to be aligned with Industry 4.0 evolution. As a VM tool to support molds production planning, the MPM shows the instant progress of each mold, the deviation from planning and the remaining time for the due date. The user has “only” to input the mold’s components critic level and the relative weight of each production process in the total time; it also requires that the production process are armed with sensors and the production task are digitalized and compiled in the information management system. The MPM can also be used in other complex production systems.

How much of Toyota's philosophy is embedded in health care at the organisational level? A review.

Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies. No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care. Sixty studies were identified for the final analysis. Some Toyota Way principles appear more deeply embedded in health care institutions than others are. Not all principles of Toyota's philosophy and production system were embedded in the studies in this review. The type of reported outcomes at the organisational level was diverse. This literature review increases our knowledge about how many (and which) of the Toyota Way principles are embedded in health care. This knowledge may support reflection by nursing managers about how the full range of lean management principles could be embedded at the managerial and/or operational level.

P129 - LEAN Management Principles Applied to Spinal Deformity Surgery have Improved Patient Safety and Increased Surgical Efficiency

BACKGROUND CONTEXT: Spinal deformity surgery is a complex procedure associated with long surgical times, high blood loss, and neurological complications. LEAN is a management principle that supports continuous improvement through small, incremental changes to improve quality and efficiency. We have adopted LEAN principles (such as sort, simplify and standardize) to improve the quality and efficiency of pediatric spinal deformity surgeries.

Exploring the Interaction Between Internal Customer Satisfaction and Talent Waste: A Lean Management Perspective

Principles of lean management have become more popular in recent years and the implementation area of Lean, spread from manufacturing environment to service sectors due to its wide applicability. Human centric structure of service sector reveals the need of lean principles which focuses on improvements related to employees. In lean thinking, elimination of wastes is one of the priority and it is essential to eliminate them for organizational enhancements. Wastes in lean were firstly defined under seven categories as overproduction, over-processing, waiting, motion, inventory, defect, transportation for manufacturing environment. However, these wastes were not found adequate, since one of the most important factor in organizations, human, was ignored. Therefore, the 8th waste of lean was presented as “talent” in order to include the human factor and it refers to underutilization of people’s talent, knowledge, skills and abilities. As eliminating talent waste has been perceived as an important concept, it should be a significant driver of increasing internal customer satisfaction. This study aims to explore the relation between talent waste and internal customer satisfaction while considering level of top management commitment. Within this context a survey was conducted with the participation of whitecollar internal customers to understand their perception of talent waste related to their jobs. At the end of the study, it is found that talent waste partially mediates the relationship between top management commitment and internal customer satisfaction.

Digitalization of learning resources in a HEI – a lean management perspective

PurposeLean is considered as a major management approach for improving operational productivity and organizational performance. It is a systemic philosophy that emphasizes on fulfilling customer needs, waste minimization, and a commitment to a culture of continual improvement. In recent years, many higher education institutions (HEIs) have leveraged on the use of technology to provide flexibility in learning and just-in-time training for learners in the efforts to improve both the internal processes of course delivery and enhance the provisions of education quality. In recognizing these trends in HEIs, the purpose of this paper is to identify the key factors that facilitate the conversion of printed learning resources to e-learning resources in a HEI.Design/methodology/approachThis study used a qualitative exploratory case study approach and examined a unique case of a HEI that is undergoing the transformation process from printed learning resources to digital sources to simplify the processes involved in educational service delivery and operational complexity. Data sources include semi-structured interviews with key personnel directly involved in the project of converting printed learning resources to digital sources, notes taken from informal discussions, and secondary data such as minutes of meetings, learning resource archives, and relevant literature. A retrospective perspective was adopted in the case analysis since the HEI has already completed 50 percent of the conversion phase when this study was carried out.FindingsAbductive reasoning approach and well-established lean principles were used to make sense of the digital transformation process of the HEI. Based on the retrospective case analysis, the authors found evidence that characterizes lean management principles and identifies the critical factors (CFs) that have facilitated the HEI to achieve the key milestones in the conversion journey. These include common vision, top management support and leadership, timely information sharing, and relationship management with key stakeholders in the transformation processes.Research limitations/implicationsSince this research is an exploratory case study, the results obtained cannot be generalized. Future research can be conducted to provide an impact analysis of the potential risk factors of a system that employs only the use of e-study materials. In addition, future studies can also assess the quality of the learning services that is supported by the e-resources by gathering student feedback on their e-learning experience that is supported by the online digital learning resources and learning management system.Practical implicationsThis study provides managerial insights into the levers to engender the transformation from a traditional print learning resources model to leaning with digital e-learning resources. The insights into the CFs aid education managers to introduce process innovations and encourage behavioral changes that will benefit learners, instructors, and administers.Originality/valueThe study is one of the first to apply lean management principles in making sense of the transformation processes involved in the use of digital innovation in higher education context. The findings provide a holistic view of the process transformations.

LEAN APPROACH OF IMPROVING MANUFACTURING EFFICIENCY AND ITS DEVELOPMENT IN LATVIA

Important role in producing goods or services of enterprises that produce products, taking into account every modern method and the latest technology in the field of quality. Among them are the logistics concept Lean Production. The principles of Lean management are familiar in the USA, Japan and other countries, but this approach is not as popular in Latvia as it is abroad. In this scientific article, the author explores Lean management and its impact on enterprises as well as its development trends in Latvia. The aim of this work is the Lean approach and its development in Latvia. To achieve the goal better, the author has used the following methods: monographic or descriptive, grouping, graphical analysis and synthesis. After the research, the author can conclude that there is no demand for Lean approach in Latvia. Only a small number of Latvian companies use the principles of Lean Management for a little more par 5%. This proves that many people do not even know what Lean management is. The author of the work will explore everything about Lean management. Will explore the benefits companies will have after implementing Lean management principles in their companies. The recent trends of the Lean approach in Latvia from 2011 to 2015.

Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P < .0001, Fisher exact test), with a marked reduction in variability. Further, the time from autopsy to presentation at weekly clinicopathological rounds was also reduced (median: 73 days prior to lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

P017: A time-driven activity-based costing method to estimate health care costs in the emergency department

Introduction: Poor physicians’ knowledge of health care costs has been identified as an important barrier to improving efficiency and reducing overuse in care delivery. Moreover, costs of tests and treatments estimated with traditional costing methods have been shown to be imprecise and unreliable. We estimated the cost of frequent care activities in the emergency department (ED) using the time-driven activity-based costing (TDABC) method. Methods: We conducted a TDABC study in the ED of the CHUL, Québec city (77000 visits/year). We estimated the cost of all potential care activities (e.g. triage) provided to adult patients with selected urgent (e.g. pulmonary sepsis) and non urgent (e.g. urinary tract infection) conditions frequently encountered in the ED. Following Lean management principles, process maps were developed by a group of ED care providers for each care activity to identify human resources, supplies and equipment involved, and to estimate the time required to complete each process. Resource unit cost (e.g. cost per minute of a nurse) and overhead rate were calculated using financial information from fiscal year 2015-16. Estimated cost of each care activity (e.g. chest X-ray) including physicians’ charges was calculated by summing overhead allocation and the cost of each process (e.g. disinfection of the X-ray machine) as obtained by multiplying the resource unit cost by the time for process completion. Results: Process maps were developed for 14 conditions and 68 ED care activities. We estimated the costs of activities (CAN$) related to nursing (e.g. urinalysis and culture triage ordering $14.70), clerk tasks (e.g. patient registration $3.40), physicians (e.g. FAST scan $20.90), laboratory testing (e.g. CBC $6.30), diagnostic imaging (e.g. abdominal CT scan $146.50), therapy (e.g. 5 mg of iv morphine $20.40), and resuscitation (rapid sequence intubation with ketamine and succinylcholine $146.40). Overall, emergency physicians’ charges, personnel salaries and overheads accounted for 38%, 22% and 16% of all ED care costs, respectively. Conclusion: Our results represent an important step toward increasing emergency physicians’ awareness on the real cost of their interventions and empowering them to adopt more cost-effective practice patterns.

Succeeding in the Shale Business With a Lean Well Manufacturing Management System

Management The current oil and gas commodity prices have posed several challenges to oil and gas companies operating in shale plays trying to generate revenue or even becoming cash neutral. Shale drilling, as opposed to conventional drilling, requires many more wells to produce similar volumes of oil or gas due to the significantly smaller wellbore drainage area and the tight nature of the reservoir. For these projects to be economically viable, a high volume of low-cost and quickly drilled and completed wells is required, which cannot be achieved with a conventional oil and gas mindset. By implementing a Lean Well Manufacturing Management System and by having a dedicated Productivity Improvement team embedded in the operations driving changes, BHP Billiton was able to reduce drilling and completion (D&amp;C) costs by 49% in the Eagle Ford Basin and 50% in the Permian Basin over an 18-month period (Fig. 1). These results are similar to those reported by other operators in similar plays that also incorporated lean management principles to their operations. A Lean Well Manufacturing Management System can be defined as a system to drill and complete a large number of wells per year in a factory-like setting using a lean manufacturing mind-set. The performance of the “factory” is measured by the ability to deliver wells at low capital costs while still performing safely, reliably, and meeting local regulatory requirements. To be successful, this model requires predictable and repeatable performance using highly dependable and fit-for-purpose equipment that is easy to operate and maintain. Value is maximized by addressing the technical specifications from the customer and optimizing the use of existing and new technology to realize the lowest achievable well cost. In turn, this translates into reduction of the unit development costs, increase in short-term production, and more efficient resource utilization. Waste can be encountered in many areas in the well delivery process, which can increase D&amp;C costs, jeopardizing the project economics. For this reason, the key objective for a lean organization is to identify areas where waste needs to be reduced and eliminated without compromising safety, quality, and performance using the resources (people), processes, and technology available.

Enhancing the performance of micro, small and medium sized cluster organisation through lean implementation

Lean management principles are developed from Toyota production system (TPS) and have been successfully applied in many sectors to reduce waste and to improve efficiency. Each business operation requires the efficient integration of people, process and technology. Presently India is one of the fastest growing economies in the world. The micro, small and medium enterprises (MSME) sector is considered as the backbone of the Indian. One of the challenge in implementing lean management principles and tools in MSMEs is that it requires the analysis of present situation and deploying suitable lean tools with involvement of everyone. In this study, different attributes like the need, levels of implementation and the results of this concept in the MSME cluster organisations in and around Chennai. The results showed that there is a significant relationship between the strategic factors to the financial performance of the organisation.

Enhancing the performance of micro, small and medium sized cluster organisation through lean implementation

Lean management principles are developed from Toyota production system (TPS) and have been successfully applied in many sectors to reduce waste and to improve efficiency. Each business operation requires the efficient integration of people, process and technology. Presently India is one of the fastest growing economies in the world. The micro, small and medium enterprises (MSME) sector is considered as the backbone of the Indian. One of the challenge in implementing lean management principles and tools in MSMEs is that it requires the analysis of present situation and deploying suitable lean tools with involvement of everyone. In this study, different attributes like the need, levels of implementation and the results of this concept in the MSME cluster organisations in and around Chennai. The results showed that there is a significant relationship between the strategic factors to the financial performance of the organisation.

P123 - LEAN Management Principles Applied to Scoliosis Surgery Have Improved Patient Safety and Increased Surgical Efficiency

P123 - LEAN Management Principles Applied to Scoliosis Surgery Have Improved Patient Safety and Increased Surgical Efficiency

Quality Improvement Intervention to Decrease Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery.

In 2010, the incidence of prolonged mechanical ventilation (> 24 hours) after isolated coronary artery bypass graft (CABG) surgery was 26.9% at the study site, The Ohio State University Wexner Medical Center, compared with the national like-hospital rate of 10.9%. To use the principles of lean management to reduce the incidence of prolonged mechanical ventilation and to assess the sustainability of that reduction over time. A multidisciplinary prolonged ventilation task force conducted a gap analysis leading to 3 interventions: (1) a standardized extubation protocol, (2) dry erase boards in patients' rooms to facilitate team communication, and (3) edits of the postoperative order set within the electronic health record. Outcomes of mechanical ventilation in CABG patients before and after the interventions are compared. All target outcomes changed significantly after the interventions, including a reduction in the median hours of initial mechanical ventilation (from 11.4 hours to 6.9 hours, P < .001). The percentage of patients reintubated did not increase (a decrease from 11.8% to 3.5% was not significant, P = .08). The rate of prolonged ventilation decreased from 29.4% to 8.6% (P = .004), and this reduction was sustained for 4 years after the interventions. Success factors included the multidisciplinary task force and continual protocol reeducation among front-line staff.