Lean Management Research Articles

Integrating Lean Management and Circular Economy for Sustainable Dentistry

The increasing focus on environmental sustainability has prompted the healthcare sector, including dentistry, to reconsider waste management practices. Dental offices generate various waste streams from outdated technologies, including single-use plastics, hazardous materials, and digital waste. This scoping review explores how integrating circular economy principles with lean management practices can enhance sustainability and operational efficiency in dental clinics. Using the PRISMA methodology, the review identifies 30 articles that passed the Cochrane Risk of Bias Tool and the Critical Appraisal Skills Program (CASP) checklist from 2000. Circular economy principles focus on reducing waste and maximizing resource reuse, while lean management seeks to improve efficiency and minimize process waste. Together, these approaches can significantly reduce resource consumption and enhance recycling efforts in dental practices. Despite barriers such as high technology costs, regulatory constraints, and limited recycling infrastructure, case studies highlight successful implementation in healthcare settings, demonstrating improved environmental and operational outcomes. Collaboration between dental professionals, policymakers, and industry leaders is essential for promoting the adoption of these sustainable practices.

Addressing Lean and Safety Readiness Assessment in Territorial Ambulatory Healthcare

Within the international healthcare landscape, it is incumbent upon all organisations to proactively address individual patient needs by offering a wide range of services. In this context, Territorial Ambulatory Healthcare (TAH) is critical to promote equal access to care as the primary point of contact between National Healthcare Systems and individuals. To achieve this goal, the adoption of Lean and Safety Management (L&SM), a managerial approach to proactively reduce clinical risk and process inefficiencies, can support organisations in pursuing high quality care objectives. Despite the positive benefits associated with the adoption of this approach, the feasibility of guaranteeing a sustainable care quality over time may encounter several challenges. Among these, key contributors to failure include the lack of tailored tools and practices suitable for the healthcare environment, insufficient readiness of the context for implementation, and the absence of a comprehensive system-wide performance strategy. Recent studies in literature address these issues presenting theoretical and practical models to assess readiness levels, highlighting opportunities for future developments of these topics. The current empirical study contributes to the existing knowledge by creating a framework to assess the level of readiness for L&SM implementations within TAH. While this context is essential for ensuring high-quality care and equitable access to care services, successfully implementing L&SM initiatives within TAH is challenging due to the organizational complexity and the involvement of multiple, fragmented stakeholders and care providers. Addressing weak Critical Readiness Factors (CRFs) before starting a project can significantly contribute to successfully implement L&SM and sustain improvement over time. This study will be conducted within the TAH setting of a healthcare organisation in Northern Italy and aims 1) to evaluate the specific care setting readiness for L&SM implementations and 2) to develop practical guidelines to support the organisation in increasing its actual readiness level. The theoretical framework will be grasped integrating prior research on Lean readiness assessment, along with specific literature on L&SM sustainability implementation factors within TAH. Once refined and tested with the purpose of developing a practical assessment tool, the framework will be applied within the selected setting, leading to the identification of practical guidelines to facilitate project success and improvements sustainability. Overall, this research will contribute to enrich the knowledge about L&SM implementation within TAH, supporting health organisations, managers, and clinical leadership to sustainably improve care quality, enhancing the role of territorial care to foster social well-being.

CMMI & Lean-Based Metrics Governance Model to Ensure Data Accuracy & Consistency for Ai/Ml Applications for Sustainable Operations in Mining Industry

In today’s competitive business environment, even small improvements in productivity and efficiency can have a huge impact on company’s profitability. Whether it is through reduced lead time/waste, minimized downtime or improved quality, operation managers are looking for any advantage at every stage. Lean management is a long-term operational discipline that methodically seeks to enhance efficiency and quality by eliminating wastage. The concept is being used in varied industries and helped by improved productivity, safety & better management. Lean in being used by few mining companies also at a small scale, which has helped them in limited way. AI/ML is another important technology used by many organizations. Many global mining companies have also used it for improving operational efficiency, which have helped miners in a limited ways in improving the productivity and safety. Mining companies have to deal with tons of data set generated from heavy machinery and plants, which have to be stored, processed, and stored. There are many challenges in the data set generated/used by AI/ML-application for mining operations. One of the key challenges in AI/ML is accessibility and availability of accurate & consistent data. To ensure consistency of data there is a need for a governance structure which will guarantee the availability of required accurate data set for AI/ML system. One possible solution could be, CMMI’s metrics processes used by IT companies and have helped in improving quality. CMMI’s Metrics related processes are being used extensively by the organizations for better monitoring & control of key measures. This paper explores the possibility of usage of CMMI’s metrics practices with lean implementation in mining for ensuring availability of accurate data sets for AI/ML applications. The proposed framework will put a governance model in place to ensure accuracy & consistency of data to be used for AI/ML-applications in Mining.

Enhancing Patient Procedures through Process Improvement: A Systematic Review of Patient-Centered Care Approaches

Patient-centered care is increasingly recognized as a fundamental component of high-quality healthcare, emphasizing the need for healthcare systems to optimize patient procedures. This systematic review explores the role of process improvement methodologies in enhancing patient procedures while aligning with patient-centered care approaches. A comprehensive search of studies published between 2016 and 2023 was conducted across multiple databases, focusing on healthcare interventions using Lean, Six Sigma, and Total Quality Management methodologies. The findings demonstrate that process improvement techniques significantly reduce waiting times, procedural errors, and inefficiencies, ultimately improving patient satisfaction and safety. Moreover, integrating patient-centered care approaches ensures that patients’ needs, preferences, and values are central to healthcare decision-making, further enhancing procedural effectiveness. However, challenges such as resistance to change and resource limitations were noted. This review underscores the importance of combining process optimization with patient-centered care to achieve sustainable improvements in patient outcomes and procedural efficiency. Future research should focus on the long-term impact of these methodologies and the role of technology in further advancing patient-centered approaches.

'Development and Psychometric Testing of the Lean Management Scale for Nursing Services in Hospitals'.

The aim of this study is to develop a new instrument (The Lean Management Scale for Nursing Services in Hospitals- LMS-N) to evaluate the lean levels of nursing services in hospitals and to evaluate its psychometric properties. A three-phase construct was used to develop this scale and to determine its psychometric properties: (1) creating the item pool, (2) preliminarily evaluating items and (3) evaluating psychometric properties. This methodological study evaluated the scale's face, content and construct validities, internal consistency, and temporal stability. The psychometric properties of the scale were tested with a total of 695 nurses in different sample groups. Data were collected between 18 November 2020 and 15 May 2021. The scale's content validity index was 0.75. According to principal component analysis, the scale included 22 items and five subdimensions, and the total variance was 60.32%. In confirmatory factor analysis, the fit indices were good or acceptable for this construct. Its internal consistency was good or acceptable according to reliability analysis. Test-retest showed that the scale had temporal stability. Lean Management Scale in Nursing Services in Hospitals is a valid and reliable tool that can evaluate the level of leanness of nursing services. It provides a comprehensive evaluation with five subdimensions: management support, visual stock management, work environment layout, preventive notification system and waste detection.

Data model to enable multidimensional process mining for data farming based value stream planning in production networks

AbstractInternational industrial companies operate complex value streams within production networks. Therefore, strategic network design aims to identify an efficient value stream from several value stream scenarios. For this purpose, Value Stream Mapping (VSM) is a well-established methodology from Lean Management. However, the complexity and variety of value streams in production networks can lead to high manual effort when using pen-and-paper-based VSM. Therefore, data-driven VSM based on process mining has to be applied. To create a comprehensive data-driven VSM, it is necessary to transparently understand the correlations between different dimensions, such as the material flow, the information flow, and the inventory, which requires a multidimensional process mining approach. Simulation experiments can generate the necessary data for each value stream scenario using a data farming based planning approach to conduct a data-driven VSM in strategic network design. However, no data model currently supports storing comprehensive datasets for multiple scenarios to enable multidimensional process mining. To overcome this shortcoming, this article presents a data model for applying multidimensional process mining that is scalable to multiple dimensions and scenarios. The data model is constructed based on the theoretical principles of data cubes and multidimensional process mining. The applicability is demonstrated by a case study of a production network from the automotive industry.

A novel integrated material flow cost accounting (MFCA)- IoT-lean management system approach to improving water use efficiency and reducing costs in the beverage industry

The purpose of this study is to present a novel approach of integrating Material Flow Cost Accounting (MFCA), Internet of Things (IoT) and lean management systems to improve water use efficiency and reduce costs in the beverage industry. The positive and negative product costs of water purification, syrup manufacture, concentrate mixing, and packing were analyzed. The MFCA analysis showed 78.5% positive and 21.5% negative product costs. The use of the Power BI application to display real-time positive and negative costs in each process, scenario modeling and simulation was able to promote water savings and cost reductions, as well as supporting factory team ideation for choosing one of three improvement plans: 1) RO flushing water recovery in water purification; 2) water conservation with automated pH correction at packaging warmer; or 3) wastewater treatment and reuse of the rejected RO brine. According to our two-scenario water conservation testing, an automation process could improve pH adjustment in the packaging process, while MFCA, IoT, and lean management systems could be applied to improve industrial water use efficiency, demonstrating the potential for sustainable water use. The beverage-industry case in the present study validated this approach, resulting in a 24.1% production rate increase and a 4.5% cost reduction of 71,010 THB savings per year.

Patient-centered lean healthcare management from a humanistic perspective

BackgroundHealthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients’ emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model.MethodsThe study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach.ResultsEight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare’s focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture.ConclusionsThis research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries.

Lean Logistics, Lean Supply Chain, And Lean Supply Chain Management For Sustainability: WOS (1987-2024)

Lean Logistics, Lean Supply Chain, And Lean Supply Chain Management For Sustainability: WOS (1987-2024)

Lean logistics and corporate green practices: messianic methodologies for achieving business excellence in the logistics industry via green stakeholder satisfaction

PurposeThis study aims to explore how logistics firms exploit lean logistics and corporate green practices as significant catalysts for achieving business excellence via the mediation roles of green internal stakeholder satisfaction and green external stakeholder satisfaction.Design/methodology/approachQuestionnaire is used in garnering data from 137 Ghanaian logistics firms. Structural equation modeling, particularly partial least squares, was applied to test all hypotheses.FindingsThe results confirm the notion that although lean logistics has positive effect on business performance, the effect is insignificant; hence, it is the concurrent implementation of lean logistics and corporate green practices that leads to superior business performance. The mediation analysis further confirms that both green internal stakeholder satisfaction and green external stakeholder satisfaction are significant precursors through which logistics firms can achieve superior business performance when lean logistics and corporate green practices can influence business performance.Research limitations/implicationsData is collected from logistics firms from a single country. Hence, the results obtained cannot be imported to reflect the general occurrence in other geographical settings.Practical implicationsThis study informs managers of logistics firms that lean and green strategies are compatible when implemented together; hence, it should not be treated in isolation. Managers are further enlightened that in their pursuit of business excellence, there is a need to prioritize green internal stakeholder satisfaction and green external stakeholder satisfaction via prudent investment in lean and green practices.Originality/valueThe research model proposed in this study magnifies the literature on lean and environmental management via bridging the literature gap concerning the interrelationship between lean logistics, corporate green practices, green internal stakeholder satisfaction, green external stakeholder satisfaction and business performance.

Kaizen as a Form of Lean Management to Improve Human Performance in the Organization

This research aims to identify one of the important improvement approaches currently in the business world, namely Kaizen, which has achieved the enhancement of the quality of the organization's outputs and the achievement of the success it aspires to, which has been reflected in achieving profit and excellence, and effectively in improving the performance of human resources in particular, as we will learn about the mechanism of this, by reviewing the most important aspects related to the concept of the Kaizen approach, passing through to give a general picture of its impact on human resources performance, and reaching to shed light on the Japanese experience in managing human resources using the Kaizen approach. The study concluded that it is necessary to follow the Japanese experience in managing human resources, given its effective role in improving performance and keeping pace with the contemporary changes and challenges witnessed by the business environment.

Operational Excellence: Process optimization for competitive edge

This study explores the concept of operational excellence and the role of process optimization in gaining a competitive edge for organizations. Operational excellence involves the continuous improvement of business processes to increase efficiency, reduce waste, enhance quality, and improve overall performance. The study reviews established methodologies such as Lean, Six Sigma, and Total Quality Management (TQM) that provide structured approaches to achieving operational efficiency. It also examines the impact of emerging technologies, including artificial intelligence (AI), machine learning (ML), and the Internet of Things (IoT), in driving data-driven decision-making and enhancing process optimization. Additionally, the study highlights the importance of leadership in fostering a culture of continuous improvement and collaboration across departments, ensuring alignment with strategic objectives. The integration of sustainability into operational strategies is discussed as a means to not only improve efficiency but also meet corporate social responsibility goals. The relationship between process optimization and innovation is also explored, showing how operational excellence can free up resources for research and development (R&D) and foster a culture of innovation. Despite the focus on these established practices and technologies, the study acknowledges limitations, particularly the challenges faced by small and medium-sized enterprises (SMEs) and service oriented sectors in implementing these strategies. The study concludes that operational excellence, supported by technological advancements and a strong organizational culture, is essential for organizations to navigate competitive markets, improve customer satisfaction, and achieve long-term success. This research offers valuable insights for businesses aiming to enhance operational performance and sustain their competitive advantage through continuous process optimization and innovation.

A Decision Support Model for Lean Supply Chain Management in City Multifloor Manufacturing Clusters

City manufacturing has once again become one of the priority areas for the sustainable development of smart cities thanks to the use of a wide range of green technologies and, first of all, additive technologies. Shortening the supply chain between producers and consumers has significant effects on economic, social, and environmental dimensions. Zoning of city multifloor manufacturing (CMFM) in areas with a compact population in large cities in the form of clusters with their own city logistics nodes (CLNs) creates favorable conditions for promptly meeting the needs of citizens for goods of everyday demand and for passenger and freight transportation. City multifloor manufacturing clusters (CMFMCs) have been already studied quite a lot for their possible uses; nevertheless, an identified research gap is related to supply chain design efficiency concerning urban CMFMCs. Thus, the main objective of this study was to explore the possibilities of lean supply chain management (LSCM) as the integrated application of lean manufacturing (LM) approaches and I4.0 technologies for customer-centric value stream management based on eliminating all types of waste, reducing the use of natural and energy resources, and continuous improvement of processes related to logistics activities. This paper presents a decision support model for LSCM in CMFMCs, which is a mathematical deterministic model. This model justifies the minimization of the number of road transport transfers within the urban area and the amount of stock that is stored in CMFMC buildings and in CLNs, and also regulating supplier lead time. The model was verified and validated using appropriately selected test data based on the case study, which was designed as a typical CMFM manufacturing system with various parameters of CMFMCs and urban freight transport frameworks. The feasibility of using the proposed model for value stream mapping (VSM) and managing logistics processes and inventories in clusters is discussed. The findings can help decisionmakers and researchers improve the planning and management of logistics processes and inventory in clusters, even in the face of unexpected disruptions.

Facilitators, Barriers, and Potential Impacts of Implementation of e-Pharmacy in India and its Potential Impact on Cost, Quality, and Access to Medicines: Scoping Review.

e-Pharmacy can potentially solve problems related to the quality of services and products, cost, and access to medicines in low- and middle-income countries. This review aims to understand the facilitators and barriers to the implementation of e-pharmacy in India. This scoping review aimed (1) to understand the facilitators and barriers to the use of e-pharmacy in India and (2) to estimate the potential for e-pharmacy in India for improving access to medication, improving the quality of services and medicines, and decreasing costs of medications. All published and gray literature from July 1, 2011, to June 30, 2021, relating to e-pharmacy, was searched from MEDLINE, Scopus, ProQuest, and Google using a systematic search strategy. In total, 1464 titles and abstracts were screened, of which 47 full-texts were included in the review. e-Pharmacy can potentially improve access to medications for remote areas, and old and debilitated individuals. e-Pharmacies can enable lean supply chain management, lower cost, and allow easy tracking of dispensed medicines. There is potential for integration of e-pharmacy services into the national program of Bhartiya Jan Aushadhi Pariyojana. However, the country is not adequately regulated to prevent the growth of illicit e-pharmacies. Lack of global accreditation and internet coverage, digital literacy, and transnational access are other challenges. E-pharmacy has the potential to improve universal health coverage in India by improving access to medicines and lowering the overall cost of health care. However, future growth will need specific regulations and accreditation mechanisms. Open Science Forum; https://doi.org/10.17605/OSF.IO/6R9YQ.

<b>Accelerating Firm’s Operational Performance through GSCM Practices and Lean Management: A Case of the Textile Sector of Karachi</b>

Sustainable performance remains a debate among the business community however, achieving it remains a challenge. Globally, firms have incorporated different initiatives to gain efficiency and effectiveness, but developing nations are still in transit. Operationalization of green initiatives to gain operational performance was rare in Asian literature and practice. Therefore, this study was conducted to examine the role of green supply chain management practices that impact a firm’s operational performance and the mediating role of lean management in the textile sector of Karachi. A quantitative method was used in this research study and data were collected from 184 respondents from the textile sector of Karachi through a convenience sampling technique. The data were analyzed by partial least structural equation modeling (PLS-SEM) through Smart PLS 3.0. The results indicated that lean management significantly mediates the relationship between green manufacturing, green procurement, and operational performance. Whereas eco-design without lean management does not positively affects operational performance. This study recommends local companies adopt green practices religiously to compete internationally and to educate workers and suppliers about the importance of using these practices.

The Impact of Lean Inventory Management on Small Pharmaceutical Companies

"Inventory lean management" is a key strategy for cost savings and quick market response in fast-moving consumer goods industries such as food, retail, and beauty. Recently, the pharmaceutical industry, with its stringent requirements on product shelf life, supply efficiency, and storage methods, has also begun to focus more on effective inventory management. For SMEs, poor inventory management can lead to lost sales and customers, as shoppers will turn to other pharmacies when they cannot find the desired products.

The Impact of Lean Management Implementation on Inpatient Discharge Prescription Services at Pertamina Central Hospital

Background: The lead time of inpatient discharge prescription services affects the overall discharge process. In 2022, lead times at Pertamina Central Hospital's Inpatient Pharmacy varied, requiring continuous efforts to meet target times and avoid disrupting discharge plans. This research aims to evaluate the impact of lean management on reducing these lead times. Methods: The study employs a combined quantitative and qualitative research design with an action research approach. It was conducted from March 4 to May 8, 2023, involving pharmacists, pharmaceutical technical personnel, compounders, and pharmacy couriers. Data analysis included measuring lead time changes pre- and post-lean management implementation and narrative analysis of qualitative findings. Results: After implementing lean management, the lead time for non-compounded prescriptions decreased from 42.6 to 25 minutes, with value added ratio (VAR) increasing from 18.9% to 27%. For compounded prescriptions, lead time dropped from 67 to 45.7 minutes, and VAR rose from 25.2% to 37.9%. The Mann-Whitney U test confirmed the significant difference in average lead time. Conclusion: The implementation of lean management in inpatient discharge prescription services has been proven to improve lead time and increase process efficiency (VAR).

Lean Management’s Effect on Industry 4.0 Regarding Innovation

Lean Management’s Effect on Industry 4.0 Regarding Innovation

Discussion on the Shortcomings and Countermeasures of Lean Management in Manufacturing Industry in the Industry 4.0 Era

Discussion on the Shortcomings and Countermeasures of Lean Management in Manufacturing Industry in the Industry 4.0 Era

Use of information technologies in lean management: the case of Gazi University Research Center in Turkey

Purpose Sustainability and accessibility of education are the main purposes of educational institutions. Higher education institutions (HEIs) have been addressing these concerns through their distance education departments for years. Especially during and after the COVID-19 pandemic, HEIs encountered challenges related to productivity, escalating costs and decreasing user satisfaction with distance education. This study proposes the integration of new and suitable information technologies (ITs) into the steps of lean management (LM) implementation. It suggests that this approach will be highly effective and beneficial, providing solutions to the problems above in higher education (HE) field. The study aims to highlight the effectiveness and benefits of incorporating new and suitable ITs into the application stages of LM principles. Sample applications in HE will be provided to enhance understanding. Design/methodology/approach A model is introduced for researching new ITs and incorporating appropriate ones in the application steps of LM. This model has been applied and analyzed in two case studies at Gazi University for a more comprehensive understanding. Findings When examining periodic surveys and usage statistics from case studies, it becomes evident that implementing LM with the support of ITs reduces waste and enhances the quality of existing work. The success observed in the case studies was notably influenced by managers’ proficiency in business processes, experience in ITs, managerial skills and support from senior management. Practical implications This case study provides a roadmap and step-by-step implementation of LM with IT support for HEIs. The implementation process and results will also be guiding for other sectors. Originality/value There is a notable absence of significant studies on integrating ITs, which have become crucial in today’s context in the stages of LM implementation. This study is envisioned as a pioneering endeavor to address this gap in the literature. Notably, challenges exist in applying LM principles outside production sectors, and limited research has been conducted. This study aims to pave the way for further research in diverse fields by conducting a comprehensive case study in the realm of HE.