Lean Methodology Research Articles

A Review of Lean Methodology Application and Its Integration in Medical Device New Product Introduction Processes

The purpose of this study is to review the Lean tool application and its utilisation in medical device design and the new product introduction process to establish the benefits and best practices for its integration with existing new product introduction processes. A review of the literature on the current state of medical device New Product Introduction (NPI) processes is completed along with a comprehensive review of the literature on the history and development of Lean NPI. The review indicates that Lean can be combined with the predominant NPI execution tools, Stage-Gate and Concurrent Engineering within the medical device industry to achieve a best-in-class continuous improvement methodology within the NPI process. This integration eliminates waste, focusses on customer value, and ultimately reduces cost and lead time to market. This review highlights for the first time the main challenges and issues with Lean in the medical device sector NPI processes, identifying possible future strands of research. Limitations of the current review are that despite the heavy emphasis placed on Lean manufacturing processes, comparatively little emphasis is placed on the use of Lean in the medical device NPI process. Future longitudinal case studies on case study application of Lean in medical device NPI processes would be useful. This study has implications for identifying best practices for Lean in NPI in the device industry, improving what is considered state-of-the-art for the introduction of devices into the public domain.

Engaging the Front Line: A Case Study on Implementing Lean Methodology to Improve Central Line-Associated Bloodstream Infections.

Employee engagement is a key driver in achieving successful quality improvement initiatives. An important aspect of engagement is enabling the nursing staff to have a role in problem solving at the front line, thus improving productivity. Finding an appropriate methodology that resonates with the frontline staff can be challenging. This article discusses the use of the Lean Methodology to prevent central line-associated bloodstream infections in a large urban hospital. The case study provided will review an initial attempt at frontline problem solving using the Lean Methodology and a more successful strategy with the development of a nurse champion program.

Evidence-Based Approach to Decrease Incidence of Hospital-Acquired Pressure Injuries.

Hospital-acquired pressure injuries (HAPIs) are a painful and unwanted experience for the patient and cause unwanted additional costs to hospitals. Because HAPIs are a preventable occurrence, they are a nurse-sensitive indictor for national benchmarking when looking at quality and safety. Controlling the occurrence of HAPI in the hospital setting can be challenging for any nurse, but the difficulty is enhanced in the intensive care unit. This article discusses how a group of nurses from various areas of the hospital came together to heighten awareness of skin care and provided frontline education to peers. Through the use of structured programs using both a nationally known Wound Associate treatment program and Lean methodology, the nurses were able to work through processes and barriers and successfully decrease the incidence of HAPI in this academic medical center.

Air-Assisted Technology: A Quality Endeavor to Reduce Employee Injury and Hospital-Acquired Pressure Injuries.

Continuous quality improvement using Lean methodology engages and values the expertise of the staff close to the patient and the everyday work of caring for them. The patients are not safe if the staff is not safe. Finding the appropriate methodology, where the problem is deeply investigated, respect is visible in the process, and evidence-based decision-making takes place to find safe patient handling solutions for moving lifting and transferring patients was a key objective in this Lean process improvement effort. This article describes the journey taken, the collaboration of 2-unit based councils, and the successful implementation of an air-assisted moving, lifting, and transferring system at a large level 1 quaternary tertiary intercity hospital.

Incorporation of lean methodology into the delivery of clinical training of advance nurse practitioners in urgent care

This pilot study was designed to investigate the ability of incorporating lean methodology into the delivery of medical education. The project worked within the academic remits of the University College Dublin (UCD), Master’s in Advanced Practice (Nursing) program, which provided the academic rigor for the project. Practical and procedural skills were taught based on an adapted version of the RNZCUC’s core skills list (CSL) Using a combination of Kaizen Burst (rapid improvements) in teaching skill sessions and Kanban Pull (the voice of the consumer), the project incorporated both lean methods into the delivery of teaching skills and knowledge. These techniques allow for better understanding, easy retention, and accelerated learning. This allows for a better learning experience to those completing the training program feeling confident in utilizing the skills learnt to treat patients presenting to urgent care clinics appropriately The project has shown a potential method for training of Advanced Nurse Practitioners (ANPs) to an accredited standard in urgent care with the use of lean methods in the delivery of skills and knowledge training. The ability for institutions to upskill and train the workforce would provide added benefits for workforce recruitment, development, and retention.

Lean Service Operations and A Lean Management Application at a Foundation University

Lean service operations and lean management are of vital importance for all service providers as much as manufacturers. Unfortunately, most universities need to be made aware of the concept of lean. However, they can benefit from lean management in all their service areas, such as admissions, administration of research funds, hiring, and nearly any functional area where multi-step processes can be simplified and focused on the needs of the users served by the organization. Lean methodologies focus on reducing waste (Muda in Japanese), removing overburden (Muri in Japanese), and unnecessary variation (Mura in Japanese). Non-value-added activities are eliminated or dealt with to develop the performance of the process. This study aims to highlight the suitability of lean in a university environment to enhance the efficiency of the operational tasks performed and provide suggestions for better performance. Lean methodologies were applied to the School of Graduate Studies at a Turkish university to study the current state of the process and provide recommendations and alternatives for the current issues faced using Value Stream Mapping (VSM). As a result, Value-Added and Non-Value-Added activities were identified with Indicative Ratios to compare the performance before and after applying lean. In the end, seven questions were answered to develop a proposal for the future state of the process, which was presented to the university management.

Integration of Lean Methodology and Energy Management in Wooden Industry

The application of Lean thinking to energy management is the methodology based on the application of the Lean values and the principles of wastes elimination of Lean system. One is then challenging and questioning why a process is using the amount of energy that it does and why it is using energy during non-production hours. One strives to continuously improve and reduce the energy used by implementing improvement ideas. Todays, the pressure of competition in the energy sector is very high. A enterprise that wants to make a difference should continuously run optimization from the production lines. The objective of this study is to measure the impact of Lean tools on energy consumption and energy efficiency improvement. Through a case study, authors point out changes in production and energy efficiency before and after implementing improvement (Kaizen) projects. Besides, this paper illustrate the framework of Lean tools application into energy sector as a guideline for energy efficiency management in industrial enterprises

One Medicalogy Pre-Launching Strategy of New Maternity Belts with Anti-Radiation Feature Using Lean Startup Methodology

This paper will discuss pre-launch strategy taken by One Medicalogy, a startup company specializing in maternity apparels. The strategy will follow lean startup methodology that will guide One Medicalogy to start, build, develop, conduct and maintain its business in the field of anti-radiation maternity belts. A maternity belt is a belt or a corset used to support the lower portion of the belly and back of pregnant women. An anti-radiation maternity belt is a modified maternity belt by embedding an additional anti-radiation layer on the inside part of the belt. The extra layer will protect the fetus growing in the belly of the mother from harmful non-ionizing RF-EMF radiation. The source of the radiation is usually electronic devices and gadgets such as personal computers or laptops as well as smartphones. One Medicalogy is committed to design, develop, produce and introduce the belts to the market. Pre-launch strategy will be employed in introducing the belt to the market. This strategy includes conducting market tests by testing the product with potential customers and performing rigorous efforts with them to ensure communication during product design and development by first determining the target market, ensuring that product features line up perfectly with customer needs. A lean startup methodology will also be used to assist One Medicalogy in introducing the belts quickly and successfully to market. In essence, lean startup methodology is a method that focus business efforts in speedy creation of product prototypes by first conducting and testing target market analysis. Feedbacks resulted from prototype try-outs and interviews involving potential customers will be employed quickly to create finished products. In addition, these feedbacks will also reveal the strength of the newly created products against that of the competitors. Using this method, One Medicalogy can reduce the risk of bad product performance.

One Medicalogy Pre-Launching Strategy of New Maternity Belts with Anti-Radiation Feature Using Lean Startup Methodology

One Medicalogy Pre-Launching Strategy of New Maternity Belts with Anti-Radiation Feature Using Lean Startup Methodology

Do we Practice What we Preach? Applying Startup Practice to Entrepreneurship Education

Definitions of the term “entrepreneurship education” vary from the process of passing the necessary skills and concepts to individuals to identifying new business opportunities and to reach high levels of self-confidence to benefit from such opportunities. Some scholars refer to entrepreneurship education as more of skill building and leadership programs, focused on new product development, creative thinking and technology innovation. This study set out to examine the entrepreneurship faculty perspective on applying venture creation methods to entrepreneurship courses. Through interviews with 15 entrepreneurship faculty in two entrepreneurship programs, in Israel and the United States, it examines their professional and academic backgrounds, thought processes and best practices for teaching entrepreneurship. Building on the Lean Startup Methodology, it mostly looks at the extent that lean startup guidelines such as iterations, customer feedback and product development are applied to their teaching methods and curriculum. The study found that many of these guidelines were applied by the professors, especially among those with an industry oriented professional background.

Quality Improvement: Implementing Nurse Standard Work in Emergency Department Fast-Track Area to Reduce Patient Length of Stay

IntroductionThe average length of stay of a fast-track area of a large urban hospital was excessively long, which affected the patient experience and the rate at which patients left without being seen. One approach to reducing average length of stay is to create nurse standard work. Nurse standard work was a defined set of process and procedures that reduce variability within a nurse’s workflow. MethodsNurse standard work was created by a team of nurses assisted by management engineering using lean methodology and A3 problem solving. Data were gathered about average length of stay and left without being seen for patients in the emergency department fast-track area of an urban emergency department from October 2018 to June 2020. This period includes 5 months before the intervention start, 4 months during nurse standard work implementation, 9 months using nurse standard work before the unit was repurposed during COVID-19, and 3 months during COVID-19. ResultsNurse standard work helped reduce average length of stay in the emergency department fast-track area from 205 minutes before project initiation to 150.4 minutes in the 7 months after implementing nurse standard work. The time spent walking for supplies was reduced from 422 and 272 seconds before nurse standard work to 25 and 30 seconds for the nurse technician and nurse, respectively, after nurse standard work. Left without being seen was decreased from 4.7% in October of 2018 to 0.7% by March of 2020. DiscussionNurse standard work reduced the amount of time that nurses spent performing support tasks and reduced delays in providing patient care, which then allowed more time for nurses to interact directly with patients. Nurse standard work provides a clear task sequence that eliminates delays in treating patients, but it also allows for fast identification of delays that do occur and simplifies problem solving to eliminate reoccurrence of delays. Therefore, nurse standard work is an essential component of efforts to reduce patient average length of stay in health care processes and reduce left without being seen to the national standard of less than 2%.

Combining Lean Methodology with Functional Resonance Analysis Method to Understand Blood Product Administration

Blood productadministrationis a safety critical, complex dynamic sociotechnicalprocess. This study aimsto combinelean analysis with Functional ResonanceAnalysis Method to understand blood product administration at a large pediatric health system. We identified a number of resonance phenomenon and variabilitywithin functionsthat can lead to waste in the process.The results from the study can help with process simplification and developing interventions to reduce safety risks associated with transfusion.

The role of age and business coaching in the relationship of lean startup approach and innovative work behavior of women entrepreneurs during COVID-19.

The purpose of the startup approach is to find an appropriate course of action that adds value to the economy’s development. This study is aimed to determine the effect of the lean startup approach with mediating effect of business coaching to foster innovative work behavior in women entrepreneurs. Additionally, the study also examines the moderating effect of age on the lean startup approach and innovative work behavior. A quantitative approach was employed. The findings show that the relationship between the lean startup approach and innovative work behavior is significant. Moreover, the findings also revealed a significant mediating effect of business coaching and moderating effect of age. This research encourages practitioners and scholars to deal with women entrepreneurship incubation initiatives in the lean startup methodology. Furthermore, this study also leads to a deeper understanding of women’s ideas for business exploration, growth, and implementation. The study contends that guidelines and directives are critical for creative entrepreneurial behavior.

From Old to New: Process of Integrating PACU Phase 1 Documentation and Workflow from Old Electronic Health Record (EHR) System to New Electronic Health Record (EHR) System

<h3>Background Information</h3> In 2019, a new Electronic Health Record (EHR) was implemented to standardize and streamline access of patient health records across the health care system. Meaningful use of EHR provides benefits such as safety, quality, and efficiency in patient-care delivery. The adoption of the new EHR system has created significant disruption in the complex workflow of busy units, as well as frustration to users specifically in the usability functions of the new EHR system. This project will outline strategies and processes to ensure that resources are equipped to handle its complexity by employing methods to assist user for seamless transition from an old EHR system to new EHR system in phase 1 PACU. <h3>Objectives of Project</h3> •Identify and create a framework of key elements to bridge the gap in nursing documentation •Provide educational tools focusing on the change in workflow and documentation of clinical pathways •Create an audit tool to address nursing documentation compliance <h3>Process of Implementation</h3> Identified super users to serve as unit resources. Staff training included mandatory learning modules, post-tests, and unlimited practice simulations. All PACU workflow and clinical pathways were reviewed and revised to ensure the necessary "must haves" were included in the new platform. Created tip sheets of new workflow processes. An audit tool was created to address nursing compliance issues and cover key elements of workflow and documentation of clinical pathways. Leveraged use of lean methodology through daily huddle discussion of issues and generating ideas. <h3>Statement of Successful Practice</h3> The goals of the EHR implementation were achieved by familiarizing users with the new system through education, hands-on training, and constant follow through via lean methodology. Success was measured by rate of resolution of issues which achieved 100% by February 2020. Completion rate of RN documentation audits exceeded the set goal by 12.4%. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> Providing the appropriate education and hands-on training served as of great value for successful implementation. The tip sheets created by the team improved effectiveness of user workflow and was spread to several PACU facilities within the healthcare system & vendor for their education and training.

The Appropriateness of Design Cognition for Entrepreneurship Education of Engineering Students

The study argues that the needs of engineering students for managerial education are distinct and evolving over time towards entrepreneurial mindset due to new industrial and technological trends. Consequently, managerial education of engineering students is shifting towards Science and technology entrepreneurship education (STEE). Moreover, considering the relevance of design cognition in entrepreneurship and engineering, it is argued that STEE can tackle the challenge more effectively by incorporating design cognition in the education process. Propositions are derived from research literature, and a teaching model approach is proposed that elaborated on the incorporation of cognitive acts of design in various aspects at ontological, didactical, and contextual levels in STEE. The proposed framework views education as a process of co-construction, centered on students where the role of teacher is like a coach. Students work in teams and practice the cognitive acts of design that lead to the development of interpersonal, entrepreneurial, and managerial skills. For this purpose, open-ended questioning, real life case studies, problem and project based learning, and lean methodology are proposed as effective content and pedagogies to promote the entrepreneurial behaviors required in the current industrial scenario.

Incentivizing Start-Ups and Start-Up Ecosystems in European Project Funds – the Case of Grant “Performance and Excellence in the Field of Environment and Renewable Energy through Modern Cluster Entities”

Capital providers, such as shareholders on capital markets or European funding providers, are interested in the net present value of discounted cash flow and the risks or opportunities that may contribute to financial planning in a negative or positive way. In an uncertain environment however, the lean start-up movement means venture capital is used to finance business models. The lean start-up complements the business plan via discovery driven planning. These are holistic approaches to uncertainty management in all business aspects, with a designated methodology. This methodology will be the scholarly literature review in this article, whose goal is to elaborate the reference lean start-up methodologies and their relevance in empirical data analysis, European project funding calls. European projects demand uncertainty management. The article purposes to make European funds easy to understand as their requirements are explained and the most suitable scientific solution is sought. The methodology is a descriptive case study, with instrumental value. Findings are that funding authorities, be they capital markets or public funds, benefit highly in their decisions by lean start-up techniques. The research concerns the suitability of start-up ecosystems with European funds, and the conclusion is a high interest from the latter to the former.

Implementation of green, lean and six sigma operations for sustainable manufacturing. A review

With ever increasing environmental concerns and global warming, green manufacturing has gained momentum to make the manufacturing processes sustainable and efficient. This review aims to analyse the models to integrate three different management systems that are green, six sigma and lean for the sustainability of various manufacturing processes. Research gaps for such integration are identified through a literature review of various studies. The importance of the concepts of eco-friendly and sustainability in business operations and practices is growing rapidly as a result of public pressure, government regulations and social responsibilities. The first step is the identification of sustainability assessment for the current industrial processes and then to make them eco-friendly and more efficient through different green, six sigma and lean tools available. The methodology presented in this review will not only help in sustainability but also is helpful in the integration of various models for the improvement of the processes. Green Lean Six Sigma (GLS) is an approach known to minimize emissions and carbon footprints while improving process efficiency. GLS includes green, six sigma and lean methodologies for high performance, sustainability, social development, economic progress and environmental protection. The successful integration of this GLS approach is dependent on different theoretical indicators and the model is developed based on DMAIC. Various tools, enablers and integration methods are employed for the GLS approach.

Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review

Despite the increasing utilization of lean practices and digital technologies (DTs) related to Industry 4.0, the impact of such dual interventions on healthcare services remains unclear. This study aims to assess the effects of those interventions and provide a comprehensive understanding of their dynamics in healthcare settings. The methodology comprised a systematic review following the PRISMA guidelines, searching for lean interventions supported by DTs. Previous studies reporting outcomes related to patient health, patient flow, quality of care, and efficiency were included. Results show that most of the improvement interventions relied on lean methodology followed by lean combined with Six Sigma. The main supporting technologies were simulation and automation, while emergency departments and laboratories were the main settings. Most interventions focus on patient flow outcomes, reporting positive effects on outcomes related to access to service and utilization of services, including reductions in turnaround time, length of stay, waiting time, and turnover time. Notably, we found scarce outcomes regarding patient health, staff wellbeing, resource use, and savings. This paper, the first to investigate the dual intervention of DTs with lean or lean–Six Sigma in healthcare, summarizes the technical and organizational challenges associated with similar interventions, encourages further research, and promotes practical applications.

Process Improvement Approach to Transform Online Business Education in the Post-COVID World

In early 2020, the World Health Organization declared COVID-19 a global emergency. This pandemic has affected higher education, especially the world of business education and professional programmes, beyond imagination. This study/project examines an innovative teaching and learning approach, Lean methodology, and its application to business education. Although Lean Thinking originated in the automobile industry several years ago, research on its application and sustainability at academic institutions, especially in the teaching and learning process, has been extremely limited. Recent research demonstrates that this approach has been successfully implemented in healthcare and health sciences education. This project takes a step forward and identifies how a similar approach can be applied to business education in post-pandemic education. The project concludes with practical tips that higher education institutions can use as planning for post-pandemic begins.

Streamlining Service Delivery of Final Duties and Taxes in a Private Banking Corporation

This paper discusses the actions taken regarding the slow delivery of final duties and taxes in a private banking corporation. The objectives were to eliminate customer complaints and close all the pending transactions to gain customer satisfaction and increase the percentage of clients and transactions served. After observations, a series of interviews, data collection and documentation, and collaboration efforts with the team members involved, the issue was constructed. Various tools were used in planning, constructing, implementing, and evaluating the streamlined process improvement. Process mapping and lean thinking methodology were applied to know which activity should be eliminated. A workflow instruction was formulated, which improved the cycle time. Time and motion analyses were crafted during the implementation to verify each transaction. Pending transactions, follow-ups, and complaints were compared before and after implementation to confirm if the streamlined process improved the service delivery. It was observed that some of the team members were hesitant to change at first, but by using convincing words and data during the team meeting, all members were convinced that streamlining service delivery is a need. After a month of implementation, the record showed that the streamlined process eliminated complaints, reduced follow-up concerns through telephone calls from clients, and decreased pending transactions by 50%. Through this, relevance of data to support a particular idea is further realized. Furthermore, it was also observed that the streamlined process improvement saved the company time, energy, and even costs. It ensures the fast delivery of products or services, resulting in customer satisfaction.