Lean Six Sigma Methodology Research Articles

Applying Lean Six Sigma in the Wood Furniture Industry: A Case Study in a Small Company

Lean Six Sigma (LSS) is a methodology that integrates two strategies used for continuous improvement by organizations: lean manufacturing and Six Sigma. LSS helps to optimize processes by focusing on reducing waste and defects and improving quality. This paper presents a study on the implementation of LSS in a small furniture company. A company diagnosis was done to identify manufacturing process problems and opportunities for improvement. Also, a Six Sigma design, measure, analyze, improve, control (DMAIC) approach was used to quantify opportunities, show evidence for improvement, and show potential benefits to be gained. Results show that with the application of LSS there is potential for the firm to reduce defects by 25 percent, reduce waste by 13 percent, and increase sales productivity by approximately 14 percent in the first year. These findings suggest that LSS strategy implementation could be useful for small wood furniture companies. The key challenges to applying LSS methodology in the case firm were associated with a poor quality management system, lack of formality, lack of procedures, and quality records. We propose a training program emphasizing theoretical knowledge for managers and employees as the first step to implementing LSS.

Developing a performance indicators lean-sigma framework for measuring aviation system's safety performance

Abstract: The paper introduces a conceptual framework that could improve aviation safety performance and the safety performance measurement process. The framework provides guidance on how organisations could design, implement and use a proactive, performance-based measurement tool for assessing and measuring Acceptable Levels of Safety (ALoS) performance at sigma (σ) level, a statistical measurement unit. Nevertheless, the framework provides a holistic view on how organisations could set leading performance indicators and monitor metrics on the top of identified root-causes that affect system's safety performance or how to set lagging indicators and feedback metrics on the top of safety outcomes. In fact, the framework adapts and combines classical Quality Management tools, a leading indicators programme and Lean-Six Sigma methodology to formally and continuously improve a stable and in-control safety management process. Finally, the paper underlines the necessity of a new way of thinking for the development of a robust, proactive process for measuring aviation safety performance and system performance variability.

Lean Six-Sigma in Aviation Safety: An implementation guide for measuring aviation system’s safety performance

The paper introduces a conceptual framework that could improve the safety performance measurement process and ultimately the aviation system safety performance. The framework provides an implementation guide on how organisations could design and develop a proactive, measurement tool for assessing and measuring the Acceptable Level of Safety Performance (ALoSP) at sigma (σ) level, a statistical measurement unit. In fact, the methodology adapts and combines quality management tools, a leading indicators programme and Lean-Six Sigma methodology to formally measure and continuously improve a stable and in-control safety management process by reducing safety defects and variability from core organisational processes and objectives. The implementation guide was empirically tested and validated with data collected and analysed within a period of nine months by the safety department of a complex aviation organisation operating a large transport aircraft fleet.

The application of Lean Six Sigma methodology to reduce the risk of healthcare-associated infections in surgery departments.

Nowadays, the monitoring and prevention of healthcare-associated infections (HAIs) is a priority for the healthcare sector. In this article, we report on the application of the Lean Six Sigma (LSS) methodology to reduce the number of patients affected by sentinel bacterial infections who are at risk of HAI. The LSS methodology was applied in the general surgery department by using a multidisciplinary team of both physicians and academics. Data on more than 20 000 patients who underwent a wide range of surgical procedures between January 2011 and December 2014 were collected to conduct the study using the departmental information system. The most prevalent sentinel bacteria were determined among the infected patients. The preintervention (January 2011 to December 2012) and postintervention (January 2013 to December 2014) phases were compared to analyze the effects of the methodology implemented. The methodology allowed the identification of variables that influenced the risk of HAIs and the implementation of corrective actions to improve the care process, thereby reducing the percentage of infected patients. The improved process resulted in a 20% reduction in the average number of hospitalization days between preintervention and control phases, and a decrease in the mean (SD) number of days of hospitalization amounted to 36 (15.68), with a data distribution around 3 σ. The LSS is a helpful strategy that ensures a significant decrease in the number of HAIs in patients undergoing surgical interventions. The implementation of this intervention in the general surgery departments resulted in a significant reduction in both the number of hospitalization days and the number of patients affected by HAIs. This approach, together with other tools for reducing the risk of infection (surveillance, epidemiological guidelines, and training of healthcare personnel), could be applied to redesign and improve a wide range of healthcare processes.

Experiencing Lean Six Sigma in the French residential construction

Purpose Compared to the manufacturing industry, Lean Six Sigma (LSS) lacks a clear methodology for its application in the tertiary service. One reason is the difficulties to assess information flow compared to physical flow. Indeed, the use of information flow as a process entry in the LSS method is not well investigated, mainly due to the difficulties in collecting adequate and sufficient data. The purpose of this research study is to investigate the application of LSS in the tertiary service, in particular, real estate development. Design/methodology/approach The paper is based on an action research methodology where LSS methodology is applied to solve client-dissatisfaction issue. One of its main causes is found to be the late delivery time. The work describes how the method was applied. Findings LSS is an adequate approach for making well-thought-out improvement in real estate development. Practical implications The work provides an implementation of LSS in real estate development. It also gives new insights into the LSS application in the tertiary service. The work also suggests practical recommendations and solutions to address the main challenges faced by real estate development. Originality/value Construction is governed by many processes that are difficult to identify and, even more, to assess. LSS helps identifying those which create real value for the client.

Inter-industry generic Lean Six Sigma project definitions

Purpose The objective of this research is to provide practitioners with inter-industry applicable rules and guidelines for the Lean Six Sigma (LSS) project definition phase. This research resulted in 13 inter-industry generic project definitions that are divided by four performance dimensions: quality, dependability, speed and cost efficiency. Design/methodology/approach A total of 312 previously executed LSS improvement projects in a broad variety of industries at black belt or master black belt level are analyzed. All these projects have followed the LSS methodology and are characterized by the use of critical to quality (CTQ) measurements and the structured improvement method of define, measure, analyse, improve and control for operations improvement. Findings This research resulted in 13 inter-industry generic project definitions that are divided by four performance dimensions: quality, dependability, speed and cost efficiency. Three factors that have stood out in this research are; the difficulty to capture the performance dimension flexibility in LSS project definitions, the strong focus on internal organizational benefits in defining CTQs for LSS project definitions and the unclear alignment of LSS project definitions to existing strategic objectives of the company. Originality/value This research established useable generic LSS project definitions including generic CTQ’s measures, applicable to multiple industries. These generic LSS project definitions provide useful guidance in the initial LSS project phase, helping to decompose strategic focal points into clear and measurable project objectives.

Lean Six Sigma in higher education institutions

Purpose This paper aims to illustrate the application of Lean Six Sigma (LSS) in higher education institutions (HEIs). A real-time case study presented as part of the paper highlights the value which LSS can bring to the higher education system. Design/methodology/approach The paper commences with an overview and the success of the LSS methodology. The uniqueness of the higher education system for imbibing quality excellence is elaborated, comparing it with the manufacturing industry. Various opportunities for LSS projects in HEIs are then discussed as part of the paper. The last section of the paper elaborates a real-time case study, explaining how LSS was leveraged to improve a university library process. Findings The study identified the key attributes of the higher education system, which need to be understood for imbibing quality excellence. The study also provided an insight into the upcoming application of LSS and the benefits it can bring to HEIs. Practical implications The introduction of LSS into the higher education setup could bring multifold organizational and social benefits Originality/value LSS has been successful in the past few decades in the manufacturing and service sector. However, its application in HEIs was very nascent. This study illustrates its importance and application to a highly responsible area of the service sector, for imbibing quality excellence, serving as an excellent resource for researchers and higher education professionals.

Using Lean Six Sigma Methodology to Improve a Mass Immunizations Process at the United States Naval Academy.

Lean Six Sigma (LSS) is a process improvement methodology developed in the manufacturing industry to increase process efficiency while maintaining product quality. The efficacy of LSS application to the health care setting has not been adequately studied. This article presents a quality improvement project at the U.S. Naval Academy that uses LSS to improve the mass immunizations process for Midshipmen during in-processing. The process was standardized to give all vaccinations at one station instead of giving a different vaccination at each station. After project implementation, the average immunizations lead time decreased by 79% and staffing decreased by 10%. The process was shown to be in control with a capability index of 1.18 and performance index of 1.10, resulting in a defect rate of 0.04%. This project demonstrates that the LSS methodology can be applied successfully to the health care setting to make sustainable process improvements if used correctly and completely.

Using a Lean Six Sigma Approach to Yield Sustained Pressure Ulcer Prevention for Complex Critical Care Patients.

Under value-based purchasing, Medicare withholds reimbursements for hospital-acquired pressure ulcer occurrence and rewards hospitals that meet performance standards. With little evidence of a validated prevention process, nurse managers are challenged to find evidence-based interventions. The aim of this study was to reduce the unit-acquired pressure ulcer (UAPU) rate on targeted intensive care and step-down units by 15% using Lean Six Sigma (LSS) methodology. An interdisciplinary team designed a pilot program using LSS methodology to test 4 interventions: standardized documentation, equipment monitoring, patient out-of-bed-to-chair monitoring, and a rounding checklist. During the pilot, the UAPU rate decreased from 4.4% to 2.8%, exceeding the goal of a 15% reduction. The rate remained below the goal through the program control phase at 2.9%, demonstrating a statistically significant reduction after intervention implementation. The program significantly reduced UAPU rates in high-risk populations. LSS methodologies are a sustainable approach to reducing hospital-acquired conditions that should be broadly tested and implemented.

Strategies to realize decentralized manufacture through hybrid manufacturing platforms

Centralized factory dominance has led to optimization and set-up for manufacture of a sole product or product-range. In-house efficacy of such systems has been greatly improved due to lean six-sigma methodologies; however, wider scale distribution and supply has undergone little to no transformation over the past century. Research pertaining to distributed manufacture, cloud-manufacture and reconfigurable systems have provided several decentralized models using traditional manufacturing capabilities. Due to practical limitations they have not been fully realized to date. This paper outlines the emerging concept and scope for hybrid manufacturing platforms – systems using a plurality of processes on a single motion platform, to manufacture products in a decentralized network. Necessity of on-machine inspection is highlighted, outlining the potential of generic artifact machine calibration and verification of parts made. A robust experimental method using a novel hybrid manufacturing approach is used to realize the post-process adaptation of subsequent parts and demonstrates significant improvement with adapted features being cut within 15 μm of nominal position, compared to the original 300 μm error. Social, economic and environmental ramifications of adopting such a system are highlighted. The combination of several key processes will allow users to manufacture parts with minimal intervention. A move to personal fabrication would allow greater customization and convenience for the end user; however, the issues of copyright and loss of economy of scale would inhibit mass uptake in the near-future. Growing interest by enthusiasts and early adopters will continue to make an impact on the way the populace views manufacture.

A Lean Six Sigma program in higher education

Purpose – The purpose of this paper is to contribute to the body of Lean Six Sigma (LSS) knowledge within the field of higher education institutions. The paper will review the initial phase of an implementation and highlight future challenges of applying the LSS method in a complex transactional environment. Design/methodology/approach – The observations presented in this paper originate from rolling out a large LSS implementation at a recently established university. The paper is supported with secondary data from literature. Findings – The implementation of LSS methodology at King Abdullah University of Science and Technology has resulted in improvements in business processes and efficiency. This has been achieved through project execution and training programs. Approximately 350 staff members have completed awareness training, 50 yellow belts and 150 green belts have been trained, and the first round of seven black belts have completed training of which two have completed certification. Research limitations/implications – This paper is based on an empirical study of a single instance and the authors’ experiences as practitioners. Originality/value – This paper is the first description of what is believed to be one of the largest implementations of LSS in higher education.

A multidisciplinary care pathway for the evaluation of falls and syncope in geriatric patients

IntroductionA multidisciplinary care pathway based on current guidelines was developed to evaluate unexplained non-accidental falls and/or syncope in geriatric patients aged 65 years or older. Material and methodsWe applied the lean six-sigma methodology. In the assessment phase, we defined the historic level of care for syncope patients in a small sample of patients. In the improvement phase, we developed a new clinical pathway with a close collaboration between geriatricians, cardiologists and neurologists. This 2 day structured diagnostic program included a comprehensive geriatric assessment, evaluation of nutritional status and disabilities, laboratory tests, and 12-lead electrocardiogram. In case of fall problems, brain-MRI or CT scans were performed. Blood pressure measurements for orthostatic and postprandial hypotension were performed. When indicated, patients were seen by a neurologist, cardiologist, dietician or old age psychiatrist. During the sustain phase, we implemented our new program and critically evaluated 262 patients. ResultsOf the 262 patients, aged 79.6±6.5 years, only 44 patients were referred for evaluation of syncope while in 117 patients, a syncope was diagnosed. Sixty-one patients were diagnosed with both a syncope and separate falls. Only 6 of the 117 elderly patients had syncope without falling. ConclusionsWith this novel multidisciplinary pathway for the combined evaluation of unexplained non-accidental falls and syncope, we achieved a diagnosis in 89% with a large overlap between falls and syncope. Therefore, cardiologists, neurologists and geriatricians should collaborate for the evaluation of falls and syncope.

The application of Lean Six Sigma to the configuration control in Intel’s manufacturing R&D environment

Purpose – The purpose of this paper is to provide an example of Lean Six Sigma (LSS) application in research and development (R&D) organizations to eliminate waste and improve systems based on available data that in turn improves the innovative environment. Manufacturing R&D involves designing and testing innovative concepts and taking them into high-volume manufacturing. The infrastructure associated with such organizations involves experimental manufacturing lines with the ability to evaluate the result under statistical process control and configuration control. The integration of LSS process improvement methodology into the R&D organization infrastructure and operations can have a dramatic effect on reducing cost and time related to the development and delivery of new technologies and products. Design/methodology/approach – The LSS methodology was systematically implemented to eliminate waste and improve the existing process of Intel’s configuration control during the development and ramp phases. The steps included an assessment of the current state through walking the process and collecting baseline data, preparing the process map to quantify waste and inefficiencies, defining the ideal state along with a realistic target, selecting and implementing the improvement actions together with realizing and documenting the improvements and finally developing and putting into place a control plan to ensure the new process is sustained. The LSS approach resulted in an efficiency improvement exceeding the target, i.e. 60 per cent reduction in idle time and waste (non-value-added activities) versus a target of 40 per cent reduction. The results also showed an increase in the stakeholder satisfaction without compromising the technical rigor of the manufacturing configuration control. Findings – The LSS case study presented in this paper provides experiences to LSS practitioners in manufacturing R&D environment where the operational excellence is to be sought in new technology and product development. Originality/value – Project leaders can use the study to help formulate strategies to cater to customer/stakeholder satisfaction and eliminate waste while maintaining the technical rigor of the R&D environment.

Process Improvement for Regulatory Analyses of Custom-Blend Fertilizers

Chemical testing of custom-blend fertilizers is essential to ensure that the products meet the formulation requirements. For purposes of proper crop nutrition and consumer protection, regulatory oversight promotes compliance and particular attention to blending and formulation specifications. Analyses of custom-blend fertilizer products must be performed and reported within a very narrow window in order to be effective. The Colorado Department of Agriculture's Biochemistry Laboratory is an ISO 17025 accredited facility and conducts analyses of custom-blend fertilizer products primarily during the spring planting season. Using the Lean Six Sigma (LSS) process, the Biochemistry Laboratory has reduced turnaround times from as much as 45 days to as little as 3 days. The LSS methodology focuses on waste reduction through identifying: non-value-added steps, unneeded process reviews, optimization of screening and confirmatory analyses, equipment utilization, nonessential reporting requirements, and inefficient personnel deployment. Eliminating these non-value-added activities helped the laboratory significantly shorten turnaround time and reduce costs. Key improvement elements discovered during the LSS process included: focused sample tracking, equipment redundancy, strategic supply stocking, batch size optimization, critical sample paths, elimination of nonessential QC reviews, and more efficient personnel deployment.

Using LSS to improve the efficiency and quality of a refund process in a logistics center

Purpose – This study aims to demonstrate a service quality improvement project implemented by the Lean Six Sigma (LSS) methodology to achieve dramatic improvements with respect to service quality and speed in the refund process of the logistics center in Amway Company, Taiwan. It describes in detail how the LSS methodology was applied and how various qualitative and quantitative tools and techniques within the define, measure, analyze, improve and control (DMAIC) logic roadmap have been employed. Design/methodology/approach – This paper adopts the case study methodology to illustrate how to use LSS approach to increase the efficiency of refund process. Findings – The DMAIC scheme with logical analysis, qualitative tools and statistical verification, were employed to identify the key process input variables (KPIVs) that affect the key process output variables (KPOVs) in the refund process. The project team also successfully eliminated non-valued-added (NVA) activities and redesigned the refund process. The most significant improvement is to increase customer satisfaction substantially by reducing the credit voucher waiting time from 14 days to 14 min and the error rate in the refund process is down to almost zero. The results prove that combining the tools of Six Sigma and lean production effects successful improvement of service activities as well as the improvement of manufacturing sectors. Research limitations/implications – The case study method limits the generalization of the findings, but provides a novel way to solve problems for the logistics center. Originality/value – This is one of the rare studies to utilize LSS approach to increase service quality of logistics centers. For the logistics center of Amway Taiwan, the financial benefit of the project was about NT$1,200,000 in annual savings. Numerous invisible gains from the LSS projects are more important for the organization, for example providing customers excellent service, increasing customer satisfaction, training the employees of the company, enhancing the reputation of Amway Taiwan and establishing continuous improvement culture.

Reducing Patient Waiting Time in Outpatient Department Using Lean Six Sigma Methodology

This article addresses the issue of longer patient waiting time in the outpatient department (OPD) of a super specialty hospital attached to a manufacturing company in India. Due to longer waiting times at OPD, employees need to be away from the workplace for a longer duration. This problem was addressed through the Lean Six Sigma (LSS) methodology. The process, starting from registration of a patient to dispensing of medicine, was included in the project. The non‐value added steps in the process were identified, and actions were initiated. A cause and effect diagram was prepared for high patient waiting time, and causes were validated with the help of data collected from the process. Statistical tools such as Kruskal–Wallis test, Box – Cox transformation, Control charts, normality test, etc., were used within the LSS methodology not only to identify the causes but also to sustain the improvements. As a result of this project, the average waiting time reduced from 57 min to 24.5 min and the standard deviation was reduced to 9.27 from 31.15 min. This will help the hospital to serve patients better and faster, which, in turn, will lead to a reduction in delay of treatment and a faster recovery of patients. The productivity loss due to absenteeism of employees from the workplace could be reduced. Generally, in an Indian health care scenario, most of the activities were dependent on individual doctors rather than processes. This project has helped the clinicians and the hospital management to identify the weak areas in the process for improvement. Because of the implemented solutions, understanding the history of past treatments and medications of the patients was easy for the doctors. Also, the practical validity of deploying LSS in a healthcare scenario was justified with this study. Copyright © 2013 John Wiley & Sons, Ltd.

A Lean Six Sigma Quality Improvement Project to Increase Discharge Paperwork Completeness for Admission to a Comprehensive Integrated Inpatient Rehabilitation Program

Lean Six Sigma (LSS) process analysis can be used to increase completeness of discharge summary reports used as a critical communication tool when a patient transitions between levels of care. The authors used the LSS methodology as an intervention to improve systems process. Over the course of the project, 8 required elements were analyzed in the discharge paperwork. The authors analyzed the discharge paperwork of patients (42 patients preintervention and 143 patients postintervention) of a comprehensive integrated inpatient rehabilitation program (CIIRP). Prior to this LSS project, 61.8% of required discharge elements were present. The intervention improved the completeness to 94.2% of the required elements. The percentage of charts that were 100% complete increased from 11.9% to 67.8%. LSS is a well-established process improvement methodology that can be used to make significant improvements in complex health care workflow issues. Specifically, the completeness of discharge documentation required for transition of care to CIIRP can be improved.

Effects of Lean Six Sigma application in healthcare services: a literature review

The healthcare organization is the place where defects and mistakes cannot be tolerated. A simple mistake can cost a human life so defects or mistakes must be eliminated in healthcare service processes. A Lean Six Sigma (LSS) approach is the best option in a healthcare environment for dealing with a critical patient. The LSS methodology optimizes the average reduction of a desired process. The expected results can be reductions in several aspects of healthcare such as patient waiting time in emergency departments, lost charges for billing in patient financial services, delinquent medical records, diagnostic result turnaround times, accounts receivable days, patients' length of stay, or medication errors. This paper mainly discusses the effects of the LSS approach in different hospitals around the world according to the literature review. This review also discusses the relationship between LSS as well as their impacts on healthcare services based on literature review.

The usefulness of lean six sigma to the development of a clinical pathway for hip fractures

The objective of this study was to show the usefulness of lean six sigma (LSS) for the development of a multidisciplinary clinical pathway. A single centre, both retrospective and prospective, non-randomized controlled study design was used to identify the variables of a prolonged length of stay (LOS) for hip fractures in the elderly and to measure the effect of the process improvements--with the aim of improving efficiency of care and reducing the LOS. The project identified several variables influencing LOS, and interventions were designed to improve the process of care. Significant results were achieved by reducing both the average LOS by 4.2 days (-31%) and the average duration of surgery by 57 minutes (-36%). The average LOS of patients discharged to a nursing home reduced by 4.4 days. The findings of this study show a successful application of LSS methodology within the development of a clinical pathway. Further research is needed to explore the effect of the use of LSS methodology at clinical outcome and quality of life.

Environmental Performance as Key Performance Indicators in the Lean Six-Sigma Methodology

Lean six-sigma methodology focuses on continuous improvement approach with an emphasis on improving the product quality and reducing waste. Recent studies of lean six-sigma methodology indicated that this methodology commonly focus on four areas of performance namely quality, cost time and service. In this paper, an environmental performance is proposed into lean six-sigma methodology. An environmental performance needs to be integrated into lean six-sigma as a new paradigm of lean six-sigma methodology to achieve overall competitiveness of product.