Lean Sustainability Research Articles

Perceptions of healthcare providers on factors affecting lean sustainability in the hospitals under the Ministry of Health Malaysia

ABSTRACT Introduction Despite the recognized benefits of continuous improvement programs such as lean methodologies, understanding of how to sustain these practices in Malaysia's public health sector remains limited. This qualitative study aims to explore perceptions of both policymakers and hospital-based healthcare providers (HCPs) on the factors affecting the sustainability of lean within the Ministry of Health (MOH) hospitals in Malaysia. Methods Data were collected through in-depth interviews with 14 participants, including policymakers and hospital-based HCPs, using purposive sampling. A deductive thematic analysis was employed to analyze the data. Results This study delineated ten primary themes: (1) Fostering lean expertise through capacity building, (2) Lean implementation approaches and processes, (3) Monitoring and evaluation of lean with performance indicators, (4) Encouraging positive behavioral change among HCPs in lean, (5) Disseminating lean findings, (6) Establishing policy for lean, (7) Incentivizing lean practices, (8) Leadership in lean practices, (9) Building and strengthening organizational capacity and (10) Values of lean. Conclusion Insights from this study reflected that sustaining lean in the MOH is a complex process and involves a multifaceted approach. Health organizations seeking to improve lean sustainability are encouraged to incorporate the themes highlighted in this study.

Examination of the effects of artificial intelligence readiness on lean sustainability and value creation in the mediation variable effect of organizational flexibility in technology-focused companies

PurposeThe purpose of this study is to understand how the level of readiness for artificial intelligence (AI) affects the overall performance of companies, determine the role of organizational flexibility in adapting to new technologies and business models and assess the importance of lean sustainability and value creation for technology-focused companies.Design/methodology/approachTechnology companies working in technoparks in Istanbul were determined, and a questionnaire was applied to senior employees such as experts, engineers and managers working in these companies. The results were processed with a sample of 456 units. SmartPLS program was used for analysis.FindingsAs a result of the analyzes, it is supported by hypotheses that AI readiness and organizational flexibility have positive effects on lean sustainability and value creation.Research limitations/implicationsWhen evaluated in terms of the limitations of the research, it would not be correct to evaluate the results of the analysis in general, since the data were collected from technology-focused companies in technoparks in Istanbul.Practical implicationsExamining the variables that make up the research model in technology-oriented companies helps to understand the critical factors for the future success of companies. At the same time, this research is important for companies to make more informed decisions in their strategic planning, technological transformation processes and value creation strategies.Originality/valueThis research topic offers a unique approach in terms of bringing together topics such as AI readiness, organizational flexibility, sustainability and value creation. These issues play an important role in the strategic planning of technology-focused companies, and when considered together, they are important in terms of examining the critical factors that affect the future success of companies.

Lean sustainability and triple bottom line performance of manufacturing industries in a developing economy: does top management commitment matter?

PurposeAlthough literature abounds on lean sustainability (LS), its contributions to manufacturing industries’ triple bottom line performance (TBLP) through top management commitment (TMC) remain scanty. This research explores the mediating role of TMC in the nexus between LS and TBLP.Design/methodology/approachGiven the study’s quantitative focus, the causal design was utilised. The structured questionnaire, a survey instrument, was used to gather primary data from 285 manufacturing organisations in Ghana, a developing country. Data analysis was done with structural equation modelling.FindingsIt was found that LS and TMC positively influence TBLP, whereas TMC partially mediates the connection between LS and TBLP of Ghanaian manufacturing organisations.Research limitations/implicationsThe study concentrates on Ghana’s manufacturing industry and embraces the stakeholder theory and quantitative methods.Practical implicationsThis research underlines why top managers must prioritise investment in LS to promote sustainable development and attain their organisations’ TBLP targets. The study also provides key insights for top managers to consistently commit enormous resources towards developing lean practices, contributing favourably to TBLP. By establishing the interplay among LS, TMC and TBLP, manufacturing practitioners and researchers can further advance new strategies to address the growing sustainability concerns and achieve higher economic, social and environmental performance.Originality/valueThe study’s originality lies in analysing the mediation effect of TMC on the linkage between LS and TBLP in a developing economy where manufacturing organisations are continuously exposed to resource and waste management problems and lack adequate commitments from top managers towards sustainability initiatives. It is also the first to establish relationships between top management commitment and TBLP in the manufacturing industries of developing economies, concentrating on Ghana.

Continual Improvement (CI) Lean Culture Continuous Quality and Cost Saving in Malaysia Manufacturing & Engineering (M&E) Companies

Lean sustainability is often perceived to only be possible to be maintained via small group application of lean culture that carry out improvement activities. The purpose of this case study is thus to examine the success factors of inculcating lean culture framework by lean practitioners in Malaysian Manufacturing and Engineering (ME) companies that faced inconsistencies in implementing and sustaining lean. The impact of lean culture framework practiced by Small Group Improvement Activities (SGIA) was analysed via productivity improvement methodologies comprises of semi-structured interviews and analysis of 633 Small Group Improvement Activities (SGIA) project reports in establishing a final lean culture framework that can contribute to the longevity of a lean company. The improved lean culture framework that had been extended to other strategic business units (SBU) in ME companies are found to be the positive factor contributing to the sustainability of lean culture and achieving tangible and intangible benefits via small group improvement activities, enhancement standard which include companies’ policy, as well as providing a guideline in problem solving methodology. The findings revealed that enhancement of inculcating lean framework is crucially in need especially in expanding the initiatives across ME companies via a systematic and standardised problem-solving methodology. This study intends to aid organisations, practitioners, academicians, and respective industries in benchmarking the best practises and at the same time further reduce the gap and continually improve the lean culture framework in other compass industries.

The sustainability of lean implementations at the hospitals of Ministry of Health Malaysia: A study protocol.

In Malaysia, lean was initiated in 2012 as part of an effort to reduce waiting time at the Ministry of Health (MOH) hospitals. As of now, there are 52 public hospitals that have officially implemented lean. However, little is known whether lean is sustained within the hospitals and the critical success factors (CSFs) affecting sustainability. Therefore, this study protocol aims to fill the gap by (i) identifying the critical success factors [CSFs] for lean sustainability in the MOH, (ii) developing a validated framework to support hospitals in sustaining lean, (iii) the framework will be adapted into a checklist to measure the level of lean sustainability (iv) interviewing hospitals with the lowest and highest level of lean sustainability to further explore the barriers and boosters in sustaining lean. This study will employ a mixed-method approach and will be conducted in three phases. The first phase involves a combination of scoping review and interviews with key informants to identify the CSFs known to affect lean sustainability at the MOH hospitals and present them in a validated framework. In the second phase, the framework will be adapted into a checklist to measure the level of lean sustainability in the MOH hospitals. The findings will be used to select the hospital with the lowest and highest level of lean sustainability for an interview in the third phase. The lean sustainability framework will be able to provide more relevant guidance on how to increase the likelihood of lean sustainability and serve as a validated measurement tool for MOH hospitals. In addition, this study will be able to outline the differences in the contributing factors between health organizations that showed a high level of lean sustainability compared to those struggling to sustain.

Preliminary Framework of Lean Healthcare Sustainability Performance Measurement for Health Sector

Introduction: Lean sustainability has gained prominence in the health sector for operational and business advantages. However, understanding the link between lean and healthcare sustainability, especially in social and environmental aspects, remains limited. This study introduces a preliminary framework for measuring lean healthcare sustainability in hospitals. The framework aligns Critical Success Factors (CSFs) with sustainability objectives and business strategies to ensure successful and enduring lean deployment. Methods: The study was conducted among 52 Lean Agile Hospitals in Malaysia using a cross-sectional approach. The validated questionnaire was employed for data collection. A reliability test and Exploratory Factor Analysis (EFA) were also performed to assess and validate the framework using Statistical Package for Social Sciences (SPSS) version 27. Results: The content validation was 0.9, which indicates that the instrument is sufficient to measure the research objective. The data screening test was performed to eliminate problem observation. The overall reliability value was over 0.830 which depicts data consistency and stability. The Kaiser-Meyer-Olkin exceeded 0.6, Bartlett’s test was under 0.001 and factor loading was between 0.507 to 0.948, thus indicating a significant correlation matrix among at least some of the variables. Therefore, the latent factors were significant to specific items of the research. Conclusion: It is concluded that important CSF is aligned with the strategic level influence of lean deployment in healthcare, which has a specific impact on certain sustainability performance. Thus, this paper proposed a generic preliminary framework to measure lean healthcare sustainability.

Readiness of lean sustainability in healthcare organizations

PurposeThis paper aims to “identify,” “analyse” and “categorise” the readiness factors of lean sustainability in health-care organisation using total interpretive structural modelling (TISM).Design/methodology/approachTo obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview. To identify how the factors interact, the TISM approach was used, and the matriced’ impacts croise’s multiplication applique’e a UN classement (MICMAC) analysis was used to rank and categorise the lean sustainability readiness factors.FindingsThis study identified ten lean sustainability readiness factors for health-care organisation. The identified factors are resources utilization practice (F1), management commitment and leadership (F2), operational flexibility (F3), workforce engagement and time commitment (F4), sustainability motivational factors (F5), awareness of lean and sustainable practice (F6), hospital design (F7), energy efficiency practices in hospitals (F8), responsible autonomy (F9) and new system adoptability training (F10). The key/driving factors are identified in this study are operational flexibility, sustainability motivational factors, management commitment and leadership, new system adoptability training.Research limitations/implicationsThe study focussed primarily on lean sustainability factors for the health-care sector.Practical implicationsThis research will aid key stakeholders and academics in the better understanding the readiness factors that influence lean sustainability in health-care organisation. This study emphasises the factors that must be considered when applying lean sustainable practices in health care as a real-world application in a health-care organisation. These readiness factors for lean sustainability can be used by an organization to comprehend more about the concept and the components that contribute to health-care lean sustainability.Originality/valueThis study proposes the TISM technique for health care, which is a novel attempt in the subject of lean sustainability in this sector.

Lean-sustainability assessment framework development: evidence from the construction industry

Lean-sustainability principles share two basic standards: waste minimization and enhanced value. The purpose of this research is to offer a conceptual model for assessing construction firms’ lean sustainability by evaluating the synergy between lean operations and sustainability using a multi-grade fuzzy method. Three enablers, fifteen criteria, and forty-four attributes were identified based on an exhaustive literature analysis and expert opinion. The multi-grade fuzzy approach is utilized in this study to measure the lean-sustainability in the case construction organization. The determined total lean-sustainability index of 7.5, which falls between the range of 6–8, demonstrates that the case construction organizations prioritize lean-sustainability. IPA technique is utilized to identify the weaker and stronger attributes of lean sustainability in the case organization that hinder the lean-sustainability overall performance. To identify the critical and triggering attributes, Graphic Theoretic (GT) Approach is utilized through sensitivity analysis. GT evaluates the weaker and stronger attributes in order to identify the essential and triggering attributes that will boost lean sustainability. Theoretically, this study contributes by providing a paradigm for assessing lean sustainability. This research can help construction organizations discover essential lean-sustainability practices on a regular basis and concentrate on their weaker attributes in order to advance their performance.

Lean daily management in healthcare: origins, practices, and associations with lean leadership and lean sustainability

This exploratory study investigates daily management (DM), a common phenomenon in healthcare and other organisations that embrace lean philosophy. Although some sources consider DM a critical component in Lean, as a research topic DM has received scant attention. This paper gives an overview of DM – its origins and components – and reviews the literature to explore DM practices in healthcare. It also investigates associations between DM and ‘lean leadership’ (LL), and between DM and the sustainability of Lean. The premise for the study is that DM is a critical component of Lean, more fundamental to lean practice and philosophy than has been acknowledged by scholars. The findings of the study reveal substantial commonality in the DM practices of lean healthcare organizations. They also indicate an association between DM practices with concepts and behaviors associated with LL, and an association between DM practices and critical factors for lean sustainability and long-term success. An implication of the findings is that DM, though formerly overlooked in research, is a critical component to lean success and sustainability. The paper contributes to the literature on Lean by expanding an area somewhat ignored by scholars and offers practical implications and research opportunities for managers and scholars.

Critical factors for sustaining lean manufacturing in the long-term: a multi-method study

In recent years, lean manufacturing (LM) has been used to improve the operational performance of organisations by improving the productivity, quality and profitability of their operations. However, some authors claim that these organisations are struggling to implement and maintain lean initiatives in a sustainable way over time. This paper proposes a list of critical factors for sustaining LM in the long-term. We used a multi-method research approach. First, we generated a list of critical factors for sustaining LM in the long-term using the systematic literature review approach. Subsequently, interviews with experts were used to refine these factors. Following this, two case studies were performed, and the results passed through another round of interviews with experts to ensure the robustness of the results. The main result of the research is a list of 19 LM sustainability factors. To the best of the authors' knowledge, this is the first research to propose a scientifically validated list of critical factors for sustaining LM. The contribution of this work lies in consolidating the lean sustainability factors widely found in the literature. In practical terms, the proposed list can guide managerial efforts towards sustaining lean in the long-term. [Submitted: 22 April 2021; Accepted: 29 December 2021]

Using Programme Theory to evaluate Lean interventions in healthcare

Lean in healthcare has continued to attract practitioner and research interest over the past two decades yet lacks evidence of sustained application. This longitudinal case study examines Lean healthcare interventions through the lens of Programme Theory, to provide an understanding of the design and implementation of a Lean programme. Through a qualitative single case study of an NHS organisation implementing Lean, content analysis of 70 reports from a 6-year period was undertaken and supported by interview data from 12 respondents involved in Lean initiatives. Through Programme Theory, we identify contextual moderators, internal and external, informing the design and development of Lean efforts. The key to successful and sustained Lean efforts is staff acceptance of the Programme Theory for delivering and maintaining outcomes. This has been identified as a key social determinant for Lean sustainability. Results from the research provide practical implications for designing a programme that accommodates resource challenges while incorporating multiple contextual drivers. The case study highlights an organisation’s Lean journey and the best practices that evolved; however, further longitudinal investigations are required to validate the findings.

FACTORS AFFECTING THE SUSTAINABILITY OF LEAN IN HEALTHCARE: A SYSTEMATIC LITERATURE REVIEW

The application of Lean in healthcare has been steadily climbing since 2000. However, Lean implementation in healthcare environments has experienced high failure rates that could be attributed to a lack of sustainable implementation. A knowledge gap has therefore been identified, in both practice and research, to understand the reason for failure and the impact of Lean sustainability on Lean success. The aim of the main study is to explore the factors that affect the sustainability of Lean healthcare in South African hospitals. This paper reports on the first part of the study, a systematic literature review (SLR) that identifies the factors that affect the sustainability of Lean healthcare in hospitals. Through the SLR, 50 factors affecting Lean sustainability in hospitals were identified and grouped into 12 themes. These themes were then tested against Lean principles. The results showed that the adaptation of Lean so that it makes sense to healthcare staff and is compatible with a hospital context is important for sustainability. Staff and organisational readiness during Lean implementation is also critical for long-term sustainability. The SLR results will be used to develop an interview protocol for the second part of the main study, which will involve interviews with South African-based practitioners, consultants, and academics who are directly involved in Lean implementation in South African hospitals. Keywords Lean; Lean healthcare; Lean principles; factors; systematic literature review; hospital

Lean Implementation Framework: A Case of Performance Improvement of Casting Process

Globalization breeds increasing competition. In today’s dynamic climate, lean thinking has been found a promising business continuous improvement strategy for improving quality while reducing product cost and delivery time. However, its implementation has dynamic nature of challenges that varies from industry to industry and country to country, necessitating a specific framework by taking all stakeholders onboard. This study aims to propose a lean implementation framework to reduce defects and waste to improve the performance of the metal casting industry. The structure of the framework has been divided into three phases namely the lean conception phase, lean implementation phase, and lean sustainability phase. The proposed framework integrates the six sigma DMAIC methodology with lean tools and techniques to reduce defects and achieve performance improvement. A solid cast software has been used as a computer-assisted casting simulation tool to perform the analysis of defects within the casting. Further, the proposed framework is demonstrated and validated by employing a real-time case study that was manufactured using the sand casting process. The obtained results show remarkable improvements in poured metal weight (33.3%), mold weight including gating system (40%), casting yield (24.56%, rejection rate (90%), and financial saving (24.63%). As a result of analysis of percentage improvements data, the proposed framework can provide the practitioners with a standard roadmap and motivate the casting industries to implement lean for performance improvement through organizational change. Through the effective application of the lean implementation framework, quality enhancement has been demonstrated.

Achieving Sustainability in Solar Energy Firms in Turkey through Adopting Lean Principles

Lean principles and sustainability are considered important terms in business. Solar firms are witnessing great competition to fulfill energy requirements, suffering from a huge amount of waste, negatively affecting the sustainability dimensions. Thus, the aim of the study is to build a framework for solar energy firms to achieve sustainability through adopting lean principles, which will help to fix many problems as waste and costs. The method included reviewing the literature to explore the founding of the relation between the two terms, and using a questionnaire that was directed to the responsible people in Turkish solar energy firms. The results of the survey were analyzed to: (1) Find out what the responsible people think about the two terms lean and sustainability; (2) Measure the probable relationship between lean principles and sustainability dimensions by applying a linear regression test; (3) Use the results of point number two to build the framework. The result showed there was a high level of relative importance about the two terms from the point of view of managers and experts in solar firms. In addition, the study found a relationship between adopting pull and flow principles of lean, and achieving economic and social dimensions of sustainability, this finding is represented in a framework.

AN INVESTIGATION INTO LEAN PRACTICES AND THEIR IMPACT ON SUSTAINABILITY PERFORMANCE IN THE LATEX GLOVE MANUFACTURING INDUSTRY

Lean is characterized as a collection of management practices. Lean's central philosophy is to minimize and eradicate non-value-adding practices and waste. High quality and customer loyalty are guaranteed by the Lean process. Lean concept obtains its root from Toyota Production system (TPS). The TPS approach is often well suited to high-volume manufacturing. Lean, however, is also applicable in any setting where process waste is encountered. The intent of this study is to develop a lean sustainability performance assessment to analyze the level of lean implementation and its impacts on sustainability performance in Latex Glove Manufacturing Industries. The assessment method is generally in the form of Five-Point Likert Scale Questionnaire which consists of two main sections, Section A, to determine the level of lean practices in the company and Section B to distinguish the impact of the implemented lean practices on sustainability performance in the aspect of social, environmental and economic. Thirty employees from three different Latex Glove Manufacturing Industries (Company A, B, and C) in Selangor were involved in this study. The data was then analyzed using Minitab 15. Among the 22 combined hard and soft lean tools, Just-In-Time (JIT) for hard lean tool and Customer focus for the soft lean tool has scored the highest level of implementation in all three Industries. As for sustainability performance, economic sustainability performance scored the highest average mean score followed by environment and social sustainability performance. Overall, the finding shows that Company A and C have an overall better impact towards sustainability performance by the execution of lean practices as compared to company B. This must be predominantly due to the high level of implementation of soft lean tools as both the companies have a high level of implementation for the majority of the soft lean tools as compared to the implementation of hard lean tools. In conclusion, the higher the level of implementation of lean tools and practices, the greater the impact on it the sustainability performance in a company.

Organizational Commitment and Lean Sustainability: Literature Review and Directions for Future Research

The vast majority of works published on Lean focus on the evaluation of tools and/or the strategies needed for its implementation. Although many authors highlight the degree of employee commitment as one of the key aspects of Lean, what has gone largely unnoticed in the literature, is that few studies have examined in-depth the concept of organizational commitment in connection with Lean. With this narrative literature review article, our main objective is (1) to identify and analyze an extensive body of literature that addresses the Lean Manufacturing approach and how it relates to employee commitment, emphasizing affective commitment as the main type of organizational commitment positively associated with Lean, and (2) to highlight the management practices required to encourage this kind of commitment and promote the success and sustainability of Lean. This paper aims to provide a comprehensive overview that can help researchers and practitioners interested in Lean better understand the importance of employee commitment in this type of approach, and as well, to identify related research questions.

Modelling and analysis of barriers of lean sustainability in metal manufacturing organizations

Lean and sustainable manufacturing strategies are essential for enabling manufacturing organisations to survive in the current competitive scenario. A metal manufacturing firm has large scope for implementing lean and sustainability tools as it has issues pertaining to both materials management and Environmental Impact reduction. Several barriers may hinder the implementation of these strategies. In this context, this paper reports a study in which 10 barriers are identified based on a survey among practitioners belonging to various metal manufacturing firms. The barriers are systematically analysed using Interpretive Structural Modelling (ISM) and the structural model has been developed. The prioritized barriers need to be focused so as to enable the implementation of integrated lean and sustainable strategies in metal manufacturing organizations. The key barriers to be improved included barriers namely Lack of resource availability, Lack of Funds for green and lean projects, Lack of Technology, Lack of Top management commitment and Lack of clear communication. The conduct of the study enabled the industry practitioners to systematically analyze the barriers and provided path for systematic implementation.

Exploring critical success factors for the implementation of lean manufacturing in machinery and equipment SMEs

Abstract This study aims to explore the predominant critical success factors (CSFs) for the implementation of lean manufacturing (LM) in small and medium-sized enterprises (SMEs) producing machinery and equipment (M&E). The convergent parallel mixed-methods (qualitative and quantitative) were employed in three Malaysian M&E manufacturing SMEs. The study identified four predominant CSFs that significantly impact on the LM application in M&E manufacturing SMEs, namely, leadership and commitment of the top management, training to upgrade skills and expertise, employee involvement and empowerment, and the development of LM implementation framework for SMEs. This study can assist the M&E manufacturing SMEs in prioritising these predominant CSFs so that the management teams can work on the improvement strategy and achieve a higher level of lean sustainability. It offers valuable insights into the LM implementation that could provide a practical reference guide to other industrial companies.

Safety Maintains Lean Sustainability and Increases Performance through Fault Control

Almost every industrial and service enterprise adopts some form of Environmental Health and Safety (HSE) practices. However, there is no unified measurement implementation framework to resist losses exacerbated due to the “lack of safety precautions”, which must be considered one of the most dangerous Lean wastes because it jeopardizes the investment in the Hex-Bottom-Line (HBLs). Despite the widespread nature of the Lean approach, there no unified and collected framework to track and measure the effectiveness of the safety measures’ progress. Therefore, the enterprises resort to establishing their own tailored safety framework that maintains their competitiveness and sustainability. The enterprises must provide insight into safety deficiencies (i.e., faults and losses suffered) that have been measured via downtime spans and costs (Lean waste), reflecting the poor Lean Safety Performance Level (LSPL). This paper aims to shed light on two issues: (1) the adverse impact of the “lack of safety precautions” on LSPL caused by the absence of (2) a Lean Safety framework included in the Measurement and Analysis phases of Define Measure Analyze Identify Control (DMAIC). This framework is based on forecasting losses and faults according to their consumption time. The proposed framework appreciates the losses’ severity (time consumption and costs) via Fault Mode and Effect Forecasting (FMEF) aided by Artificial Neural Networks through sequential steps known as Safety Function Deployment (SFD).

An empirical investigation on association between human factors, ergonomics and lean manufacturing

Most adopters focussed on lean tools and techniques (hard lean practices) alone and neglected human factors and ergonomics (soft lean practices) while implementing lean in an organisation. The implementation of hard lean practices alone worsens workers’ Quality of Work Life (QWL) which results in obtaining anticipated long-term lean performance. To promote the adaptation of soft lean practices, the study aimed to highlight the significance of Human Factors and Ergonomics (HFE) in lean performance and sustainability through structural equation modelling using survey data from 168 experts involved in lean environments. The study documented that the degree of lean performance is positively related to HFE. Also, it found that psychosocial and physical factors influence lean performance enhancement more than others do whereas cognitive factors influence them the least. The study will help managers and researchers understand the relationship between HFE and lean performance and thus help to solve human-related issues in a lean environment and lean system design for successful implementation. Finally, the implications, limitations and future scope of the study are discussed elaborately.