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An Analysis of hospital characteristics on lean and service quality

Assadej Vanichchinchai (Faculty of Engineering, Mahidol University, Nakhon Pathom, Thailand)

International Journal of Lean Six Sigma

ISSN: 2040-4166

Article publication date: 5 May 2021



The purpose of this research is to explore the differences across hospital characteristics (i.e. lean maturity, hospital size, hospital type and ISO 9001) on lean expectation, lean performance, service quality expectation and service quality performance.


The survey instruments were developed from an extensive literature review, validated by experts and tested by statistical techniques. Data was collected from the perspective of care providers in 220 outpatient departments of Thai hospitals with multiple respondents to improve reliability of data. Analysis of variance and independent sample t test were applied for analysis.


It was found that there are significant differences across lean maturity and hospital size on overall lean expectation and overall lean performance, and across ISO 9001 on overall service quality performance. Overall, service quality expectation and performance have higher mean scores than overall lean expectation and performance.


To the best of author’s knowledge, this is one of the first studies to present insights into the links between Thai hospital characteristics, expected lean and service quality and performance from the care provider viewpoint. Findings form this study can be used to improve individual hospitals or develop healthcare system at national level.



The institutional review board of Mahidol University approved this research (MU-CIRB 2019/064.2202). The author would like to thank the editor and anonymous referees for their constructive reviews; thank experts for their measurement instrument validation; thank Graham K. Rogers and Parinya Siriattakul for their language editing and valuable comments; and thank respondents, the Healthcare Accreditation Institute (Public Organization), the College of Public Health Administration of the Ministry of Public Health for support in data collection.

The author declares no potential conflicts of interest with respect to the research, authorship, and/or publication of this paper. The author receives no financial support for the research, authorship and/or publication of this paper.


Vanichchinchai, A. (2021), "An Analysis of hospital characteristics on lean and service quality", International Journal of Lean Six Sigma, Vol. ahead-of-print No. ahead-of-print.



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