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The purpose of this paper is to contribute to the limited body of empirical knowledge on the impact of Lean Six Sigma (LSS) program implementations on organizational performance in financial services by investigating how antecedents of Lean Six Sigma program success (motivations, selected LSS methods and challenges) affect organizational performance enhancement via LSS program performance.

A sample of 198 LSS professionals from 7 countries are surveyed. Structural equation modeling (SEM) is performed to test the questioned relations.

This study’s findings comprise: (1) LSS program performance partially mediates the relationship between motivations for LSS implementation and organizational performance, (2) selected LSS method applications has a fully (mediated) indirect impact on organizational performance, (3) LSS implementation challenges also have an indirect (mediated) impact on organizational performance and (4) LSS program performance has a positive impact on organizational performance.

The findings of this research predominantly provide nuances and details about LSS implementation antecedents and effects, useful for managers in advising their business leaders about the prerequisites and potential operational and financial benefits of LSS implementation. Furthermore, the paper provides evidence and details about the relationship between important antecedents for LSS implementation identified in existing literature and their impact on organizational performance in services. Thereby, this research is the first in providing empirical, cross-sectional, evidence for the antecedents and effects of LSS program implementations in financial services.

The purpose of this research is to develop a better understanding of the hurdles in implementing Lean Six Sigma (LSS) for operational excellence in digital emerging technology companies.

We have conducted case studies of LSS implementations in six US-based companies in the digital emerging technology industry.

Critical success factors (CSF) for LSS implementations in digital emerging technology companies are: (1) organizational leadership that is engaged to the implementation, (2) LSS methodology that is rebranded to fit existing shared values in the organization, (3) restructuring of the traditional LSS training program to include a more incremental, prioritized, on-the-job training approach and (4) a modified LSS project execution methodology that includes (a) condensing the phases and tools applied in LSS projects and (b) adopting more iterative project management methods compared to the standard phased LSS project approach.

The qualitative nature of our analysis and the geographic coverage of our sample limit the generalizability of our findings.

Implications comprise the awareness and knowledge of critical success factors and LSS methodology modifications specifically relevant for digital emerging technology companies or companies that share similarities in terms of focus on product development, innovation and growth, such as R&D departments in high-tech manufacturing companies.

Research on industry-specific enablers for successful LSS implementation in the digital emerging technology industry is virtually absent. Our research informs practitioners on how to implement LSS in this and alike industries, and points to aspects of such implementations that are worthy of further attention from the academic community.

Healthcare environments are highly complex and full of variation and inefficiency. However, variation and inefficiency can be measured and improved, providing better quality care at a lower cost. This study aims to report the application of Lean Six Sigma (LSS) in a haematology laboratory in a university hospital in Egypt.

The authors used case study research. Applying the define, measure, analyse, improve and control phases of the DMAIC methodology together with lean tools, the problem was identified, the process mapped, the causes analysed and improvements implemented.

Results show that LSS can be successfully implemented in challenging public sector healthcare settings. Management commitment, generating and implementing ideas from frontline staff, using a variety of quality tools and previous LSS training were all key to success. This is evidence that the LSS methodology is adaptable to any process, people or place.

There are no publications on LSS implementation in health care in Egypt. This study demonstrates the successful use of LSS in a university hospital (public sector) in a developing country, sharing insight into the facilitators and barriers in a real context with others in the healthcare field.

This study aimed to bridge the gap between the financial measurement of process improvement ideas and Lean Six Sigma measurements. It was required to increase employee engagement in process improvement initiatives.

Through both a practical and theoretical application of the Design for Lean Six Sigma methodology, the researcher was able to design a process and a benefit measuring methodology that was acceptable by finance and aligns with the benefits expected from the elimination of the Lean wastes.

The project found that benefit measurement methodology is not understood by most employees, which leads to a lack of engagement in working on improvements. The result of the study was a model for employees to identify and quantify these benefits. This has resulted in a model for cost-benefit analysis aligning financial costs with non-value add waste costs and cost of poor-quality costs resulting in increased process improvement ideas and activity.

While this study was limited to one company, applying this methodology could benefit any company experiencing the same difficulties.

This is one of the first studies to try and cost the benefits of LSS projects both from an organisational and generic viewpoint.

The reduction of costs has a more and more relevant role in the healthcare context, therefore, a large effort is done by health providers to this aim, for example, by reducing the length of hospital stay (LOS) of patients undergoing surgery. Fast track surgery fits perfectly this issue and was applied to patients undergoing knee replacement surgery due to Osteoarthritis, one of the most common diseases of aged population. The paper aims to discuss these issues.

Lean six sigma was applied to analyze the implementation of fast track surgery through the define, measure, analyze, improve, control roadmap, used as a typical problem-solving approach. It is characterized by five operational phases, which make possible the achievement of fixed goals through a rigorous process of defining, measuring, analyzing, improving and controlling business problems.

The corrective action, consisting in the application of fast track surgery, improved both effectiveness and efficiency of the process of care. The average length of hospital stay (LOS) was reduced from 8.34 to 6.68 days (–19.9 percent) and its standard deviation from 2.41 to 1.99 days (–17.1 percent). The statistical significance of this decrease was verified by means of proper tests. Moreover, some variables influencing the LOS were identified.

The follow up and the satisfaction of patients were not analyzed and could be a future development of this study.

Patients will experience a faster recovery while the hospital will benefit from a rise of available beds. The effect is a general improvement of hospital management.

The introduction of fast track surgery for patients undergoing knee replacement surgery made significantly reduce LOS and, consequently, costs’ with a money saving of more than 50,000 euro per year.