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The purpose of this paper is to assess causal relations between the implementation of the 5S approach and the reduction of patients’ waiting time at out patient departments (OPDs) of hospitals in Tanzania.

Patients’ waiting time was measured under the cluster randomized control trial (c-RCT). In all, 16 hospitals were chosen and divided into treatment and control groups using block randomization. Before the intervention, a baseline study was conducted at OPDs in all 16 hospitals. After one year of the intervention, the end-line study was carried out in both the groups. A comparison of the average waiting time reduction and Difference-in-Difference (DID) analysis was carried out to see the effect of the 5S approach on the reduction of patients’ waiting time.

Statistical significance in reduction of patients’ waiting time was seen in the medical records sections (p=0.002) and consultation rooms (p=0.020) in the intervention group. The same trend was also seen using DID analysis (−15.66 min in medical record, −41.90 min in consultation rooms).

This study has the following limitations in terms of the data. The data were collected for only three days at the time of baseline survey, and again for three days at the time of the end-line survey from 16 hospitals. Moreover, piloted areas for the implementation of the 5S approach vary from hospital to hospital. There might be a bias in the measurement of a patient’s waiting time. Caveats are therefore needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for implementing quality improvement programs in Tanzania and in other African countries for improvement of time factors.

This study used c-RCT, and has proven the effectiveness of the 5S approach in improving the working environment and reducing patients’ waiting time at OPDs in several hospitals at district level in Tanzania.

The purpose of this paper is to identify factors that influence the implementation of the rollout of the 5S approach in public hospitals in Tanzania, and share the way to scale this up for similar setting in developing countries.

The effect size was calculated from pre- and post-assessment results of Training of Trainers (ToT) to examine the effectiveness of ToT. A questionnaire with 14 explanatory variables was developed and completed based on information collected during Consultation visits (CVs) and progress report meetings (PRMs). Then, data were analysed to identify the influencing factors in relation to outcome variables (CV average score).

Among 14 explanatory variables, five explanatory variables showed statistical significant association with the CV average score. Those are: “Feedback and information sharing,” (p=0.031), “Quality Improvement Team roles and responsibility” (p=0.002), “5S knowledge,” “Involvement and commitment,” and “5S guidelines use and availability,” (p=0.000). When the explanatory variables were controlled by levels of hospitals; “involvement and commitment” was the only explanatory variable for national level hospitals. For regional referral hospitals, “QIT roles and responsibility” (p=0.02) and “5S knowledge” (p=0.03) were statistically significant. For district hospitals, “involvement and commitment” (p=0.01) and “availability of guideline (p=0.001)” were statistically significant.

This study has the following limitations. The data were collected from existing reports and presentation materials only. There might be reporting bias, as PRM data is self-reported from the hospitals. Caution is therefore needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for designing and implementing QI programs in Tanzania and in other African countries.

The authors' conceptual framework is based on the existing literature on the science of diffusion and scale up of innovation in the health sector. Few studies are known from resource constrain settings in Africa which assess the determinants of the process of nationwide scale-up of proven interventions.

Building on previous studies of the managerial application and development of the 5S concept (5S), this research aims to identify and present key concepts of 5S from a Japanese management perspective. These findings link 5S to aspects of Japanese management approach, which are aligned to an integrated management system rather than a simple management tool or technique.

Data were collected from Japanese companies that use 5S as a core management approach and use their organisational web sites to disseminate information in regard to this practise. The data were examined by the use of computer‐aided lexical analysis (Leximancer), which provided an insight into the nature of 5S within the original Japanese context.

The research found several key concepts behind the Japanese approach to 5S management. These findings demonstrate the importance of both the technical (visible) and philosophical (invisible) approaches required for each of the 5S components and are discussed in a managerial rather than cultural framework.

The findings are important both theoretically and practically as they provide insight into the meaning and logic, applied to the application of the 5S management approach within its original environmental context.

The originality and value of the paper is derived from the holistic understanding of the application of 5S and its use as a problem‐solving intervention at the system or process level; a necessary initiating point within lean management philosophies. 5S within the context identified is the strategic platform for the managerial decisions required for the development of an integrated management system.

The purpose of this paper is to present the comprehensive literature review on 5S and suggest possible gaps from the point of view of researchers and practitioners. The manuscript presents the overview of 5S implementation and highlights the achievements realized from deployment of 5S initiatives for sustainable performance of organizations.

The paper critically examines the literature on 5S, analyzes and reviews it systematically. The study highlights the critical barriers and success factors for sustainable 5S implementation in the organizations in the competitive world.

5S is an outstanding Japanese philosophy for the development of any type organization all over the world. This study bring out the concept of 5S, requirements for its holistic implementation, relationship with other lean tools, benefits, success factors and obstacles in 5S implementation. The significant contributions through 5S initiatives in the organization like production, quality, safety and effective utilization of workspace for the sustained organizational improvement have also been highlighted in the study.

The literature on assortment of 5S technique has been so far very limited. The present paper reviews large number of research publications related to 5S to highlight the significance of 5S philosophy in the sustainable organizational improvement across the world. It foregrounds the approach advised by the various researchers, practitioners and appraises censoriously the reason behind the demand of 5S program in the organization. The needful steps and obstacles are also foreground for the effective implementation of 5S in the organization.

The paper presents a comprehensive review of literature publications in the area of 5S and their assortment to develop an understanding of the significance and implementation of 5S in the organizations. The paper will be helpful or useful to researchers, safety executives, development professionals and managers in the organizations.

The purpose of this study is to see how the 5S-KAIZEN-TQM approach can contribute to improve the management of healthcare waste (HCW) in the regional level public hospitals in Tanzania.

This study employed an explanatory case study framework and focused on improvement of HCW management by assessing the information obtained through the direct observation and systematic interviewing during the consultation visits and external hospital performance assessment (EHPA) and the self-administrated questionnaires as sources of evidence.

Based on the observations, 100% adoption of the 5S approach was observed in 25 of 28 regional referral hospitals (RRHs). At these RRHs, segregation of HCW management has been improved by applying color codes and symbols for establishing self-explanatory system on proper segregation. In addition, seven out of 28 RRHs applied the KAIZEN process and reduced occurrences of improper waste segregation.

This study has the following limitations in terms of the information. The data were collected through the direct observation. Moreover, areas for the implementation of the KAIZEN vary from hospital to hospital, and only 25% of RRHs completed the KAIZEN processes for improvement of HCW management. Caveats are, therefore, needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for implementing the 5S-KAIZEN approach in Tanzania and other African countries for improvement of HCW management.

This is an original study to provide evidence about the usefulness of the 5S-KAIZEN-TQM approach for improving HCW management in a low-income country in Africa.

This paper's purpose is to help a scientific equipment company make use of the 5S tool on the shop floor so that the organization can become progressively beneficial and increasingly productive.

The organization has adopted a simple approach for making a suitable team for 5S tool implementation at the workplace. After that, they have used three types of data-collection methods so that these methods could help in the correct introduction of the 5S tool in the business workplace. They have also analysed the regression analysis with the genetic algorithm for the audit scores to predict the behaviour of 5S implementation in the coming weeks.

In this case study, it has been found after the suitable analysis that the 5S tool implementation has resulted in the overall benefits of the workplace. The major benefit achieved with the 5S tool is that the searching time for the tool in the workplace has been improved significantly. Also, the safety level is increased. The 5S audit has been carried out in the workplace and the audit score has been improved from the level of 6 scores (in week 1) to 72 score (in week 24).

5S tool has emerged as an incredible asset and it tends to be actualized in any of the ventures whether it is of a miniature, small, medium or large scale industry. The 5S tool can be applied horizontally at a large scale and it can be applied to almost all the workstations in the workplace.

The presented productions and contextual investigation for the 5S tool will be helpful and useful for all the analysts, experts and all other people who are worried about this subject of the 5S tool and its implementation in the organization.

The purpose of this study is to evaluate the role of 5S initiatives as a facilitator of accruing business excellence in the manufacturing organizations.

The study involves empirical investigation of 92 manufacturing organizations to evaluate the contributions of 5S initiatives toward accruing business performance excellence in the respondent organizations. The study involves nine significant stimulants for 5S implementation and seven crucial performance parameters leading to realization of business excellence in manufacturing organizations.

The results clearly indicate close association between the significant nine stimulants for 5S implementation and seven crucial business excellence performance parameters. The study also establishes that 5S initiatives can significantly facilitate achievement of business excellence in the manufacturing organizations.

The study deploys various statistical and validation techniques to evaluate the contributions of effective 5S approach as a facilitator for accruing business excellence in manufacturing organizations.

The purpose of this paper is to evaluate the capabilities of 5S program to meliorate the different competitive dimensions of manufacturing organizations and extracts the various significant factors which influence its successful implementation.

The paper involves empirical study of responses collected from various manufacturing organizations to investigate the inter-relationships between various 5S implementation success factors and competitive dimensions parameters through different statistical techniques. The study deploys Bonferroni post hoc test to establish the statistical significance of competitive dimensions improvements, progressively accrued over a reasonable period of time, through holistic 5S implementation.

The study validates the contributions of 5S program toward realization of significant improvements of various competitive dimensions such as overall organizational achievements, production achievements, quality and continuous improvement achievements, cost optimization achievements, employee-related achievements, effective workplace utilization and safety enhancement achievements accrued by Indian manufacturing organizations. Finally the discriminant validity test has been used in the study for classifying highly successful and moderately successful organizations.

The research aims to empirically test the relationships among various 5S implementation constructs and competitive dimensions parameters constructs in manufacturing organizations. The research work establishes that 5S initiatives have effectively contributed for realization of significant competitive dimensions, progressively from introduction to maturity phases. The research highlights the key significant implications for manufacturing managers.

The current good manufacturing practices (cGMP) are followed in the pharmaceutical sector to ensure that products are consistently produced and controlled to the appropriate quality standards as required by the marketing agencies. The purpose of this paper is to share improvement experiences due to implementation of lean principles combined with cGMP in a pharmaceutical company.

To conduct the study, an intensive review of literature has been conducted. For analysis of the problems existing in the selected production line, the 5‐whys methodology was followed. The current state value stream map (VSM) has been developed after making several company visits and necessary computations. For improvement of the system, various lean strategies have been proposed and the future state VSM developed.

The methodology assisted this company in reducing lead times, cycle times and WIP inventory in the manufacturing process. Furthermore, the storage area was reduced by 38 per cent and production staff was reduced by 50 per cent.

The prime purpose of a lean strategy is to eliminate wastes and to search for continuous improvement in processes. The proposed lean strategies indicated scope for improvement in production efficiency and effectiveness of manufacturing operations.

The guiding principle of cGMP is that quality is built into a product, and not just tested into a finished product. This paper makes several contributions to the pharmaceutical manufacturing company. The proposed lean strategies are considered to be highly valuable for implementation in similar manufacturing industries.

The purpose of this paper is to investigate England’s Accident and Emergency (A&E) portion of the National Health Service (NHS). This paper is based upon weekly published data from A&E trusts across England, spanning from November 2010 to December 2014.

Emphasis is placed on a number of variables; month (time of year), performance (patients seen in less than four hours), patient volume and exploring the relationship between these variables. A deductive approach has been selected as the most appropriate for this paper and the format of a correlational study. Lean will be discussed as a philosophy throughout this paper, as a means to improve the NHS.

The NHS’s success in reaching its 95 per cent performance objective has in a gradual downwards trend since the data started being published and the volume of patients seen in A&E is trending upwards. However, there is only a weak relationship between these variables, suggesting that peak in demand are effectively foretasted by the NHS and appropriate resources deployed to combat this. Additionally, there is a clear relationship between the time of year (month) and volume.

The data used are not broken down and are aggregated from A&E departments across the NHS in England. Therefore, outliers could be present that impact the data and results. Should outliers exist, these should be targeted for improvement or to be learnt from, depending on their ranking.

Should the NHS continue with their Lean transformation, it is believed that efficiency will improvement throughout the organisation.

Through the identification of volume trends better care and efficiency can be provided to patients visiting the A&E departments of the NHS.

This paper analyses data over the past four years which can be used to spot past trends and predict future trends, therefore smoothing the reliability and quality of the care offered to patients. This can be achieved through a Lean transformation and a flexible resourcing approach.