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The purpose of this paper is to illustrate the use of Lean Six Sigma (LSS) and its associated tools to reduce dispensing errors in an inpatient pharmacy of a teaching hospital in Thailand.

The action research methodology was used to illustrate the implementation of Lean Six Sigma through the collaboration between the researcher and participants. The project team followed the Lean Six Sigma Define, Measure, Analyze, Improve, Control (DMAIC) methodology and applied its tools in various phases of the methodology.

The number of dispensing errors decreased from 6 to 2 incidents per 20,000 inpatient days per month between April 2018 and August 2019 representing a 66.66% reduction. The project has improved the dispensing process performance resulting in dispensing error reduction and improved patient safety. The communication channels between the hospital pharmacy and the pharmacy technicians have also been improved.

This study was conducted in an inpatient pharmacy of a teaching hospital in Thailand. Therefore, the findings from this study cannot be generalized beyond the specific setting. However, the findings are applicable in the case of similar contexts and/or situations.

This is the first study that employs a continuous improvement methodology for the purpose of improving the dispensing process and the quality of care in a hospital. This study contributes to an understanding of how the application of action research can save patients' lives, improve patient safety and increase work satisfaction in the pharmacy service.

Medication errors are a significant cause of injury in Norwegian hospitals. The purpose of this study is to explore how Lean Six Sigma (LSS) has been used in the Norwegian public health-care context to reduce medication errors.

A mixed method approach was used to gather data from participants working in the four regions served by the Norway health authorities. A survey questionnaire was distributed to 38 health-care practitioners and semi-structured interviews were conducted with 12 health-care practitioners.

The study finds that the implementation of LSS in the Norwegian public health-care context is still in its infancy. This is amidst several challenges faced by Norwegian hospitals such as the lack of top-management support, lack of LSS training and coaching and a lack of awareness around the benefits of LSS in health care.

Because of the large geographical area, it was difficult to reach participants from all health regions in Norway. However, the study managed to assess the current status of LSS implementation through the participants’ perspectives. This is a fruitful area for future research whereby an action research methodology could be used.

To the best of the authors’ knowledge, this is the first empirical study into the use of LSS methodology in reducing medication errors. In addition, this study is valuable for health-care practitioners and professionals as a guideline to achieve the optimal benefit of LSS implementation to reduce medication errors.

The purpose of this paper is to evaluate the limitations and emerging trends of Six Sigma through an empirical study. Six Sigma is one of the most powerful business process improvement strategies used by numerous World Class corporations for over three decades. A handful of existing publications address some limitations and potential trends of Six Sigma, yet there are no empirical studies investigating the fundamental limitations and emerging trends of Six Sigma.

The authors developed an online survey instrument based on the existing literature addressing the above. In this study, 61 Six Sigma Master Black Belts and Black Belts from large manufacturing companies and 25 academics who are familiar with the Six Sigma topic participated and contributed to the research.

The study reports the top 5 limitations and emerging trends of Six Sigma from the viewpoints of both academics and experts from large manufacturing companies. These are: integration of Six Sigma with Big Data, use of Six Sigma in small medium and micro enterprises, over emphasis of Six Sigma on variability reduction, poor implementation of Six Sigma and its negative impact on employee satisfaction and non-exploitation of integration of Six Sigma with Industry 4.0.

In order to sustain Six Sigma initiatives, it is imperative that limitations and fundamental gaps are understood, and strategies developed to address them. The authors argue that leading academic scholars have a vital role to play in working with industry practitioners to overcome the limitations and emerging trends addressed above.

To the best of the authors’ knowledge, this is the first empirical study looking into the limitations, research gaps and emerging trends of Six Sigma.

Process improvement initiatives, such as Lean, Six Sigma and Lean Six Sigma, typically have common characteristics that are carried through projects. Whilst a project’s performance is an important determinant of the successful implementation of continuous improvement (CI) initiatives, its failure can undermine the impact of any CI initiative on business performance. As a result, an understanding of the reasons of process improvement project failures is crucial. The purpose of this paper is to present the results of a pilot survey highlighting the most common reasons for process improvement project failures.

This paper presents a pilot survey of 42 Brazilian manufacturing specialists who have been involved in process improvement projects. The participants of this survey were Six Sigma Master Black Belts, Black Belts, Green Belts and Six Sigma champions from manufacturing companies in Brazil. The survey questionnaire was piloted with five experts in the field in order to ensure that the questions were valid and technically sound.

The execution of Six Sigma projects in organizations results in a moderate rate of project failures. These failures can cost organizations several millions of dollars especially within the context of larger organizations. The main reasons for project failure, as cited by the specialists include: resistance to change, lack of commitment and support from top management and incompetent teams.

The authors report the findings from a pilot survey having a limited sample size. Moreover, the data have been collected from one country and primarily from large manufacturing companies.

To the best of the authors’ knowledge, this is the first empirical study looking into the reasons for process improvement project failures. The authors argue that if the top reasons for such failures are understood, a framework can be developed in the future that can mitigate the chance of project failures during project execution. This could potentially lead to significant savings to the bottom-line of many organizations.

The purpose of this paper is to critically review the context of adult protection in Ireland with a focus on older people. The paper traces advances and current limitations in policy, regulation, practice and legislation.

A review of historical and current contexts in adult safeguarding in Ireland is presented with consideration of key public reviews and commentaries related to care provision, governance and the legislative status of adults at risk.

While Ireland’s journey to provide adult safeguarding responses for older people has progressed since 2002, there remain many gaps. Further work needs to be addressed urgently to enable a comprehensive alignment of fit-for-purpose, responsive legislation, practice and policy to meet the complex and diverse needs of an increasing ageing population who may require safeguarding support. This includes fostering robust inter-sectorial collaboration, safeguarding legislation and cultural change related to human rights approaches.

The paper is a discussion on the context of adults safeguarding in relation to practice, policy and legislation.

Identifies the need for significant reform in the Irish system of health service. Argues for an overarching, inter-sectorial approach to addressing adult safeguarding, which focuses on prevention as well as early intervention.

The paper offers a review of the current diverse elements comprising current adult safeguarding and older people in Ireland and integrates legislative, regulatory, policy and practice realities. Challenges are illustrated within the context of reactive rather than proactive safeguarding agendas which are linked to public scandals and debates. The paper argues for a more integrated and robust inter-sectorial approach to safeguarding underpinned by adult safeguarding legislation and an overarching governance structure.