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This paper explores Lean Six Sigma principles and the DMAIC (define, measure, analyze, improve, control) methodology to propose a new Lean Six Sigma 4.0 (LSS 4.0) framework for employee occupational exams and address the real-world issue of high-variability exams that may arise.

This study uses mixed methods, combining qualitative and quantitative data collection. A detailed case study assesses the impact of LSS interventions on the exam management process and tests the applicability of the proposed LSS 4.0 framework for employee occupational exams.

The results reveal that changing the health service supplier in the explored organization caused a substantial raise in occupational exams, leading to increased costs. By using syntactic interoperability, lean, six sigma and DMAIC approaches, improvements were identified, addressing process deviations and information requirements. Implementing corrective actions improved the exam process, reducing the number of exams and associated expenses.

It is important to acknowledge certain limitations, such as the specific context of the case study and the exclusion of certain exam categories.

The practical implications of this research are substantial, providing organizations with valuable managerial insights into improving efficiency, reducing costs and ensuring regulatory compliance while managing occupational exams.

This study fills a research gap by applying LSS 4.0 to occupational exam management, offering a practical framework for organizations. It contributes to the existing knowledge base by addressing a relatively novel context and providing a detailed roadmap for process optimization.

Output from the Irish Dairy Industry has grown rapidly since the abolition of quotas in 2015, with processors investing heavily in capacity expansion to deal with the extra milk volumes. Further capacity gains may be achieved by extending the processing season into the winter, a key enabler for which being the reduction of duration of the winter maintenance overhaul period. This paper aims to investigate if Lean Six Sigma tools and techniques can be used to enhance operational maintenance performance, thereby releasing additional processing capacity.

Combining the Six-Sigma Define, Measure, Analyse, Improve, Control (DMAIC) methodology and the structured approach of Turnaround Maintenance (TAM) widely used in process industries creates a novel hybrid model that promises substantial improvement in maintenance overhaul execution. This paper presents a case study applying the DMAIC/TAM model to Ireland’s largest dairy processing site to optimise the annual maintenance shutdown. The objective was to deliver a 30% reduction in the duration of the overhaul, enabling an extension of the processing season.

Application of the DMAIC/TAM hybrid resulted in process enhancements, employee engagement and a clear roadmap for the operations team. Project goals were delivered, and original objectives exceeded, resulting in €8.9m additional value to the business and a reduction of 36% in the duration of the overhaul.

The results demonstrate that the model provides a structure that promotes systematic working and a continuous improvement focus that can have substantial benefits for wider industry. Opportunities for further model refinement were identified and will enhance performance in subsequent overhauls.

To the best of the authors’ knowledge, this is the first time that the structure and tools of DMAIC and TAM have been combined into a hybrid methodology and applied in an Irish industrial setting.

This article aims to optimise energy use and consumption by integrating Lean Six Sigma methodology with the ISO 50001 energy management system standard in an Irish dairy plant operation.

This work utilised Lean Six Sigma methodology to identify methods to measure and optimise energy consumption. The authors use a single descriptive case study in an Irish dairy as the methodology to explain how DMAIC was applied to reduce energy consumption.

The replacement of heavy oil with liquid natural gas in combination with the new design of steam boilers led to a CO₂ footprint reduction of almost 50%.

A further longitudinal study would be useful to measure and monitor the energy management system progress and carry out more case studies on LSS integration with energy management systems across the dairy industry.

The novelty of this study is the application of LSS in the dairy sector as an enabler of a greater energy-efficient facility, as well as the testing of the DMAIC approach to meet a key objective for ISO 50001 accreditation.

Data-driven quality management systems, brought about by the implementation of digitisation and digital technologies, is an integral part of improving supply chain management performance. The purpose of this study is to determine a methodology to aid the implementation of digital technologies and digitisation of the supply chain to enable data-driven quality management and the reduction of waste from manufacturing processes.

Methodologies from both the quality management and data science disciplines were implemented together to test their effectiveness in digitalising a manufacturing process to improve supply chain management performance. The hybrid digitisation approach to process improvement (HyDAPI) methodology was developed using findings from the industrial use case.

Upon assessment of the existing methodologies, Six Sigma and CRISP-DM were found to be the most suitable process improvement and data mining methodologies, respectively. The case study revealed gaps in the implementation of both the Six Sigma and CRISP-DM methodologies in relation to digitisation of the manufacturing process.

Valuable practical learnings borne out of the implementation of these methodologies were used to develop the HyDAPI methodology. This methodology offers a pragmatic step by step approach for industrial practitioners to digitally transform their traditional manufacturing processes to enable data-driven quality management and improved supply chain management performance.

This study proposes the HyDAPI methodology that utilises key elements of the Six Sigma DMAIC and the CRISP-DM methodologies along with additions proposed by the author, to aid with the digitisation of manufacturing processes leading to data-driven quality management of operations within the supply chain.

Head and neck cancers are multi-factorial diseases that can affect many sides of people's life and are due to a lot of risk factors. According to their characteristics, the treatment can be surgical, use of radiation or chemotherapy. The use of a surgical treatment can lead to surgical infections that are a main theme in medicine. At the University hospital of Naples “Federico II”, two antibiotics were employed to tackle the issue of the infections and they are compared in this paper to find which one implies the lowest length of hospital stay (LOS) and the reduction of infections.

The Six Sigma methodology and its problem-solving strategy DMAIC (define, measure, analyse, improve, control), already employed in the healthcare sector, were used as a tool of a health technology assessment between two drugs. In this paper the DMAIC roadmap is used to compare the Ceftriaxone (administered to a group of 48 patients) and the association of Cefazolin plus Clindamycin (administered to a group of 45 patients).

The results show that the LOS of patients treated with Ceftriaxone is lower than those who were treated with the association of Cefazolin plus Clindamycin, the difference is about 41%. Moreover, a lower number of complications and infections was found in patients who received Ceftriaxone. Finally, a greater number of antibiotic shifts was needed by patients treated with Cefazolin plus Clindamycin.

While the paper enhances clearly the advantages for patients' outcomes regarding the LOS and the number of complications, it did not analyse the costs of the two antibiotics.

Employing the Ceftriaxone would allow the Department of Maxillofacial Surgery to obtain lower LOS and a limited number of complications/infections for recovered patients, consequently reducing the hospitalization costs.

There is a double value in this paper: first of all, the comparison between the two antibiotics gives an answer to one of the main issues in medicine that is the reduction of hospital-acquired infections; secondly, the Six Sigma through its DMAIC cycle can be employed also to compare two biomedical technologies as a tool of health technology assessment studies.

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.

This study aims to utilise Six Sigma in an Irish-based red meat processor to reduce process variability and improve yields.

This is a case study within an Irish meat processor where the structured Define, Measure, Analyse, Improve and Control (DMAIC) methodology was utilised along with statistical analysis to highlight areas of the meat boning process to improve.

The project led to using Six Sigma to identify and measure areas of process variation. This resulted in eliminating over-trimming of meat cuts, improving process capabilities, increasing revenue and reducing meat wastage. In addition, key performance indicators and control charts, meat-cutting templates and smart cutting lasers were implemented.

The study is one of Irish meat processors' first Six Sigma applications. The wider food and meat processing industries can leverage the learnings to understand, measure and minimise variation to enhance revenue.

Organisations can use this study to understand the benefits of adopting Six Sigma, particularly in the food industry and how measuring process variation can affect quality.

This is the first practical case study on Six sigma deployment in an Irish meat processor, and the study can be used to benchmark how Six Sigma tools can aid in understanding variation, thus benefiting key performance metrics.

This paper outlines how Design for Lean Six Sigma methods aided a medical device manufacturing company in developing a new strategic space management and approval process for its manufacturing site.

The project demonstrates the application of the Design for Lean Six Sigma and structured Define, Measure, Analyse, Design, and Verify methodology in designing and implementing a process that enables the case study manufacturing site to improve its space utilisation and free up space.

The project was validated in one manufacturing department, and the Design for Lean Six Sigma methodology resulted in creating 15% new space for that area, with opportunities identified to free up 44.7% of the total manufacturing floor space and realise over €2.2 million cost savings as well as start to manufacture new products launched.

The manuscript highlights for the first time how the Design for Lean Six Sigma methodology can be utilised for space utilisation and can be leveraged by other manufacturers. The current study's limitations are that it is a single-site case study application. Future longitudinal case studies on Design for Lean Six Sigma application in more manufacturing space utilisation projects would be useful. This study has implications for identifying best practices for Design for Lean Six Sigma methodology application in the device industry, thus improving the state of the art for introducing new manufacturing lines.

This is the first published work to utilise Design for Lean Six Sigma methodology for space utilisation in a medical device company. This review will provide medical devices and other manufacturing organisations with recommendations on utilising Design for Lean Six Sigma and design for improved space utilisation to reduce costs.

One of the biggest challenges in the health sector is that of costs compared to economic resources and the quality of services. Hospitals register a progressive increase in expenditure due to the aging of the population. In fact, hip and knee arthroplasty surgery are mainly due to primary osteoarthritis that affects the elderly population. This study was carried out with the aim of analysing the introduction of the fast track surgery protocol, through the lean Six Sigma, on patients undergoing knee and hip prosthetic replacement surgery. The goal was to improve the arthroplasty surgery process by reducing the average length of stay (LOA) and hospital costs

Lean Six Sigma was applied to evaluate the arthroplasty surgery process through the DMAIC cycle (define, measure, analyse, improve and control) and the lean tools (value stream map), adopted to analyse the new protocol and improve process performance. The dataset consisted of two samples of patients: 54 patients before the introduction of the protocol and 111 patients after the improvement. Clinical and demographic variables were collected for each patient (gender, age, allergies, diabetes, cardiovascular diseases and American Society of Anaesthesiologists (ASA) score).

The results showed a 12.70% statistically significant decrease in LOS from an overall average of 8.72 to 7.61 days. Women patients without allergies, with a low ASA score not suffering from diabetes and cardiovascular disease showed a significant a reduction in hospital days with the implementation of the FTS protocol. Only the age variable was not statistically significant.

The introduction of the FTS in the orthopaedic field, analysed through the LSS, demonstrated to reduce LOS and, consequently, costs. For each individual patient, there was an economic saving of € 445.85. Since our study takes into consideration a dataset of 111 patients post-FTS, the overall economic saving brought by this study amounts to €49,489.35.