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This research aims to enhance the operational excellence and continuous improvement of the retail supply chain in the Saudi Thobe Factory through an integrated approach of Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control) with artificial intelligence (AI).

The study identified the tailoring department as the department with maximum defects by using voice of customer and critical to quality tools. An AI-integrated Six Sigma approach was applied to identify and eliminate nonproductive stages, and a new facility layout was designed to enhance productivity and customer satisfaction.

The use of the factor rating method and simulation using Arena software led to an improved sigma level from 1.597 to 2.237, representing an increment of about 40%. Additionally, the defects per million opportunities reduced from 461,538 to 230,769. The study can help production industry management to optimize facility layouts and improve overall production line efficiency.

This study addresses the lack of published research on the use of an integrated approach of Six Sigma DMAIC with AI in the retail and distribution sector of Saudi Arabia, particularly for small and medium-sized enterprises (SMEs). The study demonstrates how this approach may significantly boost SMEs’ performance and provides a basis for future research in this area.

This study provides a practical example of how an integrated approach of Six Sigma DMAIC with AI can be used in the retail and distribution sector of Saudi Arabia to enhance operational excellence and continuous improvement. The study highlights the potential benefits of this approach for SMEs in the region and provides a framework for future research.

The present environmental concern has enforced manufacturing firms to re-evaluate their business practices to reduce the adverse impact on the environment with optimum production. Therefore, the present study aims to deal with the implementation of the environmental lean six sigma (ELSS) framework in an Indian medical equipment manufacturing industry to obtain operational and environmental sustainability.

The proposed ELSS framework is based on the DMAIC (Define–Measure–Analyze–Improve–Control) methodology, sustainability and lean tools. The efficacy of the developed framework is tested through a case study in an Indian medical equipment manufacturing unit.

In the case company, four major issues were reported, i.e. improper material handling, non-productive movement of men and material, poor indoor air quality and rework. The ELSS project facilitates the case organization to enhance their capacity utilization from 59.25% to 74.3%, defects per million opportunities reduce from 309,523 to 48,951.44 and indoor air quality levels decrease from 156.87 to 86.85 µgm3.

The efficacy of the developed ELSS framework is evaluated through a case study conducted only in one Indian manufacturing environment.

The present study facilitates industrial managers and practitioners to achieve sustainability and process excellence through ELSS implementation. Organizations that intend to simultaneously improve operational and environmental performance can benefit from this paper as it can be used as a guide to conduct similar projects with both operational and environmental benefits.

This paper presents a successful implementation of the ELSS framework in the healthcare industry to achieve operational and environmental sustainability.

Continued quest for business improvement in terms of enhanced productivity and cost cuts is the most valued strategic function in an organization. Towards this endeavor, there have been evolutions of many problem-solving techniques like Lean, quality control (QC) tools, Six Sigma, total productive maintenance (TPM), etc. This paper introduces a different problem-solving methodology for quality improvement – prepare, measure, define, establish, control and stabilize (PMDECS) approach of Red Bin Analysis (RBA) – and presents empirical evidence of its effectiveness in eliminating the defectives at source (parts per million [PPM]) and improving the process capability (Cp).

An attempt has been made to compare RBA with the Six Sigma methodology in terms of number of defects, defectives, process capabilities, project duration, etc. Data validation with more than 2000 data points was conducted based on empirical data collected over multiple problem-solving projects conducted in six manufacturing industries of India to compare the effectiveness of both the methods. Finally, fuzzy AHP (analytical hierarchy process) model was proposed to identify the Quality Improvement Index for both the methods to address the manager’s dilemma in selecting an appropriate problem-solving method.

The paper provides empirical insights in establishing that the PMDECS approach of RBA is at par and sometimes better for problem-solving if the problem is not chronic and is at the initial stages, it requires less duration than Six Sigma projects and except casting process and it can yield better results in case of PPM rejection or Cp/Cpk improvement in other processes.

Because of the chosen research approach, the research results may lack generalizability. This research has been specifically conducted in automotive manufacturing industries. Therefore, researchers are encouraged to test the proposed propositions further.

The paper includes implications for the usage of alternative problem-solving methods, like PMDECS approach of RBA.

This paper intends to compare how the results of six sigma projects in manufacturing industries are effective against a different methodology, PMDECS approach of RBA.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

This research aims to conduct a literature review of Lean Six Sigma (LSS) in the Indian context and related research publications and apply bibliometric analysis and the author's visualization to map research trends in this area.

This article conducts a bibliometric analysis of LSS-related research in the Indian context using data gathered from Scopus and Web of Science databases from 2011 to 2022. The review provides information on LSS-related research in the Indian context and evaluates performance based on primary sources, authors, keywords, countries, affiliations, and documents. The analysis employs the Biblioshiny app and Bibliometrix R-tool for data analysis and scientific mapping.

The results of the bibliometric analysis indicate that the LSS culture has widely spread in India. The International Journal of Lean Six Sigma and Production Planning and Control were found to be the most productive sources for publishing LSS-related research articles. Antony J. was identified as the most active author in this field, contributing the most over the years. Among all organizations, NITs have conducted the most comprehensive research on LSS, indicating their significant investment of resources and efforts in studying this methodology and its applications in India. Additionally, the study examined the intellectual, social, and conceptual structures to identify implicit gaps and future research opportunities.

The findings of this study can inform academicians, researchers, practitioners, and policymakers about the state-of-the-art and the specifics of the most prolific studies. This study will facilitate their exploration of emerging research areas in LSS.

To the best of the authors knowledge, this is the first bibliometric analysis of LSS in the Indian context, providing an overview of relevant publications published between 2011 and 2022. This study analyzed 194 articles on LSS in India, which can help researchers and academics identify emerging research areas, suitable collaborators, and relevant journals for future publications.

Existing conceptual, empirical and case studies evidence suggests that manufacturing industries find the joint implementation of Kaizen philosophy initiatives. However, the existing practices rarely demonstrated in a single framework and implementation procedure in a structure nature. This paper, therefore, aims to develop, validate and practically test a framework and implementation procedure for the implementation of integrated Kaizen in manufacturing industries to attain long-term improvement of operational, innovation, business (financial and marketing) processes, performance and competitiveness.

The study primarily described the problem, extensively reviewed the current state-of-the-art literature and then identified a gap. Based on it, generic and comprehensive integrated framework and implementation procedure is developed. Besides, the study used managers, consultants and academics from various fields to validate a framework and implementation procedure for addressing business concerns. In this case, the primary data was collected through self-administered questionnaire, and 244 valid questionnaires were received and were analyzed. Furthermore, the research verified the practicability of the framework by empirically exploring the current scenario of selected manufacturing companies.

The research discovered innovative framework and six-phase implementation procedure to fill the existing conceptual gap. Furthermore, the survey-based and exploratory empirical analysis of the research demonstrated that the practice of the proposed framework based on structured procedure is valued and companies attain the middling improvements of productivity, delivery time, quality, 5S practice, waste and accident rate by 61.03, 44, 52.53, 95.19, 80.12, and 70.55% respectively. Additionally, the companies saved a total of 14933446 ETH Birr and 5,658 M² free spaces. Even though, the practices and improvements vary from company to company, and even companies unable to practice some of the unique techniques of the identified CI initiatives considered in the proposed framework.

All data collected in the survey came from professionals working for Ethiopian manufacturing companies, universities and government. It is important to highlight that n = 244 is high sample size, which is adequate for a preliminary survey but reinforcing still needs further survey in terms of generalization of the results since there are hundreds of manufacturing companies, consultants and academicians implementing and consulting Kaizen. Therefore, a further study on a wider Ethiopian manufacturing companies, consultants and academic scale would be informative.

This work is very important for Kaizen professionals in the manufacturing industry, academic and government but in particular for senior management and leadership teams. Aside from the main findings on framework development, there is some strong evidence that practice of Kaizen resulted in achieving quantitative (monetary and non-monetary) and qualitative results. Thus, senior management teams should use this research out to practice and analyze the effect of Kaizen on their own organizations. Within the academic community, this study is one of the first focusing on development, validating and practically testing and should aid further study, research and understanding of Kaizen in manufacturing industries.

So far, it is rare to find preceding studies proposed, validated and practically test an integrated Kaizen framework with the context of manufacturing industries. Thus, authors understand that this is the very first research focused on the development of the framework for manufacturing industries continuously to be competitive and could help managers, institutions, practitioners and academicians in Kaizen practice.

The purpose of this study is to propose the implementation of Lean Six Sigma (LSS) framework in supply chain by providing an actual case study of how to reduce the logistics cost.

In this paper, it is shown how LSS approach, basic tools and Define, Measure, Analyze, Improve and Control methodology can significantly improve a company by enhancing the supply chain and reducing the logistics expenditures.

Root causes to the main problem of this study were analyzed to identify appropriate solutions. After the implementation of solutions, the company’s product quality and internal communication were improved. Correspondingly, the percentage of customer orders that have to be transported by road instead of maritime reduced to 5% from 13% and the percentage of the road transportation cost paid unnecessarily by the company decreased to 1% from 5%.

This case study provides a roadmap and step-by-step implementation of LSS framework for especially companies in plastics industry.

To the best of the author’s knowledge, this paper is the first example of a LSS case study conducted in Turkey to improve the supply chain of a company by targeting primarily a reduction on logistics costs.

This study examines the research landscape of Lean Six-Sigma (LSS) applications in hospitals for the period of the last decade (2011–2020) to derive answers to the research questions RQ 1: What are the current publication trends for the application of LSS in hospitals concerning document type, Journal (Source), active authors and country-wise publications and their comparison in the two most reputed scientific databases, i.e. Scopus and Web of Science (WoS), RQ2: What are the clusters based on the authors and keywords? RQ3: What are the research trends and author's productivity in LSS applications in Hospitals? RQ4: What are the future research areas?

This article compares these two databases (Scopus and WoS) based on publication pattern, document type, active authors and co-citation analysis. This article analyzes the core sources, author's productivity, globally cited articles, word growth analysis, thematic map and world collaboration map on the WoS and Scopus dataset. The software used are Vosviewer, Biblioshiny (R Package for Bibliometric) and M.S. Excel.

The application of LSS in hospitals is a niche theme. In the WoS database International Journal of Lean Six-Sigma and in Scopus database International Journal of Health Care Quality Assurance are the most relevant sources publishing research articles in this field. The USA has the highest scientific production in this field. Among the authors, Antony J is the most active author in this area, with the highest contribution over the years.

This study fills the literature gap by mapping the field of LSS in hospitals.

The purpose of this study is to present the systematic literature review (SLR) on Lean Six Sigma (LSS) by exploring the state of the art on growth of literature on LSS within the manufacturing sector, critical factors to implement LSS, the role of LSS in the manufacturing sector from an implementation and sustainability viewpoint and Industry 4.0 viewpoints while highlighting the research gaps.

An SLR of 2,876 published articles extracted from Scopus, WoS, Emerald Insight, IEEE Xplore, Taylor & Francis, Springer and Inderscience databases was carried out following the protocol of systematic review. In total, 154 articles published in different journals over the past 10 years were selected for quantitative and qualitative analysis which revealed a number of research gaps.

The findings of the SLR revealed the growth of literature on LSS within the manufacturing sector. The review also highlighted the most cited critical success factors, critical failure factors, performance indicators and associated tools and techniques applied during LSS implementation. The review also focused on studies related to LSS and sustainability viewpoint and LSS and Industry 4.0 viewpoints.

The findings of this SLR can help senior managers, practitioners and researchers to understand the current developments and future requirements to adopt LSS in manufacturing sectors from sustainability and Industry 4.0 viewpoints.

Academic publications in the context of the role of LSS in various research streams are sparse, and to the best of the authors’ knowledge, this paper is one of the first SLRs which explore current developments and future requirements to implement LSS from sustainability and Industry 4.0 perspective.

Generic quality management system standard ISO 9001 and the automotive quality management system standard IATF 16949 both require organisations to demonstrate continual improvement in their customer satisfaction and the number of non-conformities identified during quality system audits. However, the long-term trends of these two parameters under ISO 9001 and IATF 16949 standards are not researched so far. It is expected that under continual improvement, organisations will achieve a step-function/stair-case shaped pattern. This study evaluates if this expectation is true when long-term performance of certified organisations is assessed.

A longitudinal exploration of three organisations certified to ISO 9001 standard and three certified to IATF 16949 standard is done. The observations are further substantiated using secondary data for the same ten years period about customer satisfaction of the major automobile manufacturers.

It is observed that none of the two indicators, i.e. the customer satisfaction and number of non-conformities, in any of the six organisations show step-wise/stair-case type improvement. All indicators followed random up and down patterns like ocean waves. It is paradoxical that certified organisations are claiming continual improvement and are remaining certified but there is actually no long-term improvement.

Longitudinal studies for the generic quality management standard ISO 9001 and the quality system standard for automotive sector IATF 16949 are rare. The revelation about ocean wave patterns observed in the long-term trends for customer satisfaction and the number of non-conformities in ISO 9001 and IATF 16949 certified organisations is a startling finding. It is outlandishly different from the conventional perception of a staircase-styled continual improvement pattern expected a priori in certified organisations.