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Although Lean Six Sigma (LSS) has been widely accepted today by more than 70 per cent Fortune 500 companies, its applications in the public sector are not widely observed and reported due to a number of challenges. The purpose of this paper is to present some of the fundamental challenges in the deployment of LSS within the higher education (HE) context.

The author uses primary data in the form of opinions or viewpoints from leading academics and parishioners around the world. The viewpoints were collected carefully to have a good balance between the leading academics and the LSS practitioners.

The challenges of LSS implementation in HE can be classified into three categories: organisational, technical and individual challenges. Lack of visionary leadership for LSS journey from top management team in the HE sector makes the deployment a total failure. The difficulty of defining and measuring quality in a HE setting along with collecting relevant and accurate data can be an immense technical challenge in any university sector. Moreover the lack of staff engagement, full academic freedom and autonomy will be a personal challenge for those who are involved in the business process improvement initiative such as LSS.

Due to limited time constraints, the number of people participated in the study was relatively small. However, the author argues that this study can provide a good foundation to various researchers and practitioners in further exploring the challenges in the implementation and deployment of LSS in any HE setting.

The findings of the study can be very useful to those who get involved in the application of LSS principles for improving the efficiency and effectiveness of HE processes.

This paper makes an attempt to reveal some of the rudimentary challenges in the deployment of LSS within the HE setting. These challenges should be taken into account when any HE sector embarks on the LSS initiative.

In the evolving landscape of Industry 5.0 (I5.0), which emphasises sustainability, human-centricity and resilience, mapping the current interrelationship and future research directions, the role of Lean Six Sigma (LSS) methodology remains underexplored. Our study addresses this gap by examining the potential of LSS to support I5.0 while identifying areas for further investigation.

This study's multifaceted approach, which includes systematic literature review (SLR), bibliographic network analysis (BNA) and expert validation (EV), provides a holistic exploration of the interaction between LSS and I5.0 as the basis for well-founded conclusions.

The analysis yields several valuable insights. Firstly, it demonstrates the absence of a direct link between LSS and I5.0. Secondly, the substantial body of literature analysed establishes connections between LSS and its pillars. Thirdly, the analysis identifies points of intersection, difference and similarity between LSS and I5.0, highlighting the potential of LSS to facilitate implementation of I5.0 through its proven methodologies, continuous improvement culture, risk management, error learning, human–machine collaboration and training and skill development.

This study pioneers the effort to realise the latent potential of LSS in the context of I5.0. Its systematic identification of the synergies between these paradigms fills a critical gap in the literature and gives policymakers, managers and researchers a guide for informed decision-making to maximise the benefits of I5.0 for individuals, companies, society and the planet.

Health-care organisations face many challenges in delivering safe, high-quality services while experiencing significant pressure to increase productivity and reduce costs. In this context, hospitals have implemented lean six sigma (LSS) programmes to improve their performance. This study aims to explore the application of LSS in three different non-profit Ecuadorian hospitals to comprehend the effectiveness of the methodology under this context.

A multiple-case analysis was performed in four phases: selecting the cases, defining a data collection protocol, performing a within-case analysis of each case and performing a cross-case analysis.

This research found that the LSS application positively impacts hospital performance indicators by reducing service time. The most frequently used tools include the supplier input process output customer diagram, value stream mapping, cause-and-effect diagram, five-why analysis, Gemba walk and paired two-sample test. Lastly, the results show that the most common challenges faced were lack of top management engagement, technical training and data availability.

The study is limited by the constraint of a single Latin American country from which the cases were analysed. Collaboration with external partners, like universities, and government policies promoting training in continuous improvement methodologies are crucial for success. Academic implications stress the importance of integrating soft skills in LSS implementation and engineering education.

This study shows a multiple-case analysis of LSS in a Latin American country highlighting the most commonly used tools, their impact on performance and the challenges of implementing LSS in health-care organisations in non-profit Ecuadorian hospitals.

This study aims to investigate how Lean Six Sigma (LSS), a widely used paradigm that promotes competitive advantage of different organisations in a more sustainable and environmentally friendly way, affects operational performance in different organisational contexts. Although LSS is widely used to improve operational performance, the impact of LSS on operational performance appears to be different in different organisational contexts, prompting the attention of researchers and managers to shift from lean philosophy to the impact of contextual variables on the effectiveness of LSS implementation.

This study uses a quantitative research design and conducts an empirical study in Pakistan. The sample consists of 339 management employees with an effective response rate of 67.8% in various sectors. In this study, partial least square structural equation modelling is used to examine the relationships among the variables using the resource-based view (RBV) and dynamic capability theory (DCT) to support the model of this study.

This study reveals that the relationship between LSS and operational performance is partially mediated by green human resource management (GHRM) and internal environmental management (IEM). The moderating effect of the organisational developmental culture between LSS and operational performance is not identified, implying that the effect of developmental culture could vary under different cultures.

There is a lack of empirical studies investigating the role of GHRM, IEM and developmental culture in developing countries. This study extends the literature on the RBV and DCT in operational performance. The study’s outcome provides theoretical and practical implications for enhancing the effect of LSS implementation on operational performance in focal small and medium-sized enterprises (SMEs) through human and environmental management factors.

The purpose of this paper is to present a case study the application of lean six sigma combined with mining transportation overall vehicle effectiveness (MTOVE) to improve mining transportation performance. MTOVE is a newly developed model to measure the overall effectiveness of mining transportation.

The method used is case study combines the MTOVE and LSS methodologies. Data were collected from the hauling operation during a three-month period. Various lean six-sigma tools, such as the Pareto chart, ANOVA, two sample t-tests, one sample t-test, cause-and-effect analysis and time study, have been used.

The case study resulted in improvement of vehicle overall effectiveness; a 35% increase in MTOVE value, a 17% improvement in productivity and a 9% increment in truck utilization. Statistical tests confirmed the significance of reducing the mean and variation in the hauling process cycle time, which led to productivity improvement.

This study provides practitioners with additional quantitative evidence of the potential benefits of LSS methods in the coal mining industry.

This paper practically and unquestionably has contributed to the LSS body of knowledge focused on the mining sector, which is recently still far behind the manufacturing sector. The study has demonstrated that some challenges in the mining environment can be solved through the effective implementation of LSS tools. Hence, this paper could be used as a reference for both researchers and practitioners.

The study contributes in the field of LSS spread in mining industries using a case study. This study shows practical evidence of improving overall vehicle effectiveness using LSS. Practitioners can refer to this study to understand the benefits of LSS in mining sector. Since the mining industry should also adopt the LSS principle into the mining business process due to its ability to improve business performance (Valente et al., 2020; Tupamahu et al., 2019; Zanon et al., 2021).

There has been little scientific study of the LSS implementation in the mining industry. This research provides detailed evidence of LSS implementation in the mining sector. The main contribution is the implementation framework, which shows the combination of newly developed indicators (MTOVE and LSS) to enhance hauling operation effectiveness. This paper demonstrates how LSS tools and methods can be applied in the mining transportation industry.

The purpose of this study is to analyze the literature on lean management and lean six sigma (LM/LSS) in local government organizations (LGOs).

A systematic literature review (SLR) was conducted to extract the most relevant academic publications on LM/LSS in LGOs. ProQuest, Web of Science and Engineering Village were used to obtain the publication set. Studies were then analyzed based on author characteristics, research design characteristics and content characteristics.

The SLR yielded 53 academic publications. The primary finding is that this research area has recently received an increase in attention within these types of organizations. Although this research area attracts new scholars every year, there remains insufficient collaboration across different research groups. Research methods, outcomes and future research areas were also investigated to comprehensively evaluate the literature and specify new research opportunities.

Although the SLR is a rigorous research methodology used to gather relevant publications, it is limited to the chosen information sources (i.e. platforms) to obtain the publications. Therefore, the researchers used multiple sources to maximize the likelihood of capturing publications related to this topic.

The insights presented here provide a foundational reference for researchers interested in investigating and exploring future research opportunities associated with LM/LSS in LGOs.

This study adds value to the research community through its detailed characterization and analysis of the existing research literature on LM/LSS within LGOs, an area that remains largely unexplored in the academic literature. By providing a rigorous understanding of the current status of this research area, this work responds to a notable gap. The review of the existing literature suggests that this effort represents the first comprehensive examination of the research literature on the evolution of LM/LSS, specifically focusing on LGOs as the primary application unit of interest.

This study investigates the role of leadership and cultural transformation in facilitating Lean Six Sigma (LSS) practices in clinical pharmacy settings to reduce medicine waste within the UK National Health Services (NHS).

A systematic literature review on Lean Six Sigma in health care was conducted to develop an analytical framework. This was followed by a qualitative case study of an English NHS trust to test the framework, exploring pharmacists' adoption of LSS practices and their impact on staff behaviour, focussing on leadership decisions and organisational culture.

The research highlights the significance of leadership’s prioritisation in waste reduction efforts and its influence on staff engagement. It also examines the intricate relationship between leadership decisions, education and training, resource allocation, and the prevailing clinical culture, which shapes pharmacists' behaviours and attitudes towards LSS practices and waste reduction.

The study’s focus on a single NHS trust limits the generalisability of the findings, suggesting the need for further research across different healthcare settings.

The study recommends a cultural transformation, earlier training, and reformation in service strategy to enhance the adoption of LSS practices and contribute to a more sustainable future for the wider health services.

Effective medicine waste management prevents harm and helps address the current NHS medicine shortage. The NHS can allocate resources efficiently, ensure timely treatment, and prepare for future disruptions by implementing the proposed framework.

We developed a leadership model for the NHS to reduce medicine waste, offering a novel approach to addressing the challenge of medicine waste through leadership and cultural transformation.

Workflow optimisation is crucial for establishing a viable acute stroke (AS) intervention programme in a large tertiary care centre. This study aims to utilise Lean Six Sigma (LSS) principles to enhance the hospital's workflow.

The Action Research methodology was used to implement the project and develop the case study. The study took place in a large tertiary care academic hospital in India. The Define-Measure-Analyse-Improve-Control approach optimised the workflow within 6 months. Lean tools such as value stream mapping (VSM), waste audits and Gemba were utilised to identify issues involving various stakeholders in the workflow. Sigma-level calculations were used to compare baseline, improvement and sustainment status. Additionally, statistical techniques were effectively employed to draw meaningful inferences.

LSS tools and techniques can be effectively utilised in large tertiary care hospitals to optimise workflow through a structured approach. Sigma ratings of the processes showed substantial improvement, resulting in a five-fold increase in clinical outcomes. Specifically, there was a 43% improvement in outcome for patients who underwent acute stroke revascularisation. However, certain sigma ratings deteriorated during the control and extended control (sustainment) phases. This indicates that ensuring the sustainability of quality control interventions in healthcare is challenging and requires continuous auditing.

The article presents a single case study deployed in a hospital in India. Thus, the generalisation of outcomes has a significant limitation. Also, the study encounters the challenge of not having a parallel control group, which is a common limitation in quality improvement studies in healthcare. Many studies in healthcare quality improvement, including this one, are limited by minimal data on long-term follow-up and the sustainability of achieved results.

This study pioneers the integration of LSS methodologies in a large Indian tertiary care hospital, specifically targeting AS intervention. It represents the first LSS case study applied in the stroke department of any hospital in India. Whilst most case studies discuss only the positive aspects, this article fills a critical gap by unearthing the challenges of applying LSS in a complex healthcare setting, offering insights into sustainable quality improvement and operational efficiency. This case study contributes to the theoretical understanding of LSS in healthcare. It showcases its real-world impact on patient outcomes and process optimisation.

This study aims to explore the potential application of blockchain technology in Lean Six Sigma (LSS) project through a proposed blockchain-LSS (BLSS) model. The proposed model can tackle real-time problems in information sharing, transparency and traceability in every stage of the LSS project.

The scoping review approach is used to develop the integrated model of the BLSS approach for operational excellence. The proposed model is validated through expert’s input, which is collected by a questionnaire survey method.

The prime function of the proposed BLSS model is the information sharing among the project team and real-time monitoring, transparency, traceability and immutability in the Define-Measure-Analyze-Improve-Control phase. The proposed model also consists the information about the role of blockchain features at each phase of the LSS project. The project team and industry employees can trace the success of the project at every moment, resulting in trust buildup and the elimination of fake data. Moreover, there would be no disputes among various sections/shops of the plant and employees to share the real information.

This paper provides guidelines to practitioners and managers for integrating the LSS approach and blockchain. The blockchain helps managers and practitioners in better data traceability and transparency, monitoring of data as well as more sustainable LSS project management.

To the best of the authors’ knowledge, this is the first research attempt that developed an integrated model of blockchain and LSS approach to maintaining the immutable records of assets in projects and targeted Industry 4.0.