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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.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

The purpose of this paper is to contribute to the limited body of empirical knowledge on the impact of Lean Six Sigma (LSS) program implementations on organizational performance in financial services by investigating how antecedents of Lean Six Sigma program success (motivations, selected LSS methods and challenges) affect organizational performance enhancement via LSS program performance.

A sample of 198 LSS professionals from 7 countries are surveyed. Structural equation modeling (SEM) is performed to test the questioned relations.

This study’s findings comprise: (1) LSS program performance partially mediates the relationship between motivations for LSS implementation and organizational performance, (2) selected LSS method applications has a fully (mediated) indirect impact on organizational performance, (3) LSS implementation challenges also have an indirect (mediated) impact on organizational performance and (4) LSS program performance has a positive impact on organizational performance.

The findings of this research predominantly provide nuances and details about LSS implementation antecedents and effects, useful for managers in advising their business leaders about the prerequisites and potential operational and financial benefits of LSS implementation. Furthermore, the paper provides evidence and details about the relationship between important antecedents for LSS implementation identified in existing literature and their impact on organizational performance in services. Thereby, this research is the first in providing empirical, cross-sectional, evidence for the antecedents and effects of LSS program implementations in financial services.

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 study aims to improve a construction company's overall project delivery by utilising lean six sigma (LSS) methods combined with building information modelling (BIM) to design, modularise and manufacture various building elements in a controlled factory environment off-site.

A case study in a construction company utilised lean six sigma (LSS) methodology and BIM to identify non-value add waste in the construction process and improve sustainability.

An Irish-based construction company manufacturing modular pipe racks for the pharmaceutical industry utilised LSS to optimise and standardise their off-site manufacturing (OSM) partners process and leverage BIM to design skids which could be manufactured offsite and transported easily with minimal on-site installation and rework required. Productivity was improved, waste was reduced, less energy was consumed, defects were reduced and the project schedule for completion was reduced.

The case study was carried out on one construction company and one construction product type. Further case studies would ensure more generalisability. However, the implementation was tested on a modular construction company, and the methods used indicate that the generic framework could be applied and customized to any offsite company.

This is one of the few studies on implementing offsite manufacturing (OSM) utilising LSS and BIM in an Irish construction company. The detailed quantitative benefits and cost savings calculations presented as well as the use of the LSM methods and BIM in designing an OSM process can be leveraged by other construction organisations to understand the benefits of OSM. This study can help demonstrate how LSS and BIM can aid the construction industry to be more environmentally friendly.

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.

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.

Cardiovascular diseases are the leading cause of death worldwide. In Italy, acute myocardial infarction (AMI) is a major cause of hospitalization and healthcare costs. AMI is a myocardial necrosis event caused by an unstable ischemic syndrome. The Italian government has defined an indicator called “AMI: 30-day mortality” to assess the quality of the overall care pathway of the heart attacked patient. In order to guarantee high standards, all hospitals had to implement techniques to increase the quality of care pathway. The aim of the paper is to identify the root cause and understand the mortality rate for AMI and redesign the patient management process in order to improve it.

A Lean Six Sigma (LSS) approach was used in this study to analyze the patient flow in order to reduce 30-days mortality rate from AMI registered by Complex Operative Unit (COU) of Cardiology of an Italian hospital. Value stream mapping (VSM) and Ishikawa diagrams were implemented as tools of analysis.

Process improvement using LSS methodology made it possible to reduce the overall times from 115 minutes to 75 minutes, with a reduction of 35%. In addition, the corrective actions such as the activation of a post-discharge outpatient clinic and telephone contacts allowed the 30-day mortality rate to be lowered from 16% before the project to 8% after the project. In this way, the limit value set by the Italian government was reached.

The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

The LSS approach has brought significant benefits to the process of managing patients with AMI. Corrective actions such as the activation of an effective shared protocol or telephone interview with checklist can become the gold standard in reducing mortality. The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

LSS, applied for the first time to the management of cardiovascular diseases in Italy, is a methodology which has proved to be strategic for the improvement of healthcare process. The simple solutions implemented could serve as a guide for other hospitals to pursue the national AMI mortality target.

This study is focused to support an ongoing development project of the case company's current state and the challenges of the order-to-cash (O2C) process. The O2C process is the most visible process to the customer, and therefore, its punctual and fluent order management is vital. It is observed that the high degree of manual work in the O2C process causes mistakes, delays and rework in the process. The purpose of this article is therefore to analyze the case company's current state of the O2C process as well as to identify the areas of development in this process by deploying the means of Lean Six Sigma tools such as value stream mapping (VSM).

The study was conducted as a mix of quantitative and qualitative analysis. Based on both the quantitative and qualitative data, a workshop on VSM was organized to analyze the current state of the O2C process of a case company, engaged in the energy and environment sector in Finland.

The results found that excessive manual work was highly connected to inadequate or incorrect data in pricing and invoicing activities, which resulted in canceled invoices. Canceled invoices are visible to the customer and have a negative impact on the customer experience. This study found that by improving the performance of the O2C process activities and improving communication among the internal and external stakeholders, the whole O2C process can perform more effectively and provide better customer value.

The O2C process is the most visible process to the customer and therefore its punctual and fluent order management is vital. To ensure that the O2C process is operating as desired, suitable process performance metrics need to be aligned and followed. The results gathered from the case company's data, questionnaire interviews, and the VSM workshop are all highlighted in this study. The main practical and managerial implications were to understand the real-time O2C process performance, which is necessary to ensure strong performance and enhance continuous improvement of the O2C process that leads to operational excellence and commercial competitiveness of the studied case company.

This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.