Lean Healthcare: A Critical Analysis

The current pandemic situation caused by COVID-19, also known as coronavirus, has put the health sector in the spotlight. It has led to the emergence of new plans and strategies that can help society control and stop the spread of COVID-19. These strategies include the Strategic Preparedness and Response Plan, led by the World Health Organization (WHO), which highlights and outlines the public health measures that countries should adopt to prepare for and respond effectively to the spread of the coronavirus. The pandemic is much more than a health crisis. It requires a response, matching the main problems detected in health and emergency centers. Some of them are quick and exponential spread of the disease, a spike in the number of COVID-19 cases, the successive waves, an increase in the number of patients, and insufficient response healthcare capacity. These problems become more important when there is also an economic downturn, which has made it impossible to expand budgeted public spending on healthcare. For this reason, research for alternative methods that can improve the quality of healthcare management, but without generating increases in budgetary costs, is timely. Implementing Lean Methodology in healthcare can enhance the quality of service, process improvement, and improve patient satisfaction. This chapter analyzes the application of lean manufacturing in the healthcare sector: from specific departments of a hospital (emergency, surgery, etc. to the healthcare management of a region. It identifies also the most commonly used lean tools and their benefits in order to achieve sustainable competitive advantages.

A case study for surgical mask production during the COVID-19 pandemic: continuous improvement with Kaizen and 5S applications

PurposeWith the emergence of the COVID-19 pandemic, the production shortage of personal protective equipment (PPE), such as surgical masks, has become increasingly significant. It is vital to quickly provide high-quality, hygienic PPE during pandemic periods. This comprehensive case study aims to confirm that Kaizen and 5S applications reduce wastage rates and stoppages, which as a result, created a more efficient and sustainable workplace in a small–mediumenterprise (SME) producing PPE in Turkey.Design/methodology/approachThe method for this case is discussed with the help of a flowchart using the DMAIC cycle: D-define, M-measure, A-analyse, I-improve and C-control.FindingsThe total stoppages due to fishing line, gripper, piston and yarn welding have decreased by approximately 42.4%. As a result of eliminating wasted time and reduced changeovers, a total of 5,502 min have been saved per month. This increased production of approximately 10.55% per month, led to an addition of 506,184 units.Originality/valueThe use of lean manufacturing (LM), Six Sigma, Lean Six Sigma and continuous improvement methodologies are not common in textile SMEs. Based on the current literature reviewed, to the best of the authors' knowledge, this is the first comprehensive case study that combines statistical tools, such as hypothesis tests and LM practices, in the production process for a PPE company operating as a textile SME.

Lean Healthcare: A Critical Analysis

The current pandemic situation caused by COVID-19, also known as coronavirus, has put the health sector in the spotlight. It has led to the emergence of new plans and strategies that can help society control and stop the spread of COVID-19. These strategies include the Strategic Preparedness and Response Plan, led by the World Health Organization (WHO), which highlights and outlines the public health measures that countries should adopt to prepare for and respond effectively to the spread of the coronavirus. The pandemic is much more than a health crisis. It requires a response, matching the main problems detected in health and emergency centers. Some of them are quick and exponential spread of the disease, a spike in the number of COVID-19 cases, the successive waves, an increase in the number of patients, and insufficient response healthcare capacity. These problems become more important when there is also an economic downturn, which has made it impossible to expand budgeted public spending on healthcare. For this reason, research for alternative methods that can improve the quality of healthcare management, but without generating increases in budgetary costs, is timely. Implementing Lean Methodology in healthcare can enhance the quality of service, process improvement, and improve patient satisfaction. This chapter analyzes the application of lean manufacturing in the healthcare sector: from specific departments of a hospital (emergency, surgery, etc. to the healthcare management of a region. It identifies also the most commonly used lean tools and their benefits in order to achieve sustainable competitive advantages. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Moving lab-based in-person training to online delivery: The case of a continuing engineering education program

Background: Online learning has recently surged due to the COVID-19 global pandemic. Because of the pandemic, many universities were forced to move to online learning, and various online teaching and learning environments emerged, both asynchronous and synchronous. Objective: This study explores how a large university in the Southeastern United States of America converted an in-person Lean Manufacturing professional course into synchronous online learning for industry participants. Method: The study analysed the performance of 212 in-person and 43 online industry participants and examined the views of online participants about the training. Paired t-tests, one-way multivariate analysis of covariance (MANCOVA), and univariate analysis of covariance (ANCOVA) were utilized to evaluate the performance of the in-person and online groups on the three competencies (Lean culture, problem-solving and Lean systems). Results and Conclusion: Both online and in-person programs performed equally well in two Lean Manufacturing competencies: Lean systems and problem solving. The online program outperformed the in-person program in the third competency, Lean culture. Overall, the participants had a positive experience with the structure and organization of the online program, and their impression of the online learning environment for the program was positive. The study findings indicated that Lean Manufacturing could be trained effectively online and in person. Best practices are suggested for the conversion of in-person to synchronous online engineering continuing education programs. © 2023 The Authors. Journal of Computer Assisted Learning published by John Wiley & Sons Ltd.

A Lean Six Sigma case study to improve the manufacturing process affected during COVID-19

The key manufacturing industry was badly affected by the COVID-19 in India. In this study, we found that the product demand is dynamic during COVID-19. We selected one of the electrical OEMs in India to execute the value added-Flow analysis and VSM study which showed 96% and 85% of total delivery lead time is contributed by NVA activities at the manufacturing process respectively. We also plotted the spaghetti diagram and analysed that total product movement is 287 metres in the current state with the complex flow. We did total of six main Kaizens after Ishikawa and FMEA. We constructed single-piece flow with saving of the half shop floor space and total product movement was reduced from 287 to 96 metres, while total delivery lead time was reduced from 14.6 to 7.72 days. We concluded that lean Six Sigma deployment in the manufacturing industry solved the problems of demand fluctuations.

Interpretive Structural Modeling: Research Trends, Linkages to Sustainable Development Goals, and Impact of COVID-19

Interpretive structural modeling (ISM) is widely used to understand the complex connections between different components. This study presents a bibliometric overview of ISM research, with a focus on its linkages to the Sustainable Development Goals (SDGs) and the impact of COVID-19. The study analyzed 1988 publications on ISM published between 2012 and 2021, of which 1202 were directly mapped to the SDGs and 59 were related to COVID-19. The study identified key authors, institutions, countries, and journals involved in the research and their linkages to the SDGs. The results showed that ISM research is strongly linked to SDG 12 (on responsible consumption and production) and SDG 9 (on industry, innovation, and infrastructure). We also identified influential SDGs on the basis of centrality measures such as betweenness and eigenvector. The top four countries contributing to ISM publications were India, China, the United Kingdom, and the United States. The most frequently cited journals were Benchmarking: An International Journal, Sustainability, the Journal of Modelling in Management, and the Journal of Cleaner Production. Four main clusters were identified in the ISM research, including (1) integration with AHP and fuzzy logic for promoting sustainability alignment, (2) ISM-based strategy development for various stakeholders, (3) ISM-based decision-making in various fields, and (4) ISM-based risk evaluation. For the first time, studies that used the ISM approach to understand the epidemiological characteristics of COVID-19 were identified, and their key findings were discussed. The study also identified several emerging topics for future ISM research, such as blockchain and IoT, environmental management systems, climate change adaptation, smart cities, and humanitarian logistics and their potential linkages to the SDGs.

Implementing and sustaining lean, buyer-supplier role, and COVID-19 pandemic: insights from the garment industry of Bangladesh

PurposeThis study aims to explore the challenges in implementing and sustaining lean in garment supplier factories and the buyer-supplier role in mitigating lean barriers in a typical situation and pandemic. Design/methodology/approachFollowing a qualitative research approach and multiple embedded case study method, data were collected through in-depth interviews with senior managers of one lead buyer and their four key garment supplier factories in Bangladesh. Within and cross-case analysis, techniques were applied to understand the context-oriented lean challenges and buyer-supplier role in mitigating the challenges. FindingsThe study findings demonstrate that garment suppliers are less prepared and unsystematic in lean implementation having limited capabilities and less preparation. Moreover, they have limited support from buyers, less commitment from top management and employee resistance to implementing lean. Lean challenges become more intense because of the COVID-19 pandemic. However, buyer-supplier responsible, cooperative and collaborative behaviour can mitigate lean challenges. Research limitations/implicationsWhereas many stakeholders may be responsible for lean challenges, this study explores dyadic role between buyer and supplier only based on a single lead buyer and their four suppliers. Hence future studies could consider more buyers and suppliers for a holistic understanding. Practical implicationsThis study could help buyers and suppliers understand the underlying causes of lean implementation challenges in garment supplier factories and their role in sustaining lean reducing the challenges, particularly in a pandemic. Originality/valueTo the best of the authors' knowledge, for the first time, this study depicts how buyer and supplier can play their due roles to mitigate lean challenges in garment supplier factories in a pandemic situation.

The Virtual Sensei: Using Assisted Reality to Digitalize Gemba Walks

As more and more companies adopt lean management as a system to continuously develop people, leaders are increasingly intent on conducting gemba walks. This means going to the workplace, be it production, engineering, or supply chain - to explore and discover important business challenges - often under the guidance of a sensei. As a result of the COVID-19 pandemic and the associated social distancing measures and travel restrictions, physical meetings in the workplace have been hampered, especially those involving outsiders. This has since led organizations to consider reducing travels and physical gatherings in general. Therefore, in this paper, we present assisted reality technology as a means of digitalizing gemba walks, allowing managers and executives to benefit from working with external sensei - albeit on a remote basis. We explore the use of RealWear HMT-1 technology as an enabler of the virtual sensei concept, comparing it with the more traditional face-to-face approach to gemba walks and offering insights from multiple interventions between external sensei offsite and local management representatives onsite. The assisted reality approach has been tested both within and across international borders. In general, we find that the digitalization of gemba walks using assisted reality offers multiple benefits over more traditional means. However, there are also several limitations. As such, this work has implications for both research and practice, in that we contribute towards the growing literature on digital lean manufacturing as well as offer practical guidelines for managers and executives embarking on a lean transformation. © 2022 IEEE.

The Toyota way

Purpose>This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.Design/methodology/approach>This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.Findings>The Toyota Way provides organizations with a blue print for adopting both lean and agile manufacturing principles, allowing them to gain a significant competitive advantage.Originality/value>The briefing saves busy executives, strategists and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

A Virtual Reality Laboratory Implementing Lean Manufacturing: Case Applied at Mechatronic Technical School

Nowadays information technologies have been essential for the advancement of teaching and professional development. The world has experienced a pandemic crisis based on a virus called Sars-cov 2 ,this changed the way of living and the way of learning, now we face the challenge of learning to distance, the virtual laboratory allows us to acquire knowledge and develop skills based on a series of practices that the student carries out, this integrates Lean Manufacturing tools in order to give added value to the client, and by effect reducing waste to the company, which is one of the characteristics most important in lean philosophy. The purpose of this work is to facilitate the scope of the topics giving students the use of a quality process into the virtual reality simulator that ensure the quality of knowledge transmission based on practices designed to learn mechatronics and lean manufacturing topics. A virtual reality application is used to simulate a physical laboratory, which consists of Research, Development and Testing steps, using Unity and 3DMax software. The virtual laboratory for a distance modality in the mechatronics career was carried out at technical high school, and developed by students of the mechanical and electrical engineering faculty, and currently designed for 2 practices, one of them is based on a DMAIC cycle [1].

Optimization model to increase the efficiency of the flexible packaging production process applying the Johnson Method, SMED and TPM in a SME in the Plastics Sector

In the current context, the plastic industry has had a recession phase caused by the COVID-19 pandemic, however, according to the Manufacturing Production Report of the year 2020 reveals a recovery of 4.7% in the manufacture of plastics compared to the previous year. Faced with this, new challenges have emerged such as the increase in demand and the demand for high quality products;these are added to the old challenges of the sector such as unproductive times and non-compliance with delivery deadlines. This research is carried out in a small Peruvian company in which the low efficiency of its production process was identified as a central problem. In this sense, we propose the implementation of an optimization model based on the Johnson method, SMED and 2 pillars ofthe TPM methodology, resulting in an increase of24.39% inthe productive efficiency of the company, product of reduced setup times and increased mean time between failures. © 2022 Latin American and Caribbean Consortium of Engineering Institutions. All rights reserved.

Healthcare Process Improvement Initiative Catalyzes Unintended Positive Consequences: An Evaluation Case Study

An After-Action Review of Mobile Charge Capture (MCC) (an electronic health record management tool that addresses billing, scheduling, and coding practices) software, post implementation, was the foundation of this "evaluation case" study that focused on process improvement (PI) at a Midwest United States specialty medical practice ("the practice"). Outcomes, influenced by the SARS-CoV-2 pandemic (COVID-19), confirmed substantial operational improvement from MCC activation and generated unintended positive consequences. The MCC Improved Process facilitated billing and scheduling continuity that cultivated a readiness for the nimble pivot to virtual healthcare delivery. Culture emerged as a key factor in organizational change;with additional PI opportunities identified for further study and consideration.

TRANSFORMER PRODUCTION IMPROVEMENT BY LEAN AND MTM-2 TECHNIQUE

The situation of the covid-19 epidemic is a driving force of the global market's demand increase of electronic devices and parts. Entire electronic component manufacturers, especially the transformer manufacturing industry, which is a device that supplies power to many electronic devices, encounters problems in producing products that are unable to keep up with the quickly increasing demand. This research aims to increase the productivity of small transformers by lean approach. The paper depicts processes relevant to improving production processes, reducing waste, and finding unnecessary processes. The method begins with two actions. First, study the current situation in transformer manufacturing of a case study. Second, study the customer order to delivery process using the Value Stream Mapping (VSM) and analyze entire processes of transformer manufacturing to identify standard time by unit work. The main technique is for measuring working time by timing the forward motion with the time measurement method version 2 (MTM-2). The Cause and Effect diagram was displayed with improving guidelines on two operations. First the concept of lean manufacturing was used in principal role, second the ECRS technique (Eliminate, Combine, Rearrange and Simplify) was applied to reduce "waste"as well as to optimize and reduce the manufacturing process of the transformer. The results lead to an increase in the final product per hour from 45 pieces per hour to 75 pieces per hour which increases up to 30% per hour. In addition, the productivity improvements increased the productivity of 3.46 workers per hour to 6.82 per hour (increase of 97.11%) and production time was reduced from 1,109 seconds to 229 seconds (73.04% of productivity). © 2022 Penerbit UTM Press. All rights reserved.

Development of Lean & Six Sigma Integration Model through Axiomatic Design Theory

After Pandemic covid19 Era, Uncertain Rapid changes in product demand, product design and introduction of new products and increasing global Competition require manufacturing systems to be highly flexible, adaptable and responsive. These characteristics of a manufacturing system must be addressed at the design stage. This paper presents a method for design of manufacturing systems by combining Lean Manufacturing and Six Sigma Methodology by the means of Axiomatic Design approach. To achieve the desired goals of a manufacturing enterprise, manufacturing systems must be designed to satisfy a specific set of functional requirements (FRs) and constraints (C).Axiomatic design theory can help you achieve this type of design. This developed Integration model, albeit hypothetical, may be an ideal and practical model for many manufacturing firms competing in consumer-oriented industries with worldwide during this Pandemic Era. © 2021 ACM.

Using Lean to Improve Operational Performance in a Retail Store and E-Commerce Service: A Portuguese Case Study

Ensuring on-shelf availability is essential for retailers to maintain high service levels for both in-store and E-Commerce consumers. The performance of this indicator largely depends on reorder planning decisions, as well as on the effectiveness of the replenishment process. This paper presents a case study that involved two Lean initiatives, which together have contributed to a significantly reduction in the number of out-of-stock events incurred by a retail store and an increase in the order fulfilment rate accomplished by the online commerce service. In the first initiative, a value stream management (VSM) methodology was adopted to redesign the existing replenishment process in the most relevant fresh food market: fruits and vegetables. The second initiative involved the implementation of a simple, but effective visual inventory management system in the warehouse of the E-Commerce division, where a wide set of fast-moving consumer goods (FMCG) is stored using kanban cards. This paper hence demonstrates, through practical application, that Lean tools can be employed to improve operational processes with positive impacts on both the physical store performance and on results regarding the online commerce business.

Developing resilient supply chains in the Southern African Development Community: Lessons from the impact of COVID-19

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on international trade and supply chains. Border closures and reduced demand for traded goods provoked demand and supply shocks in supply chains, including those of the Southern African Development Community (SADC). Continued vulnerability of regional supply chains affects the long-term socio-economic development trajectory of the SADC. Objectives: This article investigates whether supply chains and their various components have exacerbated the pandemic’s trade impact, with specific reference to the SADC. The objective is to inform regional development policy interventions to improve the resilience of the SADC supply chains in future disturbances. Method: An econometric analysis was conducted to determine the relationship between supply chain efficiency (and the various sub-indicators) and the impact of the pandemic on merchandise trade volumes. The latter constitutes the dependent variable of the analysis and is quantified by measuring the deviation from the pre-shock growth path in the base year (2020) of the pandemic. Data sets from the UNCTADstat database were used. The independent variables are the sub-indicators that form part of the Logistics Performance Index (LPI), the data of which are sourced from the World Bank (2022). In addition to the chi-square test of homogeneity and the Shapiro–Wilk test of normality, regression analyses were conducted to determine the significance of the independent variables, in addition to their association and correlation with the dependent variable. Results: The analysis indicates that supply chain efficiency and components related thereto, including customs clearance, infrastructure, international shipments, logistics competence, tracking and tracing and lead time, are of high significance to and correlate with the impact of the pandemic. Conclusion: Regional development policy in the SADC should prioritise the targeted improvement of specific physical and non-physical infrastructure to support the development of efficient and resilient supply chains. Interventions should focus on improving border and customs processes and tracking and tracing capabilities of logistics service providers. This will contribute to the achievement of regional development objectives and catalyse the competitiveness of the SADC in the face of increased supply chain regionalisation.

Managerial Problems of Enterprise Development During the Pandemic COVID-19

The research is aimed at identifying specific problems of enterprise development during the pandemic, as well as justifying the need for an adaptive approach to enterprise management, ensuring its rapid adjustment to new conditions. The article proves that the pandemic acts as a stressor for the enterprise, being a traumatic event of a high level of negative valence. The pandemic causes various types of stress in the enterprise: stress for the company’s personnel associated with the threat of dismissal;stress related to uncertainty and unpredictability;stress associated with a reduction in the enterprise’s income. The systematization of managerial problems of enterprise development is carried out depending on the type of stress caused by the pandemic: problems of personnel management of the enterprise, problems of adaptation of the enterprise to a changing environment, problems of lack of financial resources. The article presents the author’s vision of solving managerial problems of enterprise development during the pandemic. The authors justified the need for an adaptive approach to the choice of tools for solving managerial problems of enterprise development during the pandemic. The solution to the problem of personnel management of an enterprise during a pandemic is possible by using stress management tools. Uncertainty and unpredictability require clear and prompt decisions on the management of production activities based on the use of predictive analytics tools. The article determines that lean manufacturing technologies can become a tool for overcoming the problem of financial resource scarcity. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Exploring the use of operational excellence methodologies in the era of COVID-19: perspectives from leading academics and practitioners

Purpose>This paper aims to present the results of a study carried out by the authors in the form of research interviews on the topic: “Exploring the use of operational excellence methodologies in the era of COVID-19.”Design/methodology/approach>A qualitative interview approach was utilized by interviewing a panel of leading academics and practitioners who are familiar with operation excellence methodologies.Findings>Operational excellence methodologies are proven and can be utilized in pandemic situations to improve efficiency in the healthcare system and preparedness for pandemics.Research limitations/implications>One limitation of this research was that most of the interviewees who participated in this study came from Europe, North America, South America and Asia, representing four continents. It would have been better to have different views from other continents such as Australia and Africa. Also, the interviews were short and at a high level. There is an opportunity for further study and analysis.Practical implications>Operational excellence methodologies are proven and can be utilized in pandemic situations to improve efficiency in the healthcare system and preparedness for pandemics.Originality/value>The paper provides an excellent resource for those people to get an insight into the value of the application of operations excellence methodologies in pandemic situations to aid healthcare process improvement and aid public and patient safety.

Digital transformations and supply chain management: a Lean Six Sigma perspective

Purpose>With the advent of technological connectivity and access to massive data, the possibilities of augmenting Lean Six Sigma’s Define-Measure-Analyze-Improve-Control (LSS’s DMAIC) problem-solving approach with advanced technologies are enormous. This paper aims to examine digital transformations (DT) of supply chains from a process improvement angle using the LSS DMAIC approach.Design/methodology/approach>This paper uses a case study approach. Three exemplary case studies were examined to shed light on how LSS can aid in DT to achieve enterprise-wide improvements and enhance value across the supply chains.Findings>The paper provides a conceptual framework based on a structured DMAIC problem-solving approach to drive improvements in supply chains. The conceptual framework also provides a systematic approach for big data to be integrated in LSS initiatives to achieve greater supply chain performance.Originality/value>This paper extends research in LSS supply chains by providing a guidance through a conceptual framework that integrate DT and LSS supply chains to support successful digital transformation and LSS supply chains.