Implementing Lean Six Sigma in a multispecialty hospital through a change management approach

IF 3.8 Q2 MANAGEMENT TQM Journal Pub Date : 2023-08-21 DOI:10.1108/tqm-02-2023-0043
A. Samanta, G. Varaprasad, A. Gurumurthy, J. Antony
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Abstract

PurposeMany healthcare institutions, such as hospitals, have recently implemented quality improvement initiatives such as Lean Six Sigma (LSS). However, only a few have sustained the initiatives and remained successful. One of the main reasons for the failure of LSS implementation is that managers tend to view LSS as individual projects. Managers lack a Change Management (CM) focus during the implementation. The primary purpose of this study is to document the implementation of LSS through a CM approach to improve sustainability.Design/methodology/approachDefine-Measure-Analyse-Improve-Control (DMAIC) and the Awareness-Desire-Knowledge-Ability-Reinforcement (ADKAR), a popular CM approach, are combined to propose a new framework. The usefulness of the proposed framework is demonstrated using a case study in a multispeciality hospital located in southern India.FindingsThe study found that several factors are responsible for the high Length of Stay (LOS) for patients in the Emergency Department (ED). By implementing this proposed model to implement LSS and taking corrective actions, the average LOS was reduced from 267 to 158 min (a 40% reduction approximately).Practical implicationsThe complete step-by-step approach is explained, and the LOS was considerably reduced during the pilot project. The findings will provide valuable insights for healthcare practitioners to understand the steps involved in the combined DMAIC-ADKAR model. The findings would also give healthcare practitioners the confidence to identify suitable tools and implement LSS in organisations where the practitioners work.Originality/valueAccording to the authors' knowledge, this is the first study that synergises two models (DMAIC and ADKAR) into a single framework to implement in a hospital.
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通过变更管理方法在多专科医院实施精益六西格玛
许多医疗保健机构(如医院)最近实施了质量改进计划,如精益六西格玛(LSS)。然而,只有少数国家坚持了这些倡议并取得了成功。LSS实施失败的主要原因之一是管理者倾向于将LSS视为单个项目。在实施过程中,管理人员缺乏对变更管理的关注。本研究的主要目的是通过CM方法来记录LSS的实施,以提高可持续性。设计/方法论/方法定义-测量-分析-改进-控制(DMAIC)和意识-欲望-知识-能力-强化(ADKAR),一种流行的CM方法相结合,提出了一个新的框架。通过对印度南部一家多专科医院的案例研究,证明了拟议框架的有用性。研究发现:有几个因素导致急诊科(ED)患者的住院时间长(LOS)。通过实施该模型来实施LSS并采取纠正措施,平均LSS从267分钟减少到158分钟(减少约40%)。实际意义解释了完整的一步一步的方法,并且在试验项目期间大大减少了LOS。研究结果将为医疗保健从业者提供有价值的见解,以了解dmac - adkar组合模型中涉及的步骤。研究结果还将使医疗保健从业者有信心确定合适的工具,并在从业者工作的组织中实施LSS。原创性/价值据作者所知,这是第一个将两个模型(DMAIC和ADKAR)协同成一个框架并在医院实施的研究。
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来源期刊
TQM Journal
TQM Journal Business, Management and Accounting-Business, Management and Accounting (all)
CiteScore
9.10
自引率
0.00%
发文量
114
期刊介绍: Commitment to quality is essential if companies are to succeed in a commercial environment which will be virtually unrecognizable in less than a decade. Changing attitudes, changing perspectives and changing priorities will revolutionise the structure and philosophy of future business practice - and TQM will be at the heart of that metamorphosis. All aspects of preparing for, developing, introducing, managing and evaluating TQM initiatives.
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