THE ROLE OF LEAN SIX SIGMA IN BOOSTING COMPETITIVE ADVANTAGE IN THE GOVERNANCE OF HEALTHCARE ORGANIZATIONS: A CONCEPTUAL FRAMEWORK
DOI:
https://doi.org/10.15282/jgi.7.1.2024.9441Keywords:
LSS, Competitive advantage, Reward & Recognition, Customer FocusAbstract
This study aims to present a conceptual framework that brings together reward and recognition, and customer focus (organizational factors), which can help organizations achieve a competitive advantage (CA) through applying Lean Six Sigma (LSS) in healthcare. A critical review of the models of reward and recognition, and customer focus, LSS, and CA measures was performed to create the conceptual framework. A synthesis of the existing literature provides the basis for the development of the conceptual framework of the LSS measures. The independent variables are reward and recognition, and customer focus. The mediator variable in this framework is LSS, and CA is employed as the dependent variable. The framework offers a systematic method of evaluating the determinants of LSS in healthcare. Accordingly, the newly developed conceptual framework identifies and describes the direct associations between organizational factors and CA in the healthcare (HC) sector and the indirect associations through LSS. This study is important for professionals working in HC seeking to achieve CA in hospitals. Additionally, this study is valuable to researchers and academics working in the LSS field as it explores the importance of LSS implementation in hospitals. In addition, limited studies have been conducted to explore the status of LSS implementation in HC and this study is expected to provide theoretical contributions to the LSS approach in healthcare.
References
Ahmed, S. (2019). Integrating DMAIC approach of Lean Six Sigma and theory of constraints toward quality improvement in healthcare. Reviews on Environmental Health, 34(4), 427-434.
Ahmed, S., Abd Manaf, N.H. and Islam, R. (2018), Effect of Lean Six Sigma on quality performance in Malaysian hospitals. International Journal of Health Care Quality Assurance, vol. 31 no. 8, pp. 973-987.
Al-Gasawneh, J. A., AlZubi, K. N., Anuar, M. M., Padlee, S. F., ul-Haque, A., & Saputra, J. (2022). Marketing Performance Sustainability in the Jordanian Hospitality Industry: The Roles of Customer Relationship Management and Service Quality. Sustainability, 14(2), 803.
Alblooshi, M., Shamsuzzaman, M., Khoo, M. B. C., Rahim, A., & Haridy, S. (2020). Requirements, challenges and impacts of Lean Six Sigma applications–a narrative synthesis of qualitative research. International Journal of Lean Six Sigma, 12(2), 318-367.
Aleu, F. G., & Van Aken, E. M. (2017). Continuous improvement projects: an authorship bibliometric analysis. International Journal of Health Care Quality Assurance. vol. 30 no. 5, pp. 467-476.
Anning-Dorson, T. (2018). Customer involvement capability and service firm performance: The mediating role of innovation. Journal of Business Research, 86, 269-280.
Anthony, J., & Banuelas, R. (2002). Critial success factor for the successful implementing of Six Sigma projects. The TQM Magazines, 41(2), 92-99.
Antony, J., Forthun, S. C., Trakulsunti, Y., Farrington, T., McFarlane, J., Brennan, A., & Dempsey, M. (2019). An exploratory study into the use of Lean Six Sigma to reduce medication errors in the Norwegian public healthcare context. Leadership in Health Services. vol. 32 no. 4, pp. 509-524.
Ariga, R. A., Amelia, R., Astuti, S. B., Fajar, F. A. A., Ariga, S., Ariga, H. P. S., & Pane, N. K. (2022). Implementation of Lean Six Sigma in Improving Competitive Advantage through Patient Satisfaction and Nurse Resources to Face the Covid-19 Pandemic at USU Medan Hospital. Macedonian Journal of Medical Sciences, 10(G), 218-222.
Arumugam, V., Ooi, K. B., & Fong, T. C. (2008). TQM practices and quality management performance: An investigation of their relationship using data from ISO 9001: 2000 firms in Malaysia. The TQM Journal. vol. 20 no. 6, pp. 636-650.
Aswathappa, J., Garg, S., Kutty, K., & Shankar, V. (2013). Neck circumference as an anthropometric measure of obesity in diabetics. North American Journal of Medical Sciences, 5(1), 28.
Barney, J. (1991). Firm resources and sustained competitive advantage. Journal of Management, 17(1), 99-120.
Barney, J. B. (2001). Resource-based theories of competitive advantage: A ten-year retrospective on the resource-based view. Journal of Management, 27(6), 643-650.
Beleska-Spasova, E. (2014). Determinants and measures of export performance–comprehensive literature review. Journal of Contemporary Economic and Business Issues, 1(1), 63-74.
Bharadwaj, S. G., Varadarajan, P. R., & Fahy, J. (1993). Sustainable competitive advantage in service industries: a conceptual model and research propositions. Journal of Marketing, 57(4), 83-99.
Bhat, D. A. R., & Sharma, V. (2021). Enabling service innovation and firm performance: the role of co-creation and technological innovation in the hospitality industry. Technology Analysis & Strategic Management, 1-13.
Bhat, S., Antony, J., Gijo, E. V., & Cudney, E. A. (2019). Lean Six Sigma for the healthcare sector: a multiple case study analysis from the Indian context. International Journal of Quality & Reliability Management. vol. 37 no. 1, pp. 90-111
Bhat, S., Gijo, E. V., Antony, J., & Cross, J. (2022). Strategies for successful deployment and sustainment of Lean Six Sigma in healthcare sector in India: a multi-level perspective. The TQM Journal. 1754-2731
Bhat, S., Gijo, E. V., Rego, A. M., & Bhat, V. S. (2020). Lean Six Sigma competitiveness for micro, small and medium enterprises (MSME): an action research in the Indian context. The TQM Journal. vol. 33 no. 2, 2021 pp. 379-406
Bhatt, G., Emdad, A., Roberts, N., & Grover, V. (2010). Building and leveraging information in dynamic environments: The role of IT infrastructure flexibility as enabler of organizational responsiveness and competitive advantage. Information & Management, 47(7-8), 341-349.
Brown, S. P., & Lam, S. K. (2008). A meta-analysis of relationships linking employee satisfaction to customer responses. Journal of Retailing, 84(3), 243-255.
Cerfolio, R. J., & Ferrari-Light, D. (2019). Does conversion from a minimally invasive to open procedure hurt the patient, the surgeon’s ego, or the healthcare system? Journal of Thoracic Disease, 11(3), 646.
Chakrabarty, A., & Tan, K. C. (2007). The current state of SS application in services. Managing Service Quality: An International Journal, 17(2), 194-208.
Chang, D., Xu, H., Rebaza, A., Sharma, L., & Cruz, C. S. D. (2020). Protecting health-care workers from subclinical coronavirus infection. The Lancet Respiratory Medicine, 8(3), e13.
Cho, Y. S., & Linderman, K. (2020). Resource-based product and process innovation model: Theory development and empirical validation. Sustainability, 12(3), 913.
Citybabu, G., & Yamini, S. (2022). The implementation of Lean Six Sigma framework in the Indian context: a review and suggestions for future research. The TQM Journal. vol. 34 no. 6, 2022 pp. 1823-1859
D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: a comprehensive review. Health Policy, 119(9), 1197-1209.
Daft, R. L., & Lengel, R. H. (1998). Fusion leadership: Unlocking the subtle forces that change people and organizations. Berrett-Koehler Publishers.
Das, T. K., & Teng, B. S. (2000). A resource-based theory of strategic alliances. Journal of Management, 26(1), 31-61.
Deming, J. W., & Colwell, R. R. (1982). Barophilic bacteria associated with digestive tracts of abyssal holothurians. Applied and Environmental Microbiology, 44(5), 1222-1230.
Desai, D. A., Kotadiya, P., Makwana, N., & Patel, S. (2015). Curbing variations in packaging process through Six Sigma way in a large-scale food-processing industry. Journal of Industrial Engineering International, 11(1), 119-129.
Dobrzykowski, D. D., McFadden, K. L., & Vonderembse, M. A. (2016). Examining pathways to safety and financial performance in hospitals: A study of lean in professional service operations. Journal of Operations Management, 42(1), 39-51.
Douglas, T.J. and Judge Jr., W.Q. (2001) Total Quality Management Implementation and Competitive Advantage: The Role of Structural Control and Exploration. The Academy of Management Journal, 44, 158-169.
El-Jardali, F., Sheikh, F., Garcia, N. A., Jamal, D., & Abdo, A. (2014). Patient safety culture in a large teaching hospital in Riyadh: baseline assessment, comparative analysis and opportunities for improvement. BMC Health Services Research, 14(1), 1-15
Epetimehin, F. M. (2011). Achieving CA in insurance industry: the impact of marketing innovation and creativity. Journal of Emerging Trends in Economics and Management Sciences, 2(1), 18-21.
Ferdousi, F., Baird, K., Munir, R., & Su, S. (2019). Mediating role of quality performance on the association between organisational factors and competitive advantage. International Journal of Productivity and Performance Management. vol. 68 no. 3, pp. 542-560.
Freiling, J., Gersch, M., Goeke, C., & Sanchez, R. (2008). Fundamental issues in a competence-based theory of the firm. In A focused issue on fundamental issues in competence theory development. Emerald Group Publishing Limited. vol 4, 79–106.
Frye, C. A., Paris, J. J., Walf, A. A., & Rusconi, J. C. (2012). Effects and mechanisms of 3α, 5α,-THP on emotion, motivation, and reward functions involving pregnane xenobiotic receptor. Frontiers in Neuroscience, 5, 136.
Flynn, B. B., Schroeder, R. G., & Sakakibara, S. (1994). A framework for quality management research and an associated measurement instrument. Journal of Operations Management, 11(4), 339-366.
Gijo, E. V., & Antony, J. (2014). Reducing patient waiting time in outpatient department using lean six sigma methodology. Quality and Reliability Engineering International, 30(8), 1481-1491.
Gonzalez-Aleu, F., Van Aken, E. M., Cross, J., & Glover, W. J. (2018). Continuous improvement project within Kaizen: critical success factors in hospitals. The TQM Journal, 30(4), 335-355.
Gunawan, I. (2022). Customer Loyalty: The Effect Customer Satisfaction, Experiential Marketing and Product Quality. KINERJA: Jurnal Manajemen Organisasi dan Industri, 1(1), 35-50.
Gurses, A. P., & Carayon, P. (2007). Performance obstacles of intensive care nurses. Nursing research, 56(3), 185-194.
Habidin, N., & Mohd Yusof, S. R. (2013). Critical success factors of Lean Six Sigma for the Malaysian automotive industry. International Journal of Lean Six Sigma, 4(1), 60-82.
Hagan, P. (2011). Waste not, want not: Leading the lean health‐care journey at Seattle Children's Hospital. Global Business and Organizational Excellence, 30(3), 25-31.
Hamilton, S., & Chervany, N. L. (1981). Evaluating information system effectiveness-Part I: Comparing evaluation approaches. MIS quarterly, 55-69.
Handel, H. (2008). Compensation of thermal errors in vision-based measurement systems using a system identification approach. In 2008 9th International Conference on Signal Processing (pp. 1329-1333). IEEE.
Hendricks, C.A. and Kelbaugh, R.L. (1998), Implementing Six Sigma at GE, Quality and Participation, vol. 21 no. 4, pp. 48-53
Hitt, M. A., Xu, K., & Carnes, C. M. (2016). Resource based theory in operations management research. Journal of Operations Management, 41, 77-94.
Hundal, G. S., Thiyagarajan, S., Alduraibi, M., Laux, C. M., Furterer, S. L., Cudney, E. A., & Antony, J. (2021). Lean Six Sigma as an organizational resilience mechanism in health care during the era of COVID-19. International Journal of Lean Six Sigma, 12(4), 762-783.
Jayaraman, K. and Teo, L.K. (2010), Critical success factors for successful Lean Six Sigma implementation and its impact on company performance of electronics manufacturing service (EMS) industries: a practical guide for Lean Six Sigma implementation success model, International Journal of Lean Six Sigma, vol. 1 no. 3, pp. 191-215
Joosten, T. C. M., Bongers, I. M. B., & Janssen, R. T. J. M. (2009). Application of lean thinking to health care: Issues and observations. International Journal for Quality in Health Care, 21(5), 341-347.
Kaltenbrunner, M., Bengtsson, L., Mathiassen, S. E., & Engström, M. (2017). A questionnaire measuring staff perceptions of Lean adoption in healthcare: development and psychometric testing. BMC Health Services Research, 17(1), 1-11.
Kaur, R., Sharma, R. K., & Goyal, S. (2019). Improving organizational performance through competitive advantage: an empirical analysis with reference to Indian IT industry. Journal of Asia-Pacific Business, 20(4), 281-301.
Khan, J. H. (2003). Impact of total quality management on productivity. The TQM magazine, 15(6), 374-380. vol. 15 no. 6, pp. 374-380.
Knight, E., Kumar, V., Wójcik, D., & O’Neill, P. (2020). The competitive advantage of regions: economic geography and strategic management intersections. Regional Studies, 54(5), 591-595.
Kurutkan, M. N., Usta, E., Orhan, F., & Simsekler, M. C. (2015). Application of the IHI Global Trigger Tool in measuring the adverse event rate in a Turkish HC setting. International Journal of Risk & Safety in Medicine, 27(1), 11-21.
Laureani, A., & Antony, J. (2012). Critical success factors for the effective implementation of Lean Sigma: Results from an empirical study and agenda for future research. International Journal of Lean Six Sigma, 3(4), 274-283.
Laureani, A., & Antony, J. (2017). Leadership characteristics for lean six sigma. Total Quality Management & Business Excellence, 28(3-4), 405-426.
Leong, T. W., & Teh, P. L. (2012). Critical success factors of Six Sigma in original equipment manufacturer company in Malaysia. International Journal of Synergy and Research, 1(1), 7-21.
Lestari, S. D., Leon, F. M., Widyastuti, S., Brabo, N. A., & Putra, A. H. P. K. (2020). Antecedents and consequences of innovation and business strategy on performance and competitive advantage of SMEs. The Journal of Asian Finance, Economics and Business, 7(6), 365-378.
Limpanyalert, P. (2018). Patient safety in Thailand. In Global Patient Safety (pp. 175-189). Routledge.
Linderman, K., Schroeder, R. G., & Choo, A. S. (2006). Six Sigma: The role of goals in improvement teams. Journal of Operations Management, 24(6), 779-790.
Luz Tortorella, G., Cauchick-Miguel, P. A., Li, W., Staines, J., & McFarlane, D. (2022). What does operational excellence mean in the Fourth Industrial Revolution era? International Journal of Production Research, 60(9), 2901-2917.
Madhani, P. M. (2022). The “High-Road” Approach to Compensation and Benefits Practices: Enhancing Competitive Advantages. International Journal of Applied Management Sciences and Engineering (IJAMSE), 9(1), 1-21.
Malmbrandt, M., & Åhlström, P. (2013). An instrument for assessing lean service adoption. International Journal of Operations & Production Management. 33(9):1131–1165.
McDermott, O., Antony, J., Sony, M., & Daly, S. (2022). Barriers and enablers for continuous improvement methodologies within the Irish pharmaceutical industry. Processes, 10(1), 73.
Noronha, A., Bhat, S., Gijo, E. V., Antony, J., & Bhat, S. (2021). Application of Lean Six Sigma in conservative dentistry: an action research at an Indian dental college. The TQM Journal. vol. 34 no. 4, 2022 pp. 675-700.
Okpara, J. O. (2004). Personal characteristics as predictors of job satisfaction: An exploratory study of IT managers in a developing economy. Information Technology & People. vol. 17 no. 3, pp. 327-338.
Peters, B. G. (1992). Government Reorganization: A Theoretical Analysis. International Political Science Review, 13(2), 199–217.
Rahman, S. U., & Bullock, P. (2005). Soft TQM, hard TQM, and organisational performance relationships: an empirical investigation. Omega, 33(1), 73-83.
Runyan, C. W., Schulman, M., Dal Santo, J., Bowling, J. M., Agans, R., & Ta, M. (2007). Work-related hazards and workplace safety of US adolescents employed in the retail and service sectors. Pediatrics, 119(3), 526-534.
Scwartz, S.H. (2008). Cultural Value Orienttaions: Nature and Implications of National Differences. Moscow: State University – Higher School of Economic Press.
Sekhon, H., & Kennington, C. (2001). Buyer seller relationships in the UK insurance market: Is this the key competitive advantage? Journal of Financial Services Marketing, 5(3), 207-214.
Shah, R., & Ward, P. T. (2007). Defining and developing measures of lean production. Journal of Operations Management, 25(4), 785-805.
Siagian, H., Tarigan, Z. J. H., & Jie, F. (2021). Supply chain integration enables resilience, flexibility, and innovation to improve business performance in COVID-19 era. Sustainability, 13(9), 4669.
Silaban, N., & Syah, T. Y. R. (2018). The influence of compensation and organizational commitment on employees’ turnover intention. IOSR Journal of Business and Management, 20(3), 1-6.
Sim, C. L., Chuah, F., Sin, K. Y., & Lim, Y. J. (2022). The moderating role of Lean Six Sigma practices on quality management practices and quality performance in medical device manufacturing industry. The TQM Journal, (ahead-of-print).
Simsekler, M. E., Gurses, A. P., Smith, B. E., & Ozonoff, A. (2019). Integration of multiple methods in identifying patient safety risks. Safety Science, 118, 530-537.
Simsekler, M. E., Ward, J. R., & Clarkson, P. J. (2018). Design for patient safety: a systems-based risk identification framework. Ergonomics, 61(8), 1046-1064.
Sila, I. (2007). Examining the effects of contextual factors on TQM and performance through the lens of organizational theories: An empirical study. Journal of Operations Management, 25(1), 83-109.
Sodikoglu, E., & Zehir, C. (2010). Investigating the effects of innovation and employee performance on the relationship between TQM practices and firm performance: an empirical study of Turkish firms. International Journal of Production Economics, 127(1), 13-26.
Sollecito, W., & Johnson, J. (2011). McLaughlin and Kaluzny's continuous quality improvement in health care. Jones & Bartlett Publishers.
Sony, M., & Naik, S. (2020). Industry 4.0 integration with socio-technical systems theory: A systematic review and proposed theoretical model. Technology in Society, 61, 101248.
Tjosvold, D., & Tjosvold, M. (2015). Leadership for teamwork, teamwork for leadership. In Building the team organization (pp. 65-79). Palgrave Macmillan, London.
Vaishnavi, V., & Suresh, M. (2020). Modelling of readiness factors for the implementation of Lean Six Sigma in healthcare organizations. International Journal of Lean Six Sigma, vol. 11 no. 4, pp. 597-633
Wang, C. H., Chen, K. S., & Tan, K. H. (2019). Lean Six Sigma applied to process performance and improvement model for the development of electric scooter water-cooling green motor assembly. Production Planning & Control, 30(5-6), 400-412.
Wang, G., Wei, Y., Qiao, S., Lin, P., & Chen, Y. (2018). Generalized inverses: theory and computations (vol. 53). Singapore: Springer.
Williams, A., Nangia, N., & Bowman, S. R. (2017). A broad-coverage challenge corpus for sentence understanding through inference. arXiv preprint arXiv:1704.05426.
Womack, J. P., & Jones, D. T. (2003). Banish waste and create wealth in your corporation. Recuperado de http://www. kvimis. co. in/sites/ kvimis. co. in/files/ebook_attachments/James.
Yadav, N., Shankar, R., & Singh, S. P. (2020). Impact of Industry 4. 0/ICTs, Lean Six Sigma and quality management systems on organisational performance. The TQM Journal, 32(4), 815-835.
Yusaf, T., Noor, M. M., & Wandel, A. P. (2013). Mild combustion: the future for lean and clean combustion. In Proceedings of the 2nd International Conference of Mechanical Engineering Research (ICMER 2013) (pp. 1-15). Universiti Malaysia Pahang.
Yunis, M., Jung, J., & Chen, S. (2013). TQM, strategy, and performance: a firm‐level analysis. International Journal of Quality & Reliability Management. vol. 30 no. 6, pp. 690-714.
Yusuf, Y., Gunasekaran, A., & Dan, G. (2007). Implementation of TQM in China and organization performance: An empirical investigation. Total Quality Management, 18(5), 509 –530.
Zakuan, N. M., Yusof, S. M., & Shaharoun, A. M. (2009). The link between total quality management and organizational performance in Malaysian Automotive Industry: The mediating role of ISO/TS16949 efforts. In 2009 IEEE International Conference on Industrial Engineering and Engineering Management (pp. 439-443).
Zhang, Z., Waszink, A. B., & Wijngaard, J. (2000). An instrument for measuring TQM implementation for Chinese manufacturing companies. International Journal of Quality & Reliability Management, 17(7), 730-755.
Zu, X., Fredendall, L. D., & Douglas, T. J. (2008). The evolving theory of quality management: the role of Six Sigma. Journal of Operations Management, 26(5), 630-650.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
