• Suzan Al-Najjar Graduate College of Business, Universiti Sains Malaysia, Penang, Malaysia
  • Suzari Abdul Rahim Graduate College of Business, Universiti Sains Malaysia, Penang, Malaysia



LSS, Competitive advantage, Reward & Recognition, Customer Focus


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.


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