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The study presented healthcare service quality, lean thinking and Six Sigma to enhance patient satisfaction. Moreover, the notion of machine learning is combined with lean service quality to bring about the fundamental benefits of predicting patient waiting time and non-value-added activities to enhance patient satisfaction.

The study applied the define, measure, analyze, improve and control (DMAIC) method. In the define phase, patient expectation and perception were collected to measure service quality gaps, whereas in the measure phase, quality function deployment (QFD) was employed to measure the high-weighted score from the patient's voice. The root causes of the high weighted score were identified using a cause-and-effect diagram in the analysis phase.

The study employed a random forest, neural network and support vector machine to predict the healthcare patient waiting time to enhance patient satisfaction. Performance comparison metrics such as root-mean-square error (RMSE), mean absolute error (MAE) and R2 were accessed to identify the predictive model accuracy. From the three models, the prediction performance accuracy of the support vector machine model is better than that of the neural network and random forest models to predict the actual data.

Lean service quality improvement using DMAIC, QFD and machine learning techniques can be generalized to predict patient waiting times. This study provides better realistic insights into patient expectations by announcing waiting times to enable data-driven service quality deliveries.

Prior studies lack lean service quality, Six Sigma and waiting time prediction to reduce healthcare waste. This study proposes lean service quality improvement through lean Six Sigma (LSS), i.e. DMAIC and machine learning techniques, along with QFD and cause-and-effect diagram.

This paper aims to highlight how the six sigma methods helped the medical equipment manufacturing company in finding and analysing the root causes that lead to the reduction in production rate, rejection rates, quality and other major causes that lead to the reduction in productivity of the blood bags manufacturing unit.

Given the critical nature of blood bag manufacturing Six Sigma was chosen as the primary methodology for this research since Six Sigma’s data-driven approach provides a structured framework to identify, analyse and rectify inefficiencies in the production processes. This study proposes the Six Sigma DMAIC (D-Define, M-Measure, A-Analyse, I-Improve, C-Control) encompassing rigorous problem definition, precise measurement, thorough analysis, improvement and vigilant control mechanisms for effectively attaining predetermined objectives.

The paper demonstrates how the Six Sigma principles were executed in a blood bag manufacturing unit. After a detailed and thorough data analysis, it was found that a total of 40 critical-to-quality factors under the five drivers such as Machine, Components, Inspection and Testing, People and Workspace were influential factors affecting the manufacturing of blood bags. From the study, it is identified that the drivers such as inspection and testing, components and machines contribute significantly to increasing productivity.

The paper offers valuable strategic insights into implementing Six Sigma methodologies within the specific context of a blood bag manufacturing unit. The Six Sigma tools and techniques used by the project team to solve issues within the blood bag manufacturing unit can be used for similar healthcare organizations to successfully deploy Six Sigma. The insights from this research might not be directly applicable to other manufacturing facilities or industries but can be used as a guiding reference for researchers and managers.

The current state of scholarly literature indicates a significant absence in the examination of Six Sigma methodologies designed specifically to improve production output in healthcare equipment manufacturing. This paper highlights the application of Six Sigma principles to enhance efficiency in the specific context of blood bag manufacturing.

The purpose of the study is to examine how risk factors contribute to the occurrence of defects in a process. By analyzing these risk factors in relation to process quality, the study aims to help organizations prioritize their resources and efforts toward addressing the most significant risks. These challenges, integrated with the emerging concept of Quality 4.0, necessitate a comprehensive risk assessment technique.

Fuzzy logic integrated with an analytic network process is used in the process failure mode and effects analysis for conducting risk identification and assessment under uncertainty. Through a mathematical model, the linkage of risk with Six Sigma is established and, finally, a value–risk matrix is developed for illustrating and analysing risk impact on process quality.

A case study on fused filament fabrication demonstrates the proposed methodology’s applicability. The results show its effectiveness in assessing risk factors’ impact on Six Sigma metrics: defects per million opportunities/sigma level.

By integrating qualitative assessments and leveraging available data, this approach enables a more comprehensive understanding of risks and their utilization for an organization’s quality improvement initiatives.

This approach establishes a risk-centric Six Sigma assessment method in accordance with the requirement of ISO 9001:2015 and in the context of Quality 4.0.