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Article
Publication date: 8 June 2015

Janet H Sanders and Tedd Karr

Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these…

1854

Abstract

Purpose

Lean and Six Sigma are continuous improvement methodologies that have garnered international fame for improving manufacturing and service processes. Increasingly these methodologies are demonstrating their power to also improve healthcare processes. The purpose of this paper is to discuss a case study for the application of Lean and Six Sigma tools in the reduction of turnaround time (TAT) for Emergency Department (ED) specimens. This application of the scientific methodologies uncovered opportunities to improve the entire ED to lab system for the specimens.

Design/methodology/approach

This case study provides details on the completion of a Lean Six Sigma project in a 1,000 bed tertiary care teaching hospital. Six Sigma’s Define, Measure, Analyze, Improve, and Control methodology is very similar to good medical practice: first, relevant information is obtained and assembled; second, a careful and thorough diagnosis is completed; third, a treatment is proposed and implemented; and fourth, checks are made to determine if the treatment was effective. Lean’s primary goal is to do more with less work and waste. The Lean methodology was used to identify and eliminate waste through rapid implementation of change.

Findings

The initial focus of this project was the reduction of turn-around-times for ED specimens. However, the results led to better processes for both the internal and external customers of this and other processes. The project results included: a 50 percent decrease in vials used for testing, a 50 percent decrease in unused or extra specimens, a 90 percent decrease in ED specimens without orders, a 30 percent decrease in complete blood count analysis (CBCA) Median TAT, a 50 percent decrease in CBCA TAT Variation, a 10 percent decrease in Troponin TAT Variation, a 18.2 percent decrease in URPN TAT Variation, and a 2-5 minute decrease in ED registered nurses rainbow draw time.

Practical implications

This case study demonstrated how the quantitative power of Six Sigma and the speed of Lean worked in harmony to improve the blood draw process for a 1,000 bed tertiary care teaching hospital. The blood draw process is a standard process used in hospitals to collect blood chemistry and hematology information for clinicians. The methods used in this case study demonstrated valuable and practical applications of process improvement methodologies that can be used for any hospital process and/or service environment.

Originality/value

While this is not the first case study that has demonstrated the use of continuous process improvement methodologies to improve a hospital process, it is unique in the way in which it utilizes the strength of the project focussed approach that adheres more to the structure and rigor of Six Sigma and relied less on the speed of lean. Additionally, the application of these methodologies in healthcare is emerging research.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 5
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 5 March 2018

J. Muraliraj, Suhaiza Zailani, S. Kuppusamy and C. Santha

Literature reviews are a pervasive aspect in research. An ever mounting field such as Lean Six Sigma requires a perpetual touch on the subject to accentuate insights that can be…

3019

Abstract

Purpose

Literature reviews are a pervasive aspect in research. An ever mounting field such as Lean Six Sigma requires a perpetual touch on the subject to accentuate insights that can be researched about. The purpose of this paper is to address the published literatures in the field of Lean Six Sigma through multiple criterion for an enhanced understanding of the subject matter through summarizing its current trends, uncovering existing literature gaps and revealing opportunities for future research in the field.

Design/methodology/approach

The literature review on Lean Six Sigma field spans around 17 years that includes peer-reviewed journals from management, business, engineering, healthcare, manufacturing, military among the many disciplines. The study uses a content analysis approach in which several dimensions of the literature were analysed: purpose or focus of study, years of publication, journal name or publications, methodologies, theories used, country of study, industry sub-sectors, active authors in the field, critical success factors, barriers and challenges and the most contribution of Lean Six Sigma papers by universities.

Findings

Eleven important findings from the analysis were summarized among them; the field of Lean Six Sigma had begun to grow significantly since the new millennium particularly after the 2004-2007 or 2008 period; standalone concepts of Lean and Six Sigma are highly researched compared to the integrated concepts; large proportion of perspective, conceptual and descriptive based studies; lack of empirical validity on the fusion between Lean and Six Sigma; lack of theoretical based studies, etc.

Research limitations/implications

The study is limited to 102 journals in commonly searched databases in the subject matter which produced 261 journal papers. This study seeks to broaden the summary of studies done under the keyword “Lean Six Sigma”.

Originality/value

The review analysis uses a content analysis approach in search of valuable gaps in existing research. The study found 261 papers from 102 journals that were published over the past seventeen years (2000-2016). This paper provides scholars, practitioners and managers with insights on the present trends and focus of Lean Six Sigma in addition to what else are lacking in the subject matter, which could pave the way for future research and practical endeavours.

Details

International Journal of Lean Six Sigma, vol. 9 no. 1
Type: Research Article
ISSN: 2040-4166

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Article
Publication date: 2 January 2018

Vijaya Sunder M., L.S. Ganesh and Rahul R. Marathe

The purpose of this paper is to review the existing literature on Lean Six Sigma (LSS) for services, construct a morphological analysis (MA) framework and identify research gaps…

4353

Abstract

Purpose

The purpose of this paper is to review the existing literature on Lean Six Sigma (LSS) for services, construct a morphological analysis (MA) framework and identify research gaps to point to future research possibilities and priorities.

Design/methodology/approach

The MA framework is based on literature review of 175 papers published from 2003 to 2015, across 67 journals recognised by Scopus or ABS Academic Journal Quality Guide 2015. A three-phased methodology is used by the authors, with Phase1 featuring a five-stage systematic review protocol to identify relevant journal papers for review; Phase2 presenting a framework for classifying the reviewed papers in terms of their fundamental, methodological, chronological and sector-wise orientations; and Phase3 constructing an MA framework on the classified papers and identifying the research gaps.

Findings

The MA framework constructed based on six dimensions, namely, organizational context of applications, desired outcomes, implementation systems, LSS tools and techniques, integration with other management philosophies and evaluation methods, involving 40 focused themes, has revealed 355 distinct research gaps as opportunities for future research.

Practical implications

This paper confirms the existence of substantial scope and points to specific topics for further research in the area of LSS for services. The findings demonstrate the gaps in academic research on the subject. In addition, the study also helps organisational leaders and practitioners to look at LSS from a holistic perspective in the services context.

Originality/value

The MA framework of the existing literature on LSS for services presents a unique, systematic effort to identify research opportunities. In addition, a five-stage systematic review protocol is proposed in this paper. This could be valuable to researchers and practitioners in enabling them to systematically review the literature on research subjects of interest to them.

Details

International Journal of Operations & Production Management, vol. 38 no. 1
Type: Research Article
ISSN: 0144-3577

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Article
Publication date: 1 March 1974

Frances Neel Cheney

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are…

300

Abstract

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

Details

Reference Services Review, vol. 2 no. 3
Type: Research Article
ISSN: 0090-7324

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Book part
Publication date: 23 April 2013

Ryan Turner

This piece is a review of the animal selfhood literature in sociology, organized into four main parts. First, I review the sociological literature of human–animal interactions, in…

Abstract

This piece is a review of the animal selfhood literature in sociology, organized into four main parts. First, I review the sociological literature of human–animal interactions, in which sociologists claim that animals possess selves. Second, I review how sociologists have referred to the self, from which I construct five criteria of selfhood, including self as attribution, self-awareness, intersubjectivity, self-concept/reflexivity, and narration. Third, I address how animals have selves using these criteria, drawing on sociological and ethological evidence. Fourth, I critique the animal interaction sociologists’ specific claims of animal selfhood, including their epistemological failure to distinguish between human accounts of animal subjectivities and animal subjectivities, and their empirical failure to show how animals act toward themselves. Ultimately, I conclude that animal selves, particularly in an elemental Meadian sense, are potentially real, but in most cases are unobservable or unverifiable phenomena.

Details

40th Anniversary of Studies in Symbolic Interaction
Type: Book
ISBN: 978-1-78190-783-2

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Article
Publication date: 1 March 2003

Olin E. Myers

Society’s relations to animals pose possible blind spots in sociological theory that may be revealed and illuminated by studying systems of human‐animal interaction. By…

1322

Abstract

Society’s relations to animals pose possible blind spots in sociological theory that may be revealed and illuminated by studying systems of human‐animal interaction. By investigating whether and how animals enter into key processes that shape self and society we may determine the ways in which animals might be included in the core subject matter of sociology. An earlier discussion of the role of animals in sociology initiated by Weber is reviewed. Issues that debate raised about the extent of linguistically‐mediated human‐animal intersubjectivity are updated. It is in principle difficult to rule out animal languages, and some animals have acquired human language. But sociology may follow a more fecund empirical route by examining successful human‐animal performances produced by enduring interspecies relationships. Following this route, this paper specifically argues that the human self should be seen to take root in the available mixed species community. To show this, the work of G.H. Mead is revisited and corrected in light of recent work on early human development, and conceptual analyses of language, the body, and the self. The formation of the self is not dependent on only linguistic exchanges; a nonverbal nonhuman other can contribute to the self‐reflective sense of being a human self. Based on this reasoning, examples of studies of humans with wild and domestic animals illustrate the potential for a human‐animal sociology.

Details

International Journal of Sociology and Social Policy, vol. 23 no. 3
Type: Research Article
ISSN: 0144-333X

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Article
Publication date: 1 March 2003

Janet M. Alger and Steven F. Alger

Ever since Mead, sociology has maintained a deep divide between human and non human animals. In effect, Mead constructed humans as having capacities that he saw lacking in…

1939

Abstract

Ever since Mead, sociology has maintained a deep divide between human and non human animals. In effect, Mead constructed humans as having capacities that he saw lacking in animals. Recent research on animals has challenged the traditional ideas of Mead and others by providing evidence of animal intelligence, adaptability, selfawareness, emotionality, communication and culture. This paper examines the human‐animal relationship as presented in Introductory Sociology Textbooks to see if this new research on animals has allowed us to move beyond Mead. We find outdated information and confused thinking on such topics as the relationship between language and culture, the development of the self in animals, and the role of instinct, socialization and culture in animal behavior. We conclude that, with few exceptions, the main function of the treatment of animals in these texts is to affirm the hard line that sociology has always drawn between humans and other species.

Details

International Journal of Sociology and Social Policy, vol. 23 no. 3
Type: Research Article
ISSN: 0144-333X

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Book part
Publication date: 13 October 2014

Andrew S. London and Janet M. Wilmoth

To conduct an exploratory mixed-methods study of attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

Abstract

Purpose

To conduct an exploratory mixed-methods study of attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

Design

We present descriptive analyses of quantitative data from the National Social, Health, and Aging Project and of qualitative comments posted online by readers of newspaper articles that focus on extramarital relationships in the context of caring for a spouse with Alzheimer’s disease.

Findings

Analyses of the quantitative data indicate the Alzheimer’s caregivers report more negative attitudes toward extramarital sex in the context of spousal Alzheimer’s disease. However, this difference is driven by non-spousal caregivers’ attitudes; spousal caregivers have substantially less negative attitudes. Analyses of public comments suggest that those who are most negative are focused on traditional religious and family values. Those who express less negative attitudes espouse a compassionate pragmatism that makes allowances for caregiver needs in the context of managing the difficulties of the spouse-caregiver role.

Research limitations

Quantitative data are limited by the small number of Alzheimer’s caregivers; qualitative analyses are based on a convenience sample of online comments.

Practical implications

Findings can inform future research, educational initiatives for professionals, the media, and people living with Alzheimer’s disease and their family members.

Social implications

The number of individuals living with Alzheimer’s disease and spousal caregivers will increase as the Baby Boomer generation ages. Norms regarding extramarital relationships in the context of caring for a spouse with Alzheimer’s disease are evolving.

Originality

Little social scientific research examines attitudes toward extramarital relationships in the context of spousal Alzheimer’s disease.

Details

Family Relationships and Familial Responses to Health Issues
Type: Book
ISBN: 978-1-78441-015-5

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Article
Publication date: 1 February 1974

Frances Neel Cheney

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are…

411

Abstract

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

Details

Reference Services Review, vol. 2 no. 2
Type: Research Article
ISSN: 0090-7324

Available. Content available
Book part
Publication date: 14 October 2022

Petra Nordqvist and Leah Gilman

Free Access. Free Access

Abstract

Details

Donors
Type: Book
ISBN: 978-1-80043-564-3

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