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The purpose of this paper is to present a systematic review of literature reviews, summarizing how Lean and Six Sigma management techniques have been implemented in acute care settings to date, and assessing their impact. To aid decision makers who wish to use these techniques by identifying the sectors of activity most often targeted, the main results of the interventions, as well as barriers and facilitators involved. To identify areas of future research.

A literature search was conducted, using eight databases. The methodological quality of the selected reviews was appraised with AMSTAR. A narrative synthesis was performed according to the guidelines proposed by Popay et al. (2006). Data were reported according to PRISMA.

The literature search identified 149 publications published from 1999 to January 2015. Seven literature reviews were included into the systematic review, upon appraisal. The overall quality of the evidence was poor to fair. The clinical settings most described were specialized health care services, including operating suites, intensive care units and emergency departments. The outcomes most often appraised related to processes and quality. The evidence suggests that Lean and Six Sigma are better adapted to settings where processes involve a linear sequence of events.

There is a need for more studies of high methodological quality to better understand the effects of these approaches as well as the factors of success and barriers to their implementation. Field studies comparing the effects of Lean and Six Sigma to those of other process redesign or quality improvement efforts would bring a significant contribution to the body of knowledge.

Lean and Six Sigma can be considered valuable process optimization approaches in acute health care settings. The success of their implementation requires significant participation of clinical personnel from the frontline as well as clinical leaders and managers. More research is needed to better understand the factors of success and the barriers to their implementation, as well as their long-term impact.

This is the first broad systematic review of reviews, synthesizing data pertaining to implementation issues and results in acute care settings, to be published. It will benefit health care managers assessing the potential of these approaches and the potential drawbacks associated with their implementation. Moreover, it identifies directions for future research.

Lean healthcare is highlighted in the literature as an approach to quality improvement and operational efficiency. The purpose of this paper is to study how Lean healthcare has been implemented by analyzing empirical outcomes.

The authors used a literature review as the primary research method, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses process. Peer-reviewed journals were analyzed – searching for Lean healthcare implementation, tools used, wastes addressed, outcomes and sustainability.

Evidence suggests that Lean can improve healthcare operational effectiveness. However, empirical studies show implementation is still highly localized with small successes. Most transformations are focused on implementing one or two Lean tools that primarily target patient waiting times and there is minimal evidence about sustainability. Establishing clear definitions for healthcare-related Lean terminology may improve practice, especially episodic care and service quality.

This work provides a Lean healthcare case review. The research makes a significant contribution to Lean healthcare by increasing understanding (scale, scope and sustainability). From a theory building perspective, the authors suggest that barriers to adoption include a common healthcare-specific Lean terminology, and a need to expand implementation beyond small successes. This understanding will help identify key areas for further research in Lean healthcare management.

This paper seeks to examine the emerging role of the Senior Academic Technology Officer (SATO) in higher education. It aims to consider two existing templates for this professional role derived from mainstream information management and information technology: the Chief Information Officer (CIO) and the Chief Technology Officer (CTO). Characteristically, CIOs and CTOs might be expected to have different appetites for creative destruction. The paper seeks to focus on the match between a SATO's own appetite for radical technological change and innovation – that is, for creative destruction – and that of their institution. The paper concludes with some observations concerning role design and appropriate recruitment and selection criteria for SATOs in higher education.

The paper informs its discussion with a micro case study and the outcomes of a virtual anecdote circle comprised of 20 senior academics, administrators, and educational technologists from higher education institutions in Asia, Australia, North America, and the UK.

The research suggests that the preferred model for a SATO is closest to that of a CIO with a leaning towards innovation and change. However, the paper finds that a SATO's personal appetite for creative destruction may be in conflict with the institution's culture, norms and values, resulting in poor outcomes for both. In order to avoid extreme mismatch the paper recommends a realistic approach to the recruitment and selection of SATOs that is aligned with the organisation's tolerance for innovation and change.

The paper contributes to the body of research‐based literature concerning the strategic management and development of professional scientific and technical staff.

Given the strategic importance of SATOs to ICT‐driven transformation, university leaders will require evidence to formulate appropriate human resource and performance management strategies for these key academic‐related/professional staff. The paper brings together evidence from a highly informed group of stakeholders with active interests in the field using a virtual anecdote circle.

The purpose of this study was to investigate how Lean Six Sigma (LSS) may help mitigate the impact of COVID-19 within health care environments. The goals of this study were to understand the current knowledge of LSS and COVID-19 through a systematic review of the current literature, identify the gap in the current knowledge of LSS in COVID-19 mitigation within health care environments and define the principles of LSS, within organizational resilience that support a health care organization’s ability to mitigate the impact of COVID-19.

A narrative literature review was conducted to identify relevant research. A total of 21 subject matter experts (SMEs) meeting the inclusion criteria were approached through a guided interview process. Content analysis was conducted to describe how LSS principles contribute to supporting health care organizations operating in the era of COVID-19.

Study results report that personal safety is the primary subject, followed by supporting dimensions of process redesign, and telemedicine. LSS topics that directly relate to COVID-19 are in four thematic areas: tools, applications, benefits and challenges. Particular areas of application, techniques, challenges and benefits are identified and discussed that could be applied proactively and reactively, to organizational and supply chain resilience to recover from COVID-19.

There were a number of limitations to the generalizability of this work. The sample size was small and purposeful, thus, external validity of the study results are not determined. The SMEs in this study have not implemented the practices noted in the results at the time of the study, and knowledge of results is limited to the study aims.

This study of LSS principles and COVID-19 has implications for practitioners and offers specific guidance for areas of health care adoption of LSS techniques and tools that benefit patient safety, challenges for the user to be mindful of and potential benefits in resilience of operations in the era of COVID-19.

Educational technologists make significant contributions to the development, organisational embedding and service provision of technology‐enhanced learning (TEL) environments, which are key enablers for mass access to flexible higher education (HE). Given the increasing centrality of this role, it is advocated that institutions investigate sustainable career structures for educational technologists. This paper aims to address these issues.

The arguments are evidence‐driven by the small body of research literature describing the role of educational technologists and contextualized by the experiences as academics and leaders of TEL projects in HE, including managing educational technologists.

The roles of educational technologists are very diverse, requiring competencies in educational leadership, both management and technical. Their career paths, backgrounds, legitimate powers and organisational locations exhibit considerable variation.

University leaders require evidence to formulate appropriate human resource strategies and performance management strategies for educational technologists. Further empirical research to analyze current issues and future trajectories relating to their aspirations, career structures, legitimate power, management and organisational contexts is proposed.

Given the strategic importance of educational technologists to information and communications technology‐driven transformation, university leaders will require evidence to formulate appropriate human resource and performance management strategies for these key academic‐related/professional staff. This paper brings together relevant literature for the first time, generates recommendations for further research and policy discussion.

The purpose of this paper is to present the results from a study that investigates first-line healthcare managers’ views on their role and the conditions that influence their ability to drive improvement work based on Lean.

A questionnaire was sent to all first-line managers in a healthcare organization to investigate their views on their role, conditions and ability to create change according to Lean. The results from four of the questions are presented, which focus on how crucial they consider their role to be for managing improvement work based on Lean, what work tasks their time is spent on, what factors they consider to be important to their ability to drive change and what factors best describe what Lean provides.

The results show that first-line managers claim that their role is crucial in improvement work, but when they defined their work tasks, the time spent on improvements was not frequently described. Time, support from coworkers, and a clear vision and clear goals were the three factors that they considered to be most important to their ability to drive improvement work. Considering their leadership, Lean contributed to the structure with tools and supportive methods.

The questions can be used separately or as part of the entire questionnaire before and along a Lean process to obtain a better understanding of how to create a sustainable Lean approach in healthcare. Understanding the factors that first-line managers consider supporting their ability in improvement work and what they consider Lean provides is important in creating a development force in Swedish healthcare.

This study investigates the role of leadership and cultural transformation in facilitating Lean Six Sigma (LSS) practices in clinical pharmacy settings to reduce medicine waste within the UK National Health Services (NHS).

A systematic literature review on Lean Six Sigma in health care was conducted to develop an analytical framework. This was followed by a qualitative case study of an English NHS trust to test the framework, exploring pharmacists' adoption of LSS practices and their impact on staff behaviour, focussing on leadership decisions and organisational culture.

The research highlights the significance of leadership’s prioritisation in waste reduction efforts and its influence on staff engagement. It also examines the intricate relationship between leadership decisions, education and training, resource allocation, and the prevailing clinical culture, which shapes pharmacists' behaviours and attitudes towards LSS practices and waste reduction.

The study’s focus on a single NHS trust limits the generalisability of the findings, suggesting the need for further research across different healthcare settings.

The study recommends a cultural transformation, earlier training, and reformation in service strategy to enhance the adoption of LSS practices and contribute to a more sustainable future for the wider health services.

Effective medicine waste management prevents harm and helps address the current NHS medicine shortage. The NHS can allocate resources efficiently, ensure timely treatment, and prepare for future disruptions by implementing the proposed framework.

We developed a leadership model for the NHS to reduce medicine waste, offering a novel approach to addressing the challenge of medicine waste through leadership and cultural transformation.

This chapter focuses on one particular practice that came to the forefront in over a dozen teacher education sessions with government schoolteachers in southern India- the reflective practice “Dialogic Modeling.” This chapter delves into two primary facets of dialogic modeling: how it operates and how it fosters opportunities to study the practices being modeled. To help supporters’ and critics’ reading, this chapter examines the form of several episodes of dialogic modeling. By form, the author refers to terms such as logic, structure, and conditions. This form and function analytic is critical to recognizing the mechanics of the practice, and provides an understanding of how a reflective dialogic practice can operate. The chapter also takes up why this form matters for how teachers learn to do their work, and how doing the work of teaching can be bolstered through reflective practice. By doing so, the chapter aims to provide additional warrants for the claims that teacher education can, and likely should, involve teacher-learners in the deliberate study of principled practices. Moreover, the author argues that modeling as it is commonly done leaves much to chance and squanders the opportunity to learn and build teachers’ capacities.

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.

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.

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.

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”.

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.

The purpose of this paper is to describe and evaluate a Lean leadership-training program within the health-care sector. A training program developed through a cocreative process with the intent of enhancing the possibilities for a context-specific adaption of Lean.

A cocreated leadership-training program, executed over a period of one year, is described both as a model development process and as the final training program. The program was evaluated through reflective discussions and feedback as well as a written final evaluation of the program from participants in the program.

The evaluation shows that the objectives of the training program were met, at least among the participants who attended the whole program. Using a cocreative process when developing and realizing a leadership-training program enhances the possibilities for an organization to adapt Lean to its own context. One condition for this approach to be successful is that the expectations of both the organization and the university need to be in focus through the whole process. In addition, the executive team needs to be continuously engaged and create conditions for the organization to realize the potential benefits of the training program.

This paper highlights the challenge when applying Lean in a health-care organization but also describes a way to address Lean training and learning in this context.