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Article
Publication date: 24 February 2020

V. Vaishnavi and M. Suresh

This paper aims to identify, analyze and categorize the major readiness factors for implementing Lean Six Sigma (LSS) in health-care organizations using total interpretive…

2937

Abstract

Purpose

This paper aims to identify, analyze and categorize the major readiness factors for implementing Lean Six Sigma (LSS) in health-care organizations using total interpretive structural modelling technique. The readiness factors are identified would help the managers to recognize the areas that lack and provide importance to the successful implementation of LSS in those areas. The paper further intends to understand the hierarchical interrelationships among the readiness factors identified using dependence and driving power.

Design/methodology/approach

In total, 16 readiness factors are identified from the literature review and expert opinions are collected from hospitals. The scheduled interview is conducted based on a questionnaire survey in hospitals in the Indian context to identify the relevance of the relations among the readiness factors. The expert opinions are used in the initial reachability matrix and interpretative interaction matrix. Matrix impact cross multiplication applied to classification (MICMAC) analysis uses dependence and driving power to understand the hierarchical relationship among the readiness factors identified.

Findings

The result indicates that customer-oriented and goal management cultures are the key readiness factors for LSS. The execution technique and training are given according to the current demand of customers and goal change of organization. The manager needs to concentrate more on readiness factors to formulate the execution process of LSS for continuous improvement of the health-care organization. The readiness level helps the manager to identify the target area for LSS execution.

Research limitations/implications

This research focuses mainly on readiness factors for the implementation of LSS in the health-care industry.

Practical implications

This study would be useful for researchers and practitioners to understand the readiness factors before starting the implementation process of LSS.

Originality/value

Many research studies are being done on the success and failure rate of implementation of factors. The present study identifies the readiness factors related to LSS, especially for the health-care industry.

Details

International Journal of Lean Six Sigma, vol. 11 no. 4
Type: Research Article
ISSN: 2040-4166

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Article
Publication date: 18 July 2022

V. Vaishnavi and M. Suresh

Environmental sustainability (ES) is an increasing tendency in the healthcare industry as it seeks to enhance the environmental friendliness and reduces waste in operations to…

694

Abstract

Purpose

Environmental sustainability (ES) is an increasing tendency in the healthcare industry as it seeks to enhance the environmental friendliness and reduces waste in operations to save money. The objective of research article is to identify the factors that contribute to improving the performance of ES in hospitals. Understanding the factors that contribute to the improvement of healthcare services may be helpful for practitioners, who need to address and implement an effective framework to enable an environment-friendly practice in hospitals.

Design/methodology/approach

The current study utilised the technique called total interpretive structural modelling (TISM) to identify the factors and understand the interconnection between the identified factors. A literature review revealed 12 factors, which were then refined with the input of hospital experts. Based on a questionnaire survey, a planned interview is conducted in chosen Indian hospitals. The matrix impact cross multiplication applied to classification (MICMAC) study employs dependency and driving power to identify the hierarchical relationship between the detected factors.

Findings

Green building initiatives, water consumption, resource usage, and renewable energy were identified as key factors in the study. Other factors such as staff behaviour, procurement of goods and management of hazardous substance would be influenced by these fundamental components. With the implementation of green initiatives in the hospital, ES is primarily used to reduce the excessive use of scarce resources.

Practical implications

The ES programme begins at the hospital grounds, with awareness and specific training provided to all personnel, including doctors, nurses, and managers at all levels. The training programme is intended to raise awareness; sessions are divided into targeted groups; a new organisational structure is created; and a consultant agent is hired to commence ES.

Originality/value

Existing literature has focussed mostly on ES factors such as carbon emissions, water conservation, and effective waste disposal, while ignoring organisational viewpoints and their interrelationships. As a result, the current study used TISM to show the relationship between various organisational and environmental perspective components in order to comprehend the reasoning behind improving performance.

Details

Management of Environmental Quality: An International Journal, vol. 34 no. 1
Type: Research Article
ISSN: 1477-7835

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Article
Publication date: 9 August 2019

Vaishnavi V., Suresh M. and Pankaj Dutta

The purpose of this paper is to identify and analyze the interactions among different readiness factors for implementing agility in healthcare organization. Total interpretive…

2372

Abstract

Purpose

The purpose of this paper is to identify and analyze the interactions among different readiness factors for implementing agility in healthcare organization. Total interpretive structural modeling (TISM) based readiness framework for agility has been developed to understand the mutual interactions among the factors and to identify the driving and dependence power of these factors.

Design/methodology/approach

The identification of factors is done by TISM approach used for analyzing the mutual interactions between factors. Cross-impact matrix multiplication applied to classification analysis is utilized to find the driving and dependent factors of agile readiness in healthcare.

Findings

This paper identifies 12 factors of readiness for change in literature review, which is followed by an expert interview to understand the interconnection of factors and to study interrelationships of factors. The study suggests that factors like environmental scanning, resource availability, innovativeness, cost effectiveness, organizational leadership, training and development are important for implementing/improving the readiness of agility in healthcare organizations.

Research limitations/implications

This research focuses mainly on readiness factors for agility in healthcare sector.

Practical implications

Top management must stress on readiness factors that have a strong driving power for efficient implementation of agility in healthcare. This study helps the managers to take quick decisions, and continuous monitoring of readiness factors would be more beneficial to improve the quality of service, which makes the organization more agile.

Originality/value

In this research, TISM-based readiness for agile framework structural model has been proposed for healthcare organizations, which is a new effort for implementation of agility in healthcare.

Details

Benchmarking: An International Journal, vol. 26 no. 7
Type: Research Article
ISSN: 1463-5771

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Article
Publication date: 18 May 2020

V. Vaishnavi and M. Suresh

Lean Six Sigma (LSS) is a widely accepted business improvement methodology in healthcare, which aims to improve operations and quality and reduce cost, medical errors and waiting…

1229

Abstract

Purpose

Lean Six Sigma (LSS) is a widely accepted business improvement methodology in healthcare, which aims to improve operations and quality and reduce cost, medical errors and waiting time by combing the principles of lean thinking with Six Sigma methodologies. To implement LSS successfully in healthcare organizations it is necessary to know the readiness level before starting the change process. Thus, the purpose of this paper is to assess the readiness level for the implementation of LSS in healthcare using a fuzzy logic approach.

Design/methodology/approach

The current study uses a fuzzy logic approach to develop an assessment model for readiness to implement LSS. The conceptual model for readiness is developed with 5 enablers, 16 criteria and 48 attributes identified from the literature review. The current study does the study in a medium-size hospital from India.

Findings

The fuzzy readiness for implementation of LSS index (FRLSSI) and fuzzy performance importance index (FPII) are calculated to identify the readiness level for the implementation of LSS in the case hospital. The FRLSSI is computed as average ready with (3.30, 5.06 and 6.83) and the FPII computed helps to identify 15 weaker attributes from 48 attributes.

Research limitations/implications

The current study uses only one hospital for study. In the future, the model can be tested in many hospitals.

Practical implications

The current study would be used by the managers of a healthcare organization to identify the readiness level of their organization to implement LSS. The proposed model is based on the identification of enablers, criteria and attributes to assess the readiness level of a healthcare organization and it helps to improve the readiness level to implement LSS effectively.

Originality/value

The present study contributes to the knowledge of readiness for the implementation of LSS in a healthcare organization. The conceptual model is developed for assessing the readiness level of a healthcare organization and it helps to improve the readiness level for successful implementation of LSS. Weaker attributes are identified and necessary corrective actions should be taken by the management to improve the readiness. The continuation of the assessment readiness model over a period of time would help to improve the readiness level of healthcare for the implementation of LSS.

Details

International Journal of Lean Six Sigma, vol. 12 no. 2
Type: Research Article
ISSN: 2040-4166

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Article
Publication date: 4 February 2019

V. Vaishnavi, M. Suresh and Pankaj Dutta

The purpose of this paper is to identify, analyze and develop a model to measure the interactions among different factors of organizational readiness for change in service sector…

4793

Abstract

Purpose

The purpose of this paper is to identify, analyze and develop a model to measure the interactions among different factors of organizational readiness for change in service sector specific to healthcare organization. The total interpretive structural modeling (TISM)-based readiness for change is to build a theoretical framework to understand the mutual interactions among the factors and to identify the driving and dependence power of these factors.

Design/methodology/approach

TISM is used to identify factors that contribute to analyze the readiness state before starting a change implementation process in healthcare. Matrice d’Impacts croises-multiplication applique´ a classement analysis is used to find the driving and dependent factors of change in healthcare.

Findings

This paper identified 12 factors of readiness for change from literature review followed by expert interview to understand the inner connection of factors and study inner relationships. The result says that state of affairs, recent trends in healthcare sector, technology advancement and interdependence among departments are key factors for readiness of change.

Research limitations/implications

This research mainly focused on readiness factors for change in the healthcare sector.

Practical implications

This study will be useful for researcher and practitioners to understand the readiness factors for change.

Originality/value

In this research work, TISM-based readiness for the change framework structural model has been proposed for healthcare organizations which is a new effort in the area of organizational change management in this sector.

Details

Benchmarking: An International Journal, vol. 26 no. 4
Type: Research Article
ISSN: 1463-5771

Keywords

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Article
Publication date: 9 March 2020

M. Suresh, V. Vaishnavi and Rajesh D. Pai

Lean practices are one of the fundamental practices adopted by health-care organizations to improve service quality and to reduce cost. In this context, the measurement of…

304

Abstract

Purpose

Lean practices are one of the fundamental practices adopted by health-care organizations to improve service quality and to reduce cost. In this context, the measurement of leanness in health-care organizations has become imperative. The purpose of this study is to measure the leanness of a hospital using fuzzy logic.

Design/methodology/approach

The design of the research includes two major steps. First, the identification of enablers, criteria and attributes of leanness constitutes the measures of assessment. Second, the above measures in the case hospital are assessed by using fuzzy logic approach.

Findings

This study suggests that leanness assessment is essential to identify the current lean capability of a health-care organization. This would help the health-care organizations to improve their lean performance further. The findings of the study suggest that the leanness of the case hospital is “Lean” (fuzzy range: 5.61, 7.24 and 8.91).

Practical implications

This study brings in three important implications from managerial point of view. First, it helps the management to assess the current level of leanness of the hospital. Second, it identifies the attributes that prevent the organization from being more lean. Third, it provides suggestive measures to address the weaker attributes and enables the enhancement of lean performance further.

Originality/value

The leanness assessment framework developed in the hospital operations is found to be original, and it adds value to the leanness assessment in health-care operations.

Details

International Journal of Organizational Analysis, vol. 28 no. 6
Type: Research Article
ISSN: 1934-8835

Keywords

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Book part
Publication date: 11 June 2021

Hanlie Smuts and Alet Smith

Significant advances in digital technologies impact both organisations and knowledge workers alike. Organisations are now able to effectively analyse significant amounts of data…

Abstract

Significant advances in digital technologies impact both organisations and knowledge workers alike. Organisations are now able to effectively analyse significant amounts of data, while accomplishing actionable insight and data-driven decision-making through knowledge workers that understand and manage greater complexity. For decision-makers to be in a position where sufficient information and data-driven insights enable them to make informed decisions, they need to better understand fundamental constructs that lead to the understanding of deep knowledge and wisdom. In an attempt to guide organisations in such a process of understanding, this research study focuses on the design of an organisational transformation framework for data-driven decision-making (OTxDD) based on the collaboration of human and machine for knowledge work. The OTxDD framework was designed through a design science research approach and consists of 4 major enablers (data analytics, data management, data platform, data-driven organisation ethos) and 12 sub-enablers. The OTxDD framework was evaluated in a real-world scenario, where after, based on the evaluation feedback, the OTxDD framework was improved and an organisational measurement tool developed. By considering such an OTxDD framework and measurement tool, organisations will be able to create a clear transformation path to data-driven decision-making, while applying the insight from both knowledge workers and intelligent machines.

Details

Information Technology in Organisations and Societies: Multidisciplinary Perspectives from AI to Technostress
Type: Book
ISBN: 978-1-83909-812-3

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Article
Publication date: 29 July 2022

Aswathy Sreenivasan and M. Suresh

The purpose of this paper is to “identify”, “analyze” and “construct” a framework to quantify the relationships between several determinants of organizational preparedness for…

511

Abstract

Purpose

The purpose of this paper is to “identify”, “analyze” and “construct” a framework to quantify the relationships between several determinants of organizational preparedness for change in the start-ups during the COVID-19 emergencies.

Design/methodology/approach

Total interpretive structural modelling (TISM) is used to find characteristics that assist in analyzing the readiness or preparedness level before initiating a change deployment process in start-ups. A cross-impact matrix multiplication applied to classification (MICMAC) analysis is performed to determine the driving and dependent elements of change in start-ups.

Findings

From literature research and an expert interview, this study selected ten variables of change preparedness to explore inner interconnections and comprehend the inner connections factors. The findings depict that clarity of mission and goals, reward system, technological advancement and motivational readiness have been considered the most important readiness factor for deploying organizational change in start-ups during the COVID-19 emergencies.

Practical implications

This research will aid the management and researchers gain a better understanding of the factors that influence change preparedness. Constant observation of current changes in the start-ups and the external environment will aid in improving the quality of products or services provided by the start-ups during the COVID-19. The start-ups can use these criteria linked to change readiness. The priority of each element is determined using MICMAC analysis and ranking using the TISM technique, which assists start-ups in ordering the enablers from highest to lowest priority.

Originality/value

There is no research regarding factors influencing organizational readiness for change in start-ups during the COVID-19 emergencies. This research gap is filled by analyzing aspects linked to organizational readiness for change in start-ups. This gap inspired the present study, which uses the “Total Interpretive Structural Modelling (TISM)” technique to uncover change determinants and investigate hierarchical interconnections among factors influencing organizational readiness to change in start-ups during the COVID-19 emergencies.

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Article
Publication date: 19 July 2021

Vikas Swarnakar, Anthony Bagherian and A.R. Singh

The objective of this paper is to investigate, assess and develop a hierarchical model to evaluate the interrelationship of critical success factors (CSFs) that influence the…

710

Abstract

Purpose

The objective of this paper is to investigate, assess and develop a hierarchical model to evaluate the interrelationship of critical success factors (CSFs) that influence the deployment of Sustainable LSS framework in hospitals. Further, developed model has been validated to investigate its applicability in hospitals towards sustainable LSS implementation.

Design/methodology/approach

“Interpretive Structural Modeling” (ISM) has been utilized to develop a convenient hierarchy and contextual relationship of key CSFs throughout the implementation pathway in Indian healthcare industry through systematic literature review and expert opinion, which is ensured by a taxonomy of CSFs using MICMAC (“Matrice d' Impacts Croisés-Multiplication Appliquée á un Classement”) and questionnaire-based survey to empirically validate the model through utilizing “Structural Equation Modelling” (SEM).

Findings

In this study, 17 keys CSFs to sustainable LSS implementation in healthcare industry have been investigated, and modeled. “Social and environmental responsibility,” “Financial return and project success stories,” “Top management involvement and leadership to implement Sustainable LSS,” “Availability of required resources, and their efficient utilization” are found to be the most essential CSFs for successful sustainable LSS implementation in healthcare industry. Further, classification of CSFs has been done for better interpretation of their nature using MICMAC approach. Moreover, the applicability of the proposed model has been empirically assessed utilizing SEM.

Research limitations/implications

The scrutiny of data reveals that the initial inputs from experts throughout the ISM pathway could trigger biased inputs into the study and generalization of the results into others, it might be viable that this propounded model might trigger distinct outcomes for contrasting types of healthcare organizations.

Practical implications

This model on sustainable LSS would support the decision-makers, practitioners and researchers to predict key CSFs through deployment and support the existing academic research on sustainable LSS. Accordingly, the focus on the CSFs of the sustainable LSS can be prioritized to diminish waste, and enhance patient satisfaction and safety.

Originality/value

This paper is an original contribution of analysis of CSFs in Indian healthcare industry utilizing an integrated ISM-MICMAC and SEM approach.

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Article
Publication date: 31 August 2023

Albi Thomas and M. Suresh

This paper aims to “identify,” “analyse” and “categorise” the readiness factors of lean sustainability in health-care organisation using total interpretive structural modelling…

403

Abstract

Purpose

This paper aims to “identify,” “analyse” and “categorise” the readiness factors of lean sustainability in health-care organisation using total interpretive structural modelling (TISM).

Design/methodology/approach

To obtain the data, a closed-ended questionnaire was used in addition to a scheduled interview. To identify how the factors interact, the TISM approach was used, and the matriced’ impacts croise’s multiplication applique’e a UN classement (MICMAC) analysis was used to rank and categorise the lean sustainability readiness factors.

Findings

This study identified ten lean sustainability readiness factors for health-care organisation. The identified factors are resources utilization practice (F1), management commitment and leadership (F2), operational flexibility (F3), workforce engagement and time commitment (F4), sustainability motivational factors (F5), awareness of lean and sustainable practice (F6), hospital design (F7), energy efficiency practices in hospitals (F8), responsible autonomy (F9) and new system adoptability training (F10). The key/driving factors are identified in this study are operational flexibility, sustainability motivational factors, management commitment and leadership, new system adoptability training.

Research limitations/implications

The study focussed primarily on lean sustainability factors for the health-care sector.

Practical implications

This research will aid key stakeholders and academics in the better understanding the readiness factors that influence lean sustainability in health-care organisation. This study emphasises the factors that must be considered when applying lean sustainable practices in health care as a real-world application in a health-care organisation. These readiness factors for lean sustainability can be used by an organization to comprehend more about the concept and the components that contribute to health-care lean sustainability.

Originality/value

This study proposes the TISM technique for health care, which is a novel attempt in the subject of lean sustainability in this sector.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 18 no. 1
Type: Research Article
ISSN: 1750-6123

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