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The aim of this study reported in this paper was to explore the application of operational excellence methodologies in a global context.

A qualitative interview approach was used to understand the current state, benefits, challenges, success factors, tools and techniques of operational excellence methodology implementation with relevance to logistics companies worldwide. About 16 interviews were undertaken with practitioners working in leading companies and with leading academics in Asia, Europe, Africa, North America, South America and Australia.

The findings show that operational excellence methodologies including Lean, Six Sigma, Lean Six Sigma and Agile can apply in logistics firms to improve operations and productivity and save costs. Top management support and involvement play an important role in the success of operational excellence projects in the logistics service.

The findings will be of interest to top and middle managers and logistics practitioners, with a dual aim of improving logistics performance and saving costs.

The present study has been one of the first global study attempts to explore the implementation of operational excellence methodologies in the logistics sectors.

The purpose of this paper is to illustrate the use of Lean Six Sigma (LSS) and its associated tools to reduce dispensing errors in an inpatient pharmacy of a teaching hospital in Thailand.

The action research methodology was used to illustrate the implementation of Lean Six Sigma through the collaboration between the researcher and participants. The project team followed the Lean Six Sigma Define, Measure, Analyze, Improve, Control (DMAIC) methodology and applied its tools in various phases of the methodology.

The number of dispensing errors decreased from 6 to 2 incidents per 20,000 inpatient days per month between April 2018 and August 2019 representing a 66.66% reduction. The project has improved the dispensing process performance resulting in dispensing error reduction and improved patient safety. The communication channels between the hospital pharmacy and the pharmacy technicians have also been improved.

This study was conducted in an inpatient pharmacy of a teaching hospital in Thailand. Therefore, the findings from this study cannot be generalized beyond the specific setting. However, the findings are applicable in the case of similar contexts and/or situations.

This is the first study that employs a continuous improvement methodology for the purpose of improving the dispensing process and the quality of care in a hospital. This study contributes to an understanding of how the application of action research can save patients' lives, improve patient safety and increase work satisfaction in the pharmacy service.

The aims of this paper are to illustrate the use of Lean tools to reduce inpatient waiting time and to evaluate critical success factors of Lean implementation in an inpatient pharmacy in a Thai public hospital.

This study was carried out through action research methodology by following four key phases: identification of problems; planning action; taking action; and evaluation. In the “taking action” phase, Lean tools, including value stream mapping and 5S were implemented to improve dispensing process in an inpatient pharmacy. In the “evaluation phase”, the critical success factors of Lean implementation in an inpatient pharmacy were evaluated by the participants.

Lean methodology was successfully implemented to reduce the waiting time associated with a three days dose distribution system. As a result of Lean application, the average process time reduced from 8.81 to 7.2 min and the standard deviation reduced from 5.49 to 4.45 min. Moreover, the support of middle management and the leadership were the key success factors of Lean implementation in an inpatient pharmacy.

Hospitals can improve the dispensing process by using Lean tools which are easy to apply and use. This study is appropriate for hospital managers looking for changes in pharmacy services or other departments.

This is the first study that has applied Lean tools to improve the dispensing process in an inpatient pharmacy in Thai hospitals. This study offers important insights into the critical success factors of Lean employment in the inpatient pharmacy.

The purpose of this paper is to present the implementation of Lean Six Sigma (LSS) to reduce medication errors, by using four case examples. The paper will also suggest appropriate Lean and Sigma tools to improve the medication process.

The authors critically analyze four case examples that used LSS projects, to demonstrate the approach, benefits, success factors and lessons learnt.

LSS is a powerful process improvement methodology that could be applied by health-care sectors to reduce medication errors, increase patient safety and reduce operational costs. Common Lean and Six Sigma tools play a significant role in improving and sustaining the medication process.

It is necessary for the project team to select the most appropriate LSS tools to address medication process problems. Adoption of a LSS roadmap could help health-care organizations in the successful implementation of LSS.

The paper is valuable for health-care professionals seeking to reduce errors in the medication process or other processes that need to be improved.

The purpose of this study is to propose a Lean Six Sigma (LSS) roadmap to guide healthcare practitioners in the implementation of LSS along with a customized LSS tool kit for reducing medication errors.

The authors initially critically reviewed several frameworks/roadmaps of Lean, Six Sigma and LSS which have been proposed in healthcare sector from the existing literature. This review has led to an understanding of key characteristics, limitations and reasons behind the development of such frameworks/roadmaps. A conceptual roadmap was developed and then validated by a number of LSS experts and a healthcare practitioner. Based on the previous studies and taking LSS experts’ opinions into account, a revised roadmap for reducing medication is presented.

The roadmap for LSS in reducing medication errors is developed. This roadmap includes three phases: Phase 1 cultural readiness for LSS employment in reducing medication errors; Phase 2 preparation, initialization and implementation; and Phase 3 sustainability.

The roadmap has been tested with only a handful of practitioners of LSS. Moreover, only two case studies have been carried out in a Thai hospital setting which followed the roadmap. In order to improve the validity of research, more case studies need to be executed and more people should be used for testing the roadmap with varied cultures.

This is the first attempt in the development of a LSS roadmap that healthcare practitioners can follow to reduce medication errors using LSS methodology and sustaining LSS in their organizations.

Medication errors are a significant cause of injury in Norwegian hospitals. The purpose of this study is to explore how Lean Six Sigma (LSS) has been used in the Norwegian public health-care context to reduce medication errors.

A mixed method approach was used to gather data from participants working in the four regions served by the Norway health authorities. A survey questionnaire was distributed to 38 health-care practitioners and semi-structured interviews were conducted with 12 health-care practitioners.

The study finds that the implementation of LSS in the Norwegian public health-care context is still in its infancy. This is amidst several challenges faced by Norwegian hospitals such as the lack of top-management support, lack of LSS training and coaching and a lack of awareness around the benefits of LSS in health care.

Because of the large geographical area, it was difficult to reach participants from all health regions in Norway. However, the study managed to assess the current status of LSS implementation through the participants’ perspectives. This is a fruitful area for future research whereby an action research methodology could be used.

To the best of the authors’ knowledge, this is the first empirical study into the use of LSS methodology in reducing medication errors. In addition, this study is valuable for health-care practitioners and professionals as a guideline to achieve the optimal benefit of LSS implementation to reduce medication errors.

Green lean six sigma (GLSS) is a sustainable development approach that leads to improved patient care with improved safety and quality of service to patients. This study aims to identify, study, model and analyze GLSS success factors for the Indian health-care facility.

Interpretive structural modeling (ISM) and Impact Matrix Cross-Reference Multiplication Applied to a Classification analyses have been used to understand the hierarchical structure among the GLSS success factors. This enabled the development of dependency relationships between success factors, in particular, which factors support the development of other factors.

Specifically, this study found that the success factors “commitment of management” and “financial availability” are the most critical to GLSS implementation success, as they support the development of all other success factors. Meanwhile “embedding sustainable measures at each stage of the service”; “the capability and effectiveness of real-time data collection”; and “feedback and corrective actions” most directly support the GLSS implementation in the health-care facility and serve as the final indicators of implementation progress.

The major implication of this research work lies in suggesting a direction for practitioners to execute the GLSS approach through a systematic understanding of classification and structural relationships among different enablers. This study also facilitates health-care managers to explore different GL wastes in hospitals and challenges to sustainability pursuits in health-care that assist in an organization’s efforts toward sustainable development.

This research work is the first of its kind that deals with the identification and analysis of the prominent factors that foster the inclusive implementation of GLSS within the health-care facility.