Implementing Lean Six Sigma in health care: a review of case studies

Purpose Health care organisations implement lean six sigma (LSS) methodology to achieve improved performance in terms of cost, quality and productivity. However, the way it gets implemented differs between organisations. Hence, this paper deal with a review of case studies describing the implementation of LSS in health care organisations to understand the nuances of implementation and identify future research directions. Design/methodology/approach The journal articles indexed in the Web of Science and Scopus database were filtered out. In total, 154 articles were evaluated using specific structural dimensions to categorise the literature into various groups, and content analysis was performed to synthesise the same. Findings This review revealed that the number of articles publishing the application of LSS in health care has been increasing in the last five years. Academic hospitals play a pivotal role to bridge the gap between LSS theory and practice. Despite this fact, certain themes remain unexplored. Not many studies are available that document the application of LSS in non-clinical areas such as pharmacy, internal logistics, maintenance and medical records. Only 20% of articles mentioned the post-intervention data up to three years, thus questioning the sustainability aspect of the achieved improvements. Research limitations/implications Various research gaps were identified, which can be used by the researchers to build the body of knowledge in the domain of LSS in health care. Practical implications This review provides a diversified view regarding the utility of LSS in the health care scenario. The findings will provide valuable insights for the health care practitioners regarding tools, techniques, drivers and performance measures. Originality/value To the best of the authors’ knowledge, this is the first study to review only the case studies that describe the implementation of LSS in the health care sector.