Search Results (18)

The main thrust of the study is the need to cut down the time taken for mold changes in plastic injection molding which is fundamental to the productivity and efficiency of the process. The research encompasses Lean Manufacturing, DMAIC, and SMED which are improved using fuzzy logic and AI for rapid changeover optimization on the NEGRI BOSSI 650 machine. A decrease in downtime by 65% and an improvement in the Process Cycle Efficiency by 46.8% followed the identification of bottlenecks, externalizing tasks, and streamlining workflows. AI-driven analysis could make on-the-fly adjustments, which would ensure that resources are better allocated, and thus sustainable performance is maintained. The findings highlight how integrating Lean methods with advanced technologies enhances operational agility and competitiveness, offering a scalable model for continuous improvement in industrial settings. Full article

Colorectal cancer (CRC) is the third most common cancer in men and the second most common in women globally. CRC is considered a priority public health issue due to its incidence and the high associated costs. Surgery is the predominant therapeutic approach for CRC. Given the involvement of the intestinal tract in the surgical process, there is a significant increase in postoperative morbidity rates, and the average length of hospital stay (LOS) tends to lengthen. In this research, we employed the Lean Six Sigma (LSS) methodology, specifically utilizing the DMAIC cycle, to identify and subsequently examine the effects of fast-track surgery on hospitalization times for interventions related to CRC at the AORN “Antonio Cardarelli” Hospital in Naples (Italy). The process analysis, guided by the DMAIC cycle, facilitated a reduction in the median LOS from 14 days to 12 days. The most notable improvement was observed in the 66–75 age group without comorbidities. The LSS approach provides methodological rigor, as previously recognized, enabling substantial enhancements to the process. This involves standardizing outcomes, minimizing variability, and achieving an overall reduction in the LOS from 14 to 12 days. Full article

Laparoscopic cholecystectomy (LC) is the gold standard technique for gallbladder diseases in both emergency and elective surgery. The incidence of the disease related to an increasingly elderly population coupled with the efficacy and safety of LC treatment resulted in an increase in the frequency of interventions without an increase in surgical mortality. For these reasons, managers implement strategies by which to standardize the process of patients undergoing LC. Specifically, the goal is to ensure, in accordance with the guidelines of the Italian Ministry of Health, a reduction in post-operative length of stay (LOS). In this study, a Lean Six Sigma (LSS) methodological approach was implemented to identify and subsequently investigate, through statistical analysis, the effect that corrective actions have had on the post-operative hospitalization for LC interventions performed in a University Hospital. The analysis of the process, which involved a sample of 478 patients, with an approach guided by the Define, Measure, Analyze, Improve, and Control (DMAIC) cycle, made it possible to reduce the post-operative LOS from an average of 6.67 to 4.44 days. The most significant reduction was obtained for the 60–69 age group, for whom the probability of using LC is higher than for younger people. The LSS offers a methodological rigor that has allowed us, as already known, to make significant improvements to the process, standardizing the result by limiting the variability and obtaining a total reduction of post-operative LOS of 67%. Full article

Inadequate staffing and long waiting times in hospital emergency rooms are key concerns that can have a negative impact on patient safety and health, as well as the hospital’s overall performance. The purpose of this paper is to investigate the scope of combining the DMAIC (define, measure, analyze, improve, and control) methodology with discrete event simulation and to explore its successful deployment in the Jordanian healthcare sector. The study discussed in this paper is based on a case study conducted utilizing the DMAIC and simulation technique and its application in reducing waiting time and enhancing overall system efficiency in Jordan’s Princess Rahma hospital’s pediatric emergency department. The study shows improvements in the performance of the process and thus productivity in the emergency department through adapting the combined Six Sigma DES methodology. The cycle time of the process was reduced by 73% of the present value, while simultaneously enhancing the total performance of the emergency department by 83%. Full article

This research addresses and analyzes the results of a six-sigma approach used to optimize the logistics costs of a pipe manufacturing company. Two mathematical models are developed for containers to control the company’s logistics. The Mathematical Programming Language (MPL) software is used to generate and solve these models. The results verify that the proposed mathematical models result in the company’s logistics improvement, especially in the DMAIC (define, measure, analyze, improve, and control) cycle by providing flexibility in choosing the most appropriate containers for logistics. Full article

Background: SSIs (surgical site infections) are associated with increased rates of morbidity and mortality. The traditional quality improvement strategies focusing on individual performance did not achieve sustainable improvement. This study aimed to implement the Six Sigma DMAIC method to reduce SSIs and to sustain improvements in surgical quality. The surgical procedures, clinical data, and surgical site infections were collected among 42,233 hospitalized surgical patients from 1 January 2019 to 31 December 2020. Following strengthening leadership and empowering a multidisciplinary SSI prevention team, DMAIC (Define, Measure, Analyze, Improve, and Control) was used as the performance improvement model. An evidence-based prevention bundle for reduction of SSI was adopted as performance measures. Environmental monitoring and antimicrobial stewardship programs were strengthened to prevent the transmission of multi-drug resistant microorganisms. Process change was integrated into a clinical pathway information system. Improvement cycles by corrective actions for the risk events of SSIs were implemented to ensure sustaining improvements. We have reached the targets of the prevention bundle elements in the post-intervention period in 2020. The carbapenem resistance rates of Enterobacteriaceae and P. aeruginosa were lower than 10%. A significant 22.2% decline in SSI rates has been achieved, from 0.9% for the pre-intervention period in 2019 to 0.7% for the post-intervention period in 2020 (p = 0.004). Application of the Six Sigma DMAIC approach could significantly reduce the SSI rates. It also could help hospital administrators and quality management personnel to create a culture of patient safety. Full article

Continuous improvement is the prime requirement for all industries to sustain and grow in the competitive global market. This paper is a case study of a manufacturing industry in Taiwan, facing the problem of rejection in the brushless motor product. The DMAIC (Define, Measure, Analyze, Improve, and Control) cycle was used to improve processes to reduce the rejection rate. In the Define phase, anything related to processes, products, suppliers, customers, and customer needs related to good quality products were determined. SIPOC diagrams (Supplier, Input, Process, Output, and Customer) and Critical to Quality (CTQ) were identified. The Measure phase focused on data collection by determining the baseline of the process and determining the root causes of the process. DPMO and the Control Chart were applied in this phase. In the Analyze phase, the causes of production process failures that result in defective products were identified. Tools like Pareto Diagram, Fishbone Diagram, and FMEA were used in this phase. In the Improve phase, the improvement solutions in overcoming priority problems were determined by using the 5W + 1H tool. Several improvement solutions were implemented, such as improvement in inspection methods, re-selection for the supplier, increasing the number of workers, providing training to workers, and others. In the control phase, the Six Sigma values were improved. In January–May 2022, the Six Sigma level increased from 5.11 to 5.44. Full article

Industry 4.0 is fast becoming a mainstream goal, and many companies are lining up to join the Fourth Industrial Revolution. Small and medium-sized enterprises, especially in the manufacturing industry, are the most heavily challenged in adopting new technology. One of the reasons why these enterprises are lagging behind is the motivation of the key personnel, the decision-makers. The factories in question often do not have a pressing need for advancing to Industry 4.0 and are wary of the risk in doing so. The authors present a rapid, low-cost prototyping solution for the manufacturing companies with legacy machinery intending to adopt the Industry 4.0 paradigm with a low-risk initial step. The legacy machines are retrofitted through the Industrial Internet of Things, making these machines both connectable and capable of providing data, thus enabling process monitoring. The machine chosen as the digitization target was not connectable, and the retrofit was extensive. The choice was made to present the benefits of digitization to the stakeholders quickly and effectively. Indeed, the solution provides immediate results within manufacturing industrial settings, with the ultimate goal being the digital transformation of the entire factory. This work presents an implementation cycle for digitizing an industrial broaching machine, supported by state-of-the-art literature analysis. The methodology utilized in this work is based on the well-known DMAIC strategy customized for the specifics of this case study. Full article

Process optimization with Lean Six Sigma (LSS) has become more popular every day for years in almost every kind of industry. This integration has brought an even wider variety of possible application areas for industries and research institutes. Recently, the use of LSS for process optimization in biological fields has become more and more common. In this study, LSS methodology is used for process optimization in an industrial scale biogas plant in Hamburg, Germany. The methodology used includes all the DMAIC cycle and related tools. Hypothesis tests were used to calculate the p-value of each experiment for the LSS interpretation. Due to the experimental factors, one-way ANOVA and 1-sample Z-test were used to determine the p-values. By conducting hypothesis testing after the analysis phase of this study, it was found that particle size, freshness of the substrate, and the amount of sand content in the substrate had a significant effect on the desired amount of biogas produced with a p-value of less than 0.01. These root causes led to approaches that focused on high quality feedstock and sufficient pretreatment methods. This paper represents a pioneering example of integrating Lean Six Sigma into biogas plant operation. Full article

Polymer nanocomposites have found wide acceptance in research applications as pressure sensors under the designation of force-sensing resistors (FSRs). However, given the random dispersion of conductive nanoparticles in the polymer matrix, the sensitivity of FSRs notably differs from one specimen to another; this condition has precluded the use of FSRs in industrial applications that require large part-to-part repeatability. Six Sigma methodology provides a standard framework to reduce the process variability regarding a critical variable. The Six Sigma core is the DMAIC cycle (Define, Measure, Analyze, Improve, and Control). In this study, we have deployed the DMAIC cycle to reduce the process variability of sensor sensitivity, where sensitivity was defined by the rate of change in the output voltage in response to the applied force. It was found that sensor sensitivity could be trimmed by changing their input (driving) voltage. The whole process comprised: characterization of FSR sensitivity, followed by physical modeling that let us identify the underlying physics of FSR variability, and ultimately, a mechanism to reduce it; this process let us enhance the sensors’ part-to-part repeatability from an industrial standpoint. Two mechanisms were explored to reduce the variability in FSR sensitivity. (i) It was found that the output voltage at null force can be used to discard noncompliant sensors that exhibit either too high or too low sensitivity; this observation is a novel contribution from this research. (ii) An alternative method was also proposed and validated that let us trim the sensitivity of FSRs by means of changing the input voltage. This study was carried out from 64 specimens of Interlink FSR402 sensors. Full article

Railway operations is a complicated field that requires a specialized team to operate trains safely and effectively. The focus of this paper was on a Middle Eastern-based railway company to understand the current train shunting process at the north–south passenger line and investigate possible issues in order to resolve them. The aim of this paper is to go through the DMAIC cycle and use it to define, measure, analyze and recommend improvements to enhance and control the current process. The results show that the bottleneck process can be greatly improved and optimized by fixing the root causes identified by the cause and effect diagram, which should positively contribute to increasing the overall performance of train operations and provide more time to maintain the trains. Full article

Total thyroidectomy is very common in endocrine surgery and the haemostasis can be obtained in different ways across surgery; recently, some devices have been developed to support this surgical phase. In this paper, a health technology assessment is conducted through the define, measure, analyse, improve, and control cycle of the Six Sigma methodology to compare traditional total thyroidectomy with the surgical operation performed through a new device in an overall population of 104 patients. Length of hospital stay, drain output, and time for surgery were considered the critical to qualities in order to compare the surgical approaches which can be considered equal regarding the organizational, ethical, and security impact. Statistical tests (Kolmogorov–Smirnov, t test, ANOVA, Mann–Whitney, and Kruskal–Wallis tests) and visual management diagrams were employed to compare the approaches, but no statistically significant difference was found between them. Considering these results, this study shows that the introduction of the device to perform total thyroidectomy does not guarantee appreciable clinical advantages. A cost analysis to quantify the economic impact of the device into the practice could be a future development. Healthy policy leaders and clinicians who are requested to make decisions regarding the supply of biomedical technologies could benefit from this research. Full article

Background: competition in the healthcare market is becoming increasingly intense. Health technology continues to evolve, so hospitals and clinics need to strengthen hospital management techniques and also adopt a more patient-centered approach in order to provide high-quality healthcare services, including a more simplified process and shorter waiting times for examinations. The Lean and Six Sigma methodologies and smart technology were introduced and implemented into the integrated perioperative management (PERIO) processes for the purpose of decreasing pre-admission management waiting time, as well as increasing the completion rate and quality of pre-admission management for surgical patients in a 1576-bed medical center in central Taiwan. Methods: in order to improve hospital admission procedures for surgical patients by shortening process waiting times, simplifying admission processes, emphasizing a patient-centered approach, and providing the most efficient service process, the present study applied the DMAIC architecture of the Lean Six Sigma. This approach allowed the patients to save time on the hospital admission process. The current workflow used value flow mapping to identify wasted time caused by unnecessary walking and waiting during the hospital admission process. Therefore, we improved the process cycle for each patient by simultaneously selecting and controlling the process for the purpose of saving time. Results: the experimental results show that the percentage of Process Cycle Efficiency (PCE) increased from 35.42% to 42.47%, Value Added was reduced from 34 to 31 min, and Non-Value Added was reduced from 62 to 42 min. The satisfaction score of the 97 pre-implementation patients was 4.29 compared with 4.40 among the 328 post-implementation patients (p < 0.05). The LOS (Length of Stay) of 2660 pre-implementation patients was 2.49~3.31 days and for 304 after-implementation patients it was 1.16~1.57 days. Conclusions: by integrating different units and establishing standard perioperative management (PERIO) procedures, together with the support of the information systems, the time spent by patients on hospital admission procedures was shortened. These changes also improved the comprehensiveness of the preoperative preparations and the surgical safety of patients, thereby facilitating the provisions necessary for high-quality healthcare services. This in turn reduced the average length of hospital stays and increased the turnover of patients, benefiting the overall operations of the hospital. Full article

Squamous cell carcinoma represents the most common cancer affecting the oral cavity. At the University of Naples “Federico II”, two different antibiotic protocols were used in patients undergoing oral mucosa cancer surgery from 2006 to 2018. From 2011, there was a shift; the combination of Cefazolin plus Clindamycin as a postoperative prophylactic protocol was chosen. In this paper, a health technology assessment (HTA) is performed by using the Six Sigma and DMAIC (Define, Measure, Analyse, Improve, Control) cycle in order to compare the performance of the antibiotic protocols according to the length of hospital stay (LOS). The data (13 variables) of two groups were collected and analysed; overall, 136 patients were involved. The American Society of Anaesthesiologist score, use of lymphadenectomy or tracheotomy and the presence of infections influenced LOS significantly (p-value < 0.05) in both groups. Then, the groups were compared: the overall difference between LOS of the groups was not statistically significant, but some insights were provided by comparing the LOS of the groups according to each variable. In conclusion, in light of the insights provided by this study regarding the comparison of two antibiotic protocols, the utilization of DMAIC cycle and Six Sigma tools to perform HTA studies could be considered in future research. Full article

Several health services have used lean healthcare to seek continuous improvement of their processes. Therefore, it is important to investigate the evidence available in the literature about the most used lean tools in the health area to review processes and the main results achieved by the researchers. As an integrative literature review methodology was used, it was conducted in five databases, using the descriptor “quality improvement” and the keyword “Lean Healthcare”. A total of 33 complete articles were selected for analysis. The most recurrent tools were: define, measure, analyze, improve and control (DMAIC); value stream map (VSM); suppliers, inputs, process, outputs, customers analysis (SIPOC), Ishikawa Diagram and 5S. Through the analysis of waste, different interventions were implemented and the main results achieved were reduction in times (processing, waiting, cycle and total), costs, workload and increase in the number of calls. The findings enabled the identification of the main lean tools used in the health area to achieve better results. In particular, we highlight recent studies that have explored the lean six sigma healthcare approach. The results, in addition to contributing to the literature, will also assist managers in choosing the best tool to achieve continuous improvement in hospitals and other health services. Full article