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Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24

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Start date: 2022Subject: search.filters.subject.Lean Six Sigma

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Now showing 1 - 5 of 5
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    Testing Realist Programme Theories on the Contribution of Lean Six Sigma to Person-Centred Cultures: A Comparative Study in Public and Private Acute Hospitals
    (MDPI, 2025-09-04) Teeling, Sean Paul; Baldie, Deborah; Daly, Ailish; Pierce, Anthony; Wolfe, Nicola; Fagan, Gillian; Garry, Catherine
    Person-centred cultures are increasingly recognised as essential to the delivery of compassionate, safe, and effective healthcare. While Lean Six Sigma (LSS) is widely adopted as a process improvement methodology, its application is often critiqued for lacking alignment with relational or values-based care. This study aimed to test the transferability of three previously developed Programme Theories (PTs), generated through realist inquiry in a public hospital setting, within a large private acute hospital. Realist-informed adjudication workshops were conducted with interdisciplinary staff who had completed university-accredited training in LSS. Structured workbooks, visual artefacts, and thematic synthesis were used to identify how context–mechanism–outcome configurations (CMOCs) held, shifted, or evolved in the new setting. All three PTs were confirmed, with six CMOCs refined, and eight new configurations generated. Key refinements included the role of strategic intent, informal improvement communities, and intrinsic motivation. These findings suggest that values-based mechanisms underpinning person-centred LSS are not confined to public systems and may be equally active in private settings. The study confirms the explanatory strength of the original PTs while contributing new insights into their adaptability. It offers practical guidance for healthcare leaders seeking to embed person-centred improvement approaches across diverse systems, regardless of sectoral funding or governance structures.
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    The contribution of a person-centred model of Lean Six Sigma to the development of a healthful culture of health systems improvement
    (Frontiers Media, 2025-08-18) Teeling, Sean Paul; Baldie, Deborah; Daly, Ailish; Keown, Anne Marie; Igoe, Aileen; Dowling, Ciara; McNamara, Martin
    Background: A failure to distinguish between person-centredness, person-centred care, and person-centred cultures can result in improvement initiatives focusing solely on improvement initiative metrics and outcomes, excluding the authentic experiences of patients and staff. Building on the foundational work of Dewing and McCormack, we have designed, piloted, and implemented the Person-centred Lean Six Sigma (PCLSS) model in public and private acute and community healthcare settings across Ireland. This model uses Lean Six Sigma, a widely adopted improvement methodology, through a person-centred lens with which improvement practitioners and healthcare staff can inspect their Lean Six Sigma practice and critically evaluate whether, to what extent, and how it is synergistic with person-centred approaches. Aim: This paper explores the deployment of the PCLSS model across four clinical study sites and examines its alignment with McCance and McCormack's conceptual work on healthful cultures, evaluating its contribution to creating cultures that support sustainable improvement, compassion, and respect. Methods: The PCLSS model was embedded within a university-accredited education programme for healthcare staff. The model was applied across four distinct healthcare settings in Ireland: a public acute teaching hospital, a private full-service acute hospital, an integrated ophthalmology service bridging hospital and community care, and a public rehabilitation hospital. A case study methodology was used to examine implementation and impact. Results: Across all four sites, the PCLSS model facilitated improvements in operational efficiency, staff and patient engagement, interprofessional collaboration, and reflective practice. The model supported leadership at all levels, fostered sustainable change, and successfully mapped onto key domains associated with healthful cultures, as articulated in the work of McCance and McCormack. Conclusion: The PCLSS model represents a sustainable, values-based approach to improvement that aligns operational excellence with person-centred principles. Its application contributes meaningfully to the development of healthful cultures in healthcare organisations.
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    Developing new methods for person-centred approaches to adjudicate context−mechanism−outcome configurations in realist evaluation
    (MDPI, 2022-02-18) Teeling, Sean Paul; Dewing, Jan; Baldie, Deborah
    Realist evaluation provides a general method of evaluating the application of interventions including policy, legislation, projects, and new processes in social settings such as law enforcement, healthcare and education. Realist evaluation focuses on what about interventions works, for whom, and in what circumstances, and there is a growing body of work using realist evaluation to analyse interventions in healthcare organizations, including those using Lean Six Sigma improvement methodologies. Whilst realist evaluation facilitates the analysis of interventions using both qualitative and quantitative research, there is little guidance given on methods of data collection and analysis. The purpose of this study is to address this lack of guidance through detailing the use of innovative person-centred methods of data collection and analysis in a realist evaluation that enabled us to understand the contribution of Lean Six Sigma to person-centred care and cultures. This use of person-centred principles in the adjudication of identified program theories has informed novel methods of collecting and analysing data in realist evaluation that facilitate a person-centred approach to working with research participants and a way of making the implicit explicit when adjudicating program theory.
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    The use of Lean Six Sigma methodology in the reduction of patient length of stay following anterior cruciate ligament reconstruction surgery
    (MDPI, 2022-01-30) Moffatt, Sinead; Garry, Catherine; McCann, Hannah; Teeling, Sean Paul; Ward, Marie; McNamara, Martin
    Background: The purpose of this study was to reduce the length of stay of anterior cruciate ligament reconstruction patients within a private hospital in Ireland, reducing any non-value-added activity in the patient pathway, with the goal of increasing patient flow, bed capacity, and revenue generation within the hospital system, while maintaining patient satisfaction. Methods: We used a pre-/post-intervention design and Lean Six Sigma methods and tools to assess and improve the current process. Results: A reduction in inpatient length of stay by 57%, and a reduction in identified non-value-added activity by 88%, resulted in a new day-case surgery pathway for anterior cruciate ligament reconstruction patients. The pathway evidenced no re-admissions and demonstrated patient satisfaction. Conclusion: Six months post-project commencement, we had successfully achieved our goals of reducing our anterior cruciate ligament reconstruction patient’s length of stay. This study contributes to the growing body of published evidence which shows that adopting a Lean Six Sigma approach can be successfully employed to optimise care and surgical pathways in healthcare.
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    A case study of a whole system approach to improvement in an acute hospital setting
    (MDPI, 2022-01-22) Ward, Marie E.; Daly, Ailish; McNamara, Martin; Garvey, Suzanne; Teeling, Sean Paul
    Changes in healthcare tend to be project-based with whole system change, which acknowledges the interconnectedness of socio-technical factors, not the norm. This paper attempts to address the question of whole system change posed by the special issue and brings together other research presented in this special issue. A case study approach was adopted to understand the deployment of a whole system change in the acute hospital setting along four dimensions of a socio-technical systems framework: culture, system functioning, action, and sense-making. The case study demonstrates evidence of whole system improvement. The approach to change was co-designed by staff and management, projects involving staff from all specialities and levels of seniority were linked to each other and to the strategic objectives of the organisation, and learnings from first-generation projects have been passed to second and third-generation process improvements. The socio-technical systems framework was used retrospectively to assess the system change but could also be used prospectively to help healthcare organisations develop approaches to whole system improvement.