Attribution 4.0 International (CC BY 4.0)Teeling, Sean PaulMcGuirk, MichelleMcNamara, MartinMcGroarty, MarieIgoe, Aileen2023-06-192023-06-192023-06-08Teeling, S.P., McGuirk, M., McNamara, M., McGroarty, M. and Igoe, A. (2023) ‘The utilization of lean six sigma methodologies in enhancing surgical pathways and surgical rehabilitation’, Applied Sciences, 13(12), p. 6920. Available at: https://doi.org/10.3390/app13126920.https://eresearch.qmu.ac.uk/handle/20.500.12289/13253https://doi.org/10.3390/app13126920From Crossref journal articles via Jisc Publications RouterHistory: epub 2023-06-08, issued 2023-06-08Article version: VoRPublication status: PublishedSeán Paul Teeling - ORCID: 0000-0002-4102-7280 https://orcid.org/0000-0002-4102-7280The authors offer their perspective on the application of Lean Six Sigma methodology to surgical pathways, from referral to post-operative rehabilitation, and how it has resulted in sustainable improvements in patient outcomes, and patient and staff satisfaction. The origin of Lean Six Sigma is described before considering its application to improving scheduled surgical care. The concept of ‘flow’, and its relevance to pre-, intra-, and post-operative care, is discussed as well as the role of Lean Six Sigma in supporting innovation and in promoting an organizational culture that promotes openness to new ideas. The elements of the methodology that render it especially suitable for the redesign of surgical pathways include eliciting the customer voice, co-design, enabling system awareness and inculcating a continuous improvement mindset. The necessary conditions for the successful implementation of Lean Six Sigma initiatives include managerial support, high-quality education and training, and alignment with organizational strategy. Future directions for practice and research are discussed before presenting a key finding from the literature and from the authors’ collective experience: Lean Six Sigma initiatives will not lead to sustainable improvements where the key elements of the methodology are not recognized and enacted, and where the necessary conditions are absent.Licence for VoR version of this article starting on 2023-06-08: https://creativecommons.org/licenses/by/4.0/Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).http://creativecommons.org/licenses/by/4.0/Fluid Flow and Transfer ProcessesComputer Science ApplicationsProcess Chemistry and TechnologyGeneral EngineeringInstrumentationGeneral Materials Sciencearticle2023-06-17