Academic Group 36:

DEVANSHI HAMIRWASIA (PGP-18-

184)
MAYANK WADHAWAN (PGP-18-
201)
RAHUL SHAH (PGP-18-214)
SAAKSHI NAIDU (PGP-18-220)
SRIRAM V (PGP-18-231)

OPERATIONS
MANAGEMENT II
End Term Paper
 CONTENTS

SL NO. TOPIC PAGE NO.

1 Abstract 01

2 Introduction 01

3 Lean, Six Sigma and Lean Six Sigma: an analysis based on 01

operations strategy

4 Lean Six Sigma in Manufacturing 05

5 Lean Six Sigma in Services 09

6 Overall Learning Outcomes 13

7 Recommendations 14

1
SIX SIGMA, LEAN AND LEAN SIX SIGMA
Abstract
The purpose of this paper is to study the scope of business improvement methodologies like Six
Sigma, Lean Thinking and Lean Six Sigma (LSS), to understand and contrast these methodologies
in terms of their objectives and the tools utilized in each of them. The research reported in this
term paper summarizes three academic journal papers – first on Six Sigma, Lean and Lean Six
Sigma (LSS), second on LSS implementation in the Manufacturing Industry (Refinery) in respect
of Industrial Safety and third on LSS implementation in the Service Industry (Healthcare).
Although LSS has been extremely successful in the past couple of decades, organizations still
struggle when it comes to its implementation and this paper analyses this implementation in detail.
The paper is concluded with overall learnings from this exercise.

Introduction
In this world susceptible to constant change in the internal and external environment of the
organizations, in most cases driven by factors like cut-throat competition, evolving consumer
needs and economic instability of many major economies, running operations at the minimum
possible cost with highest levels of reliability is becoming more and more important. The phrase
Continuous Improvement is mostly associated with the Total Quality Movement wherein models
like Six Sigma and approaches like Lean Manufacturing form foundations of lean systems. For
many decades the number of continuous improvement models has been proliferating based on the
concepts of wastage reduction and quality improvement and a lot of research has been done on the
appropriateness and the limitations of implementing these for solving business problems. Some of
these methods include: Total Quality Management (TQM), Lean Manufacturing, Six Sigma etc.
However, in some cases these standalone methodologies are unable to solve the business problems
under consideration and thus hybrids models like Lean Six Sigma (LSS) are adopted to overcome
their deficiencies (Bhuiyan and Baghel, 2005).

Lean, Six Sigma and Lean Six Sigma: an Analysis based on Operations Strategy

Six Sigma concepts are widely used across the manufacturing and service sectors as the Gold
standard of precision and accuracy. Lean manufacturing/enterprise is widely used for increasing
cost-competitiveness by eliminating waste. The combination of these two yields an effective
technique that increases productivity and maximizes profitability. In this paper, Six Sigma, Lean
concepts, the combined application of these tools in various industries with a few illustrated
examples are given. The learnings from the introduction and implementation is also given.

Operations Strategy:
Hayes and Wheelwright (1985) determined that in a competitive environment companies need a
performance edge in their production system and that there are certain specific characteristics
which can set them apart from the herd. They classified these characteristics into four stages of
operational effectiveness wherein the first stage production has only a small contribution in the
success of the organization, while in the fourth stage production becomes the source of the
competitive edge of the organization. For aligning the competitive operations strategy of the
organization with the business strategy, it becomes pertinent to identify the competitive priorities
for different products and families of products. The below table summarizes these competitive

2
priorities (also known as performance dimensions) according to the research done by various
authors over the years –
Leong, Snyder and
Wheelwright (1978) Slack (1991) Garvin (1993)
Ward (1990)

Efficiency, Reliability, Quality, Delivery Quality, Reliability, Quality, Reliability,

Quality, Flexibility, Performance, Cost, Flexibility, Speed, Cost, Flexibility, Speed, Cost,
Speed, Cost Innovation Innovation Services

Some of these competitive priorities are defined thus –

Quality: offer products that meet specifications
Reliability: meet delivery deadlines
Flexibility: adapt and respond quickly to impulses like change in demand etc.
Speed: short interval time between start of production and delivery to customer
Innovation: newer and more diverse products offered faster than competitors

Six Sigma (6σ):

Six Sigma is a set of tools and techniques aimed at eliminating defects and reducing process
variability thereby contributing to process improvement. Various quality management methods,
mainly empirical and statistical, are used to achieve this. Six Sigma was introduced by a Motorola
engineer Bill Smith and the company patented it in 1993. It was later popularized by General
Electric, where it formed an important part of the organizational strategy. A Six Sigma process is
one which has utmost 3.4 defects per million opportunities, that is, 99.99966% accuracy achieved.
According to Snee (2000), Six Sigma can be thought of as a business improvement strategy with
the aim to identify and eliminate causes of defects in business processes. For successful
implementation of Six Sigma commitment from top management, supporting infrastructure,
proper training and knowledge of statistical tools are critical (Van Iwaarden et al. 2008)
Six Sigma doctrine asserts:
 There are continuous efforts required to achieve stable & predictable process results,
for example, by reducing process variation, and are of paramount importance if the
business is to be a success.
 The characteristics that are possessed by manufacturing and business processes can
be defined, analysed, manufactured, improved, and thus controlled.
 The top-level management has to be committed along with the entire organization to
achieve sustained quality improvement

Based on this doctrine, two broad approaches are employed while formulating the Six Sigma
methodology -
DMAIC & DMADV, which is also known as DFSS - Design For Six Sigma)

Although DMAIC is used for projects aimed at improving existing processes while DMADV is
used for projects aimed at creating new product or process designs.
Application of Six Sigma can drastically reduce the operating cost for companies. A famous
example is of General Electric where a saving of USD 2 Billion in 1999 is attributed to six sigma
(Kwak and Anbari, 2006)

3
Lean Manufacturing:
The origins of Lean manufacturing can be traced back to the crisis in Japan in the wake of World
War II. With soaring unemployment rates and widespread destruction of post-war, the productivity
in Japan was very low when compared to America, and thus a systematic process to banish all
waste was formulated. Lean production or lean manufacturing is a concept which aims to reduce
the wastage in the production by identifying and eliminating processes or steps that do not add
value. Lean concepts are largely derived from the Toyota Production System (TPS). Lean uses
various tools to achieve the objective which includes value stream mapping (VSM), Kaizen, 5S,
Kanban (pull systems), poka- Figure 1: DMAIC vs DMADV yoke (error-proofing), control
charts etc. Overburden and unevenness are the two aspects of
a system which are targeted to achieve the elimination of wastage. The original wastes from TPS
include:

Transport- moving products that are not required

1. Inventory- all components, work in process, and finished product not being processed
2. Motion- Unnecessary motion of people or equipment during processing
3. Waiting- waiting time, interruptions during shift change
4. Overproduction- production ahead of demand
5. Over Processing- resulting from a poor tool or product design
6. Defects- cost and effort involved in inspecting for and fixing defects
7. Human potential- waste of talents

Lean differs from TPS primarily in the implementation phase. Lean manufacturing is an
amalgamation of various thoughts like understanding waste, understanding the value chain,
process mapping, pull production and Continuous Improvement (seeking perfection). One of the
important tool used in the beginning of lean application is the Value Stream Mapping (VSM),
although lean is based on a much wider set of tools which include Single-Minute Exchange of Die
(SMED), the 5S Methodology among others. Singh, Garg and Sharma (2010) showed that it is
possible to reduce WIP inventory by almost 89%, finished goods stock by 17.85% and processing
time by almost 13% by application of VSM tool of Lean in an effort to identify various points for
improvement in the processes.

4
Lean Six Sigma (L6σ or LSS):

Lean Six Sigma is a synergistic managerial concept that relies on collaborative team efforts to
improve the performance by minimizing the variability and eliminating wastage. This is achieved
by combining six sigma and lean concepts. Both sets of tools are used simultaneously administered
by a team of trained professionals who form a definite hierarchy to look after the processes. The
training for Lean Six Sigma is provided through the belt-based training system which is also the
standard for Six Sigma. The belt personnel are designated as white belts, yellow belts, green belts,
black belts and master black belts according to their level of proficiency.
The differentiating aspects of Lean and Six Sigma are listed below:

Parameters Lean Manufacturing Six Sigma

Operating Lean manufacturing Six Sigma

Philosophy
Objective Flawless execution of Value adding Consistent delivery of expected
work outcomes

Work Focus Waste elimination Defect elimination and reduction in

variability

Worker process design and operations Product/service and process design,

Engagement operations management

Improvement Management facilitates the A trained professional supports process

focus Involvement of line operators. workers

Basic Tools Correction and Prevention Correction and prevention

Advanced Value stream mapping, cycle time Failure Mode and Effects Analysis
tools reduction, Kanban, Kaizen, 5S, Line (FMEA), Root cause analysis,
balancing Benchmarking

Figure 2: 6σ, Lean

and LSS

Some Six Sigma tools Some Common tools Some lean tools
5
LEAN SIX SIGMA IN MANUFACTURING
Applications of Lean Six Sigma Methodologies for Improvement in Industrial Safety
Industrial safety is of utmost importance as accidents cause human/material loss and result in huge
losses and legal implications. For the welfare of the workers and sustained productivity, safety of
the plant should be ensured with stringent control measures. Safety Management is an
organizational function which ensures that all safety risks have been identified, assessed and
satisfactorily mitigated. As an example, industrial safety in a petroleum refinery is discussed here.
The approach is common to many hazardous industries of scale.

Objectives of the paper:

1. To reduce the number of accidents
2. To identify hazards and implement effective risk controls
3. To ensure workers’ safety in the plant premises.
4. To avoid unwanted shut-downs and avoid financial loss
5. Encourage use of Personnel Protective Equipment (PPEs) apart from other job-specific
prescribed Safety Equipment and follow due procedures in the industry.
6. Obtain sigma values for the findings and ensure that the actual values are above the
expected values.

The Define Phase

This is the problem identification step. Information is gathered about various hazards by studying
processes and talking to workers and managers. The various tools generally used are PDCA,
SIPOC, SMART, SWOT and CEA. Here CIPOC and SWOT are given for example.

Suppliers Input Process Output Customer

Field Engineers Project Work is assigned Safe productive worker
behaviour

Safety Safety rules Construction Improvement in worker

Department work worker
efficiency

Process Design Complete Safe work worker

Engineer Process procedure
Assessment

Plant operator Toolbox talk Erection of Safe working Contract worker

vessels with no near
misses

Likewise, all facets in a particular department and consequently the whole refinery is covered
under this framework, where objective and desired output is clearly given out. These processes are
monitored for desired outcomes.

6
SWOT reveals potential weak links in the system:

Cause and Effect Analysis (CEA):

Cause and effect analysis technique is used to identify all the causes and optimize the potential
ones. The effect being occurrence of an accident, various causes were identified by classifying
them into different sections.

Figure 3: CEA of tank farm area of a refinery

The Measure Phase

This is the phase where numerical studies and analysis of data obtained during the ‘Define’ phase
is performed. For example, 5S Audit is performed to measure the upkeep of plant area.

Sort, set in order, shine, standardize and sustain- These are the headings under which checklist
items are classified and scores are given based on the satisfactory level of the item to be checked.
Suppose if the audit scores of plant area is 3.5 out of 6, say and the score of maintenance shop is
4 out of 6, then more emphasize should be placed on plant area to improve safety.

7
The Analyze Phase
Failure Mode and Effect Analysis (FMEA), Root Cause Analysis (RCA) and 5 why’s are
commonly used frameworks to statistically analyze the reasons for occurrences especially of
accidents. After the find, the anomaly is rectified.

Figure 4: Sample Template of FMEA

The rating of severity, occurrence and detection are given as per the benchmarking of the
frontrunner. One case from the paper can be taken as example.

Process- Handling hot fluids

Failure type- Splashing on worker
Failure method- mishandling
The ratings given:
Severity- 5, Occurrence- 8, Detection- 6, Risk priority number assigned- 240

Root cause analysis:

RCA is used to find the cause of a problem and recommends solution. For the hot liquid splashing
problem, if the root cause is the open container handling, then the recommendation will be to
handle the liquid using a secure vessel/ closed pipeline.

The Improve Phase

In this phase, all the lagging parameters identified are worked upon and continuous measurements
are taken to ensure that there is an improvement in the performance. 5S Audit, Safety control sheet,
safety control sheet and post kaizen checklist are utilized in this phase.

5-S Audit System:

The scores are subjectively rated from 0 to 5 as whole numbers with the following criteria as a
guide:

1. zero effort, no evidence, not started Applications of Lean Six Sigma Methodologies for
Improvement in Industrial Safety
2. activity started with minimal effort but not sustainable
3. widespread activity with more opportunity for improvement

8
 4. minimum acceptable level sustained for a month
5. all encompassing activity and sustained for over a month
6. best in class and sustained for at least six months

A sample 5-S Audit done after improvement phase for the Furnace Section of the plant is shown
here. Similar audits were done for all the six sections of the industry. Their Audit score is given
below:

1 Furnace Section 3.17

2 Inventory Section 3.83
3 Processing Section 4
4 Route-up Section 4.34

The Control Phase

This is the last phase which ensures the sustenance of the sigma value obtained so far and its
potential improvement. Safety Improvement plan and post kaizen checklist are two tools that are
used in this phase. While kaizen checklist is a comprehensive checklist of action plans intended to
reduce accidents after studying the causes and pressure points through the previous phases, safety
improvement plan gives recommendations for what to be done for sustainability of the safety
precautions employed. Some the measures can be-

1. Conduct department safety training

2. Conduct department audit every week
3. Conduct an internal audit of the plant quarterly
4. Conduct an annual external audit
5. Periodic hazard assessment plans
6. Safety committee meetings every month
7. Tool box talks and safety talks every month
8. Risk reporting and near miss reporting targets
9. Job safety analysis and plan for work areas
10. Implementation of safety improvement measures and documentation

Learnings:
Thus, by combining the methodologies of lean and six sigma, accidents occurring can be reduced
in industries. Systematic application of these frameworks are easy for the personnel to conduct gap
analysis to find the gaps and plug it. Control phase ensures that the sigma level never degrades and
with time the plant can aim for zero accidents and injuries. Worker and management support is
imperative for this to be achieved.

9
LEAN SIX SIGMA IN SERVICES
Lean Six Sigma, as a business improvement methodology is rooted in the manufacturing industry,
where it is evolved in the past few decades, and has been adopted in all parts of the world.
According to the World Economic Outlook Database (published in 2011 by International
Monetary Fund), the distribution of PPP (Purchase Power Parity) GDP in 2015 in key worldwide
economies reflected a decline in the industrial sector, and a corresponding upward movement in
the service sector, across various industry sectors.
PPP GDP 2015 Agriculture Industry Service
European Union 1.5% 24.5% 70.7%
United States 1.1% 20% 78.9%
China 8.8% 40.9% 50.2%
India 17.5% 29.6% 52.9%

In the light of evidence regarding increasing importance of the service sector in major world
economies, the objective of this section of the term paper is discuss how the methodology of Lean
Six Sigma for business improvement is applicable to the service industry as well, and support the
argument with examples.
The service industry has its own special characteristics, which can act as challenges and make it
harder to apply Lean Six Sigma concepts and tools as discussed thus far. These characteristics can
be summarized in the following areas (Kotler, 1997; Regan, 1963; Zeithmal, Parasur and Berry,
1985) – Intangibility, Perishability, Inseparability and Variability
Owing to these inherent differences between products and services, it has been difficult for the
companies in the service industry, such as financial services companies, healthcare providers,
hospitality organizations, public services, education institutions, airline companies, and many
more to adopt the Lean Six Sigma methodology.

LEAN SIX SIGMA IN HEALTHCARE INDUSTRY

The Indian healthcare providers sector has experienced fast-paced double digit growth over the
past few years, and is expected to continue in the forecast period to 2019, albeit at the decreased
pace. As one of the largest emerging markets, India and China are even expected to enjoy
competitive advantage of medical tourism. In the heat of increasing competition, the healthcare
industry in India is facing tremendous pressure to improve the quality of treatment while reducing
costs. In the healthcare industry as the customers are patients, keeping the customer satisfied is
critical and takes the highest priority. Because nowadays there is no dearth of choices of healthcare
providers to the patients, it is important to maintain high level of quality in the healthcare industry.
As in the case of manufacturing companies where wastage of money, time, supplies and good-will
decreases the value of the organization, same thing applies to the service industry as well. By
adopting Lean Six Sigma, service organizations can design better processes to deliver the best
treatment and services to the patients.

10
Application of Lean Six Sigma methodology in the registration process of a Hospital
This paper has presented the step-by-step application of the LSS approach to reduce the cycle time
of a patient’s registration process in a hospital. The reduced cycle time in turn resulted in drastic
reduction of the waiting time of patients in the system, the length of the queue and the percentage
utilization of the assigned staff.
The methodology followed by the authors was – as a part of the research, one author who holds a
Black Belt in Six Sigma worked in a Hospital that had never implemented LSS earlier. After
formulating the research problem and conducting the literature survey, the authors collected data
according to the detailed data collection plan with the help of the OP-HID (Out Patient – Health
Information Department) of the Hospital. The Data collected was used to establish baseline
performance and testing of hypothesis, followed by detailed analysis using Control Charts (X-bar
Chart), Capability Analysis and Value Stream Mapping. Now we will summarize the
implementation process using the DMAIC framework of LSS.
The Define Phase
The objective of the define phase is to finalize the goal of the project by formulating the business
problem at hand, identifying the scope of the project and process to be improved. A project charter
was prepared to formulate the business problem with the aim of reducing the cycle time of the
patient registration process from 3 minutes to less than two minutes. For agreement on the scope
of the project, a SIPOC (Supplier-Input-Process-Output-Customer) process definition was
developed. Finally, for the improvement of the process, it was mapped using a process flow chart.

Figure 5: SIPOC and Process Flow

The Measure Phase
The objective of this phase is to translate the problem under consideration into a measurable form
and thus evaluate the current situation as it stands. In this phase, the project team prepared detailed
data collection plan for the CTQ items with information like data type, UOM, sampling technique
etc. To determine the process sigma level, the team used digital stop watches with least count of 1
second to record time after calibration was performed. The Sigma Level of the process, which
compares the process variability with the requirements, is dependent on the specification limits,
mean and standard deviation (SD) of the process. For one week, after every hour data was collected
to identify the baseline performance of the process, and the X-bar chart was plotted and analysed.
It showed that the process was stable and within specification limits, thus statistically under
control. Every case with a cycle time of more than 2 minutes was considered a defect, the DPMO
thus found from the process capability analysis was 833,222 which meant a sigma level of 0.53.

11
The Analyze Phase
Identifying the influencing factors and causes that determine the CTQ’s behaviour is the main
objective of this phase. A Value Stream Mapping (VSM) was prepared of the current state to
visualize and understand the flow of materials, manpower and information. From the current-state
VSM, it was deduced that the process consists of 94 seconds (52.2 percent) of Non-Value Add
(NVA) activity. For identification of the NVA activities that could be eliminated and the potential
causes for process variation, the team conducted a brain storming session with the Hospital staff.
The result of the brain storming session helped in performing the Root-Cause Analysis with output
resulting in the form of a Fishbone Diagram (or Cause and Effect Diagram).

Pareto Analysis - Incomplete Patient Info

120 100%
100 80%
80
60%
60
40%
40
20 20%

0 0%
Doctor Problem Patient Patient Other
Name Address Age

Figure 6: Fishbone Diagram and Pareto Chart

To validate all the causes thus identified, various data was gathered and appropriate analyses were
prepared. For potential causes such as lack of experience, lack of training, lack of printer with high
configurations, insufficient printers etc. statistical analyses were used for validation whereas
causes like non-availability of currency, incomplete information, error in entering patient
information etc. were validated by observing the process (i.e. by performing GEMBA). As an
example, we will look at how Pareto Analysis was used to study the cause “incomplete information
from patients” from which it was evident that more than 80% of the problem was associated with
identifying the patient’s disease and the doctor to diagnose that disease. A table was used to
summarize and record the causes based on the Fishbone diagram, the type of analysis planned for
each cause and the result of the same.
The Improve Phase
The objective of this phase is to deal with the design and implementation of the solutions involved
in the process, with an effort to improve the performance of the CTQ. It involves intervention by
the project team to determine how significantly reduce the defect levels of the process by
generating and implementing solutions.
For example, for quicker cash transactions cash drawers were recommended and the team
performed two sample t-test to check the statistical significance of the solution in reducing the
cycle time. In house training programs were conducted for all the staff in spelling skills, quick
typing skills and other activities. Also, a specialized training was given to the staff so that they
could better recommend a particular doctor for specific patients’ symptoms. Submitting ID proof
was made mandatory for registration, which reduced mistake made while entering patient
information. Similarly, the doctor’s availability was displayed at appropriate and convenient
12
locations to ease the registration process. A future state Value Stream Mapping (VSM) was
prepared using the improved process steps after the implementation of the solutions. A detailed
risk analysis was also carried out to conclude whether the implemented solutions had any negative
impacts. After a bit more data gathering, a graphical representation of the results comparing the
cycle time before and after the project was formulated and a two sample t-test was used to verify
the statistical significance of the results (found significant at 5% level).

Figure 7: Graphical representation of Results

The Control Phase

This last phase of the DMAIC approach has the objective to ensure that the improved process
continue to work level, provide desired results and maintain required levels of performance. Here
a mix of tools from the six sigma approach and lean thinking are utilized – such as “Poka-Yoke”
also commonly known as Mistake Proofing, was introduced at the Registration with sign like
“Keep the Currency Ready” etc. to ensure that the staff was ready with everything before the
activities started. Standard Operating Procedures (SOP) and 5S audit sheet were prepared to
communicate and uphold improvements. An X-bar control chart was introduced at the hospital by
establishing a process to measure cycle times every day so that any special causes for variation
could be identified and eliminated.
Final Result and Learnings
The average cycle time was reduced from three to 1.5 minutes and the Standard Deviation (SD)
was reduced from 60 to 21.2 seconds. Also, there was a significant reduction in the average queue
length (~91%) and scheduled utilization of the staff (~48%). From this study it is apparent that the
LSS methodology provides concepts and tools which are very structured but capable to bringing
drastic changes for process improvement, and can not only be used in Manufacturing area but also
service organizations like a Hospital to improve their transactional, administrative and other
business processes. Another learning was that effective leadership at the top and middle
management level is one of the key success factors in such LSS implementation projects, in
addition to employee involvement, timely training and motivation (Laureni and Antony, 2012).
Some typical hurdles that were faced during the project were lack of knowledge about the
methodology, lack of human resources, non-availability of data and impatience to get quick results,
but these were effectively overcome because of strong leadership at the top level and this led to
achievement of the intended goals.

13
 CTQ Average (sec) SD (sec) DPMO Sigma Level

Before 178.99 61 833,222.57 0.53

After 88.63 29.21 141,484.45 3.69

Percentage
SI. No. KPI Before After
Reduction

Waiting time in the system

1 21.10 1.19 94
(min)

2 Queue Length (no) 12 1 91

3 % scheduled utilization of staff 94 48 48

Managerial Implications and Conclusion

The methodology as showcased in the research paper motivated the Hospital management to take
up organization-wide LSS implementation due to its effective and timely results. It also led to the
establishment of a team of LSS experts within the organization by training the existing staff
associated with the various processes. Lastly, the project brought about a change in the culture of
the organization by involving, education and motivating everyone related to the processes to think
in way that can lead to continuous improvement on their journey towards excellence.
In conclusion, the study was conducted for the OPD department, which is one of the most
congested hospital services and is always under a great deal of pressure from the other
departments. Delays in OPD result in scheduling difficulties and decreased patient satisfaction.
The main objective of the study was to analyse the implementation of LSS strategy and successful
deployment in Healthcare in general and Indian Hospitals in particular.
The study was restricted in two dimensions – one that the impact of LSS was analysed on the
workflow and resource consumption of only one process i.e. patient registration, two that it was
not conducted in a controlled environment as the patient arrival was not controlled for the sake of
the experiment.

Overall Learning Outcomes:

Six Sigma and Lean both are proven methodologies aimed at productivity improvement and profit
maximization and this has been superbly demonstrated by the superior performance of Motorola,
General Electric and Toyota, the companies that are responsible for the popularity of these
techniques. Lean Six Sigma combines the tools and techniques of both to provide a wholesome
package of refined process targeting zero waste and variability. LSS implementation results in
greater efficiency, cost reduction, reduced delivery times, improved quality of product/service,
customer satisfaction, employee satisfaction, reduced variation and financial benefits including
increased profits. Both manufacturing sector and service sector can benefit from the deployment
of LSS techniques.

14
Recommendations:

Lean Six Sigma implementation is predominantly observed in manufacturing sector. This is

because the phases are not clearly defined and monitored in a typical service industry and the
margins are often high to trigger any need of extreme control measures. Given the cut-throat
competition between companies in the free market economy, it is imperative for companies to
have tighter control over their processes to cut costs so that they can withstand price wars triggered
by the competitors. In this context, companies must adopt Lean Six Sigma methodology along
with the tools and techniques that improve.

References:

Everton Drohomeretski, Sergio E. Gouvea da Costa, Edson Pinheiro de Limaa, Paula Andrea da
Rosa GarbuioaLean. (2013). Six Sigma and Lean Six Sigma: an analysis based on operations
strategy. International Journal of Production Research, 2014, Vol. 52, No. 3, 804–824.
P. R. Gajbhiye, A. C Waghmare, R. H. Parikh. (2016). Applications of Lean Six Sigma
Methodologies for Improvement in Industrial Safety. International Journal for Innovative
Research in Science & Technology, Volume 3, Issue 06, November 2016.
Shreeranga Bhat, E.V. Gijo, N.A. Jnanesh. (2014). Application of Lean Six Sigma
methodology in the registration process of a hospital. International Journal of Productivity
and Performance Management, Vol.63 Issue: 5.
Atanas J.P., Rodrigues C.C., Simmons, R.J. (2016). Lean Six Sigma Applications in Oil and Gas
Industry: Case Studies. International Journal of Scientific and Research Publications, Volume 6,
Issue 5, May 2016.
Jiju Antony. (2011). Six Sigma vs Lean. International Journal of Productivity and Performance
Management.
Anass Cherrafia, Said Elfezazia, Kannan Govindanb, Jose Arturo Garza-Reyesc, Khalid
Benhidaa, Ahmed Mokhlisa. (2017). A framework for the integration of Green and Lean Six
Sigma for superior sustainability performance. International Journal of Production Research,
2017, Vol. 55, No. 15, 4481–4515.
Taieb Ben Romdhane, Ahmed Badreddine, Manel Sansaa. (2017). A new model to implement
Six Sigma in small- and medium-sized enterprises. International Journal of Production Research,
2017, Vol. 55, No. 15, 4319–4340.
Rupali S. Tupkar, Manisha S. Lande, Sagar B. Jawalekar. (2016). Implementation of Lean Six
Sigma. International Research Journal of Engineering and Technology, Volume 3.
Werner Timans, Kees Ahaus, Rini van Solingen, Maneesh Kumar, Jiju Antonye. (2016).
Implementation of continuous improvement based on Lean Six Sigma in small- and medium-
sized enterprises. Total Quality Management, 2016, Vol. 27, No. 3, 309 –324.
Greg H Watson. (2003). A marriage of necessity: Lean and Six sigma. Manufacturer’s Monthly.

15