Systematic review of literature on lean and six sigma in healthcare and directions for future research

Rodrigo E. Peimbert-García, Timothy Matis, Jonathan Cuevas-Ortuño, Samuel M. Nucamendi-Guillen

Research output: Chapter in Book/Report/Conference proceedingConference proceeding contributionpeer-review

3 Citations (Scopus)


Healthcare organizations have increasingly turned to Lean and Six Sigma (LSS) as management systems to achieve quality and efficiency in patient care. This study aims to classify this body of literature and to discover factors that enable and prevent successful LSS implementations. Peer-reviewed literature in journals that were published through 2018 in English language were sought through a search of multiple databases. The inclusion criterion was broad in that all areas of healthcare and interpretations of LSS were considered. The literature search yielded 368 publications. One third of the studies present a U.S. affiliation and only 19% has been conducted in developing countries. The case study is the most popular study type but only represents around 52% of the body of literature. Lean and the ED are preferred approach and setting, respectively. Factors that enable and prevent successful implementation were grouped by Managerial, Preparation, People, and Project relationships. There is a need for future literature to provide a longitudinal balanced view on the benefits and challenges of implementations, and for studies to follow experimental designs for statistical validity. This is the most inclusive review about LSS in healthcare as it includes different study types, healthcare settings and LSS tools together.

Original languageEnglish
Title of host publicationProceedings of the International Conference on Industrial Engineering and Operations Management
Subtitle of host publicationDubai, UAE, March 10-12, 2020
Place of PublicationMichigan, US
PublisherIEOM Society International
Number of pages12
ISBN (Electronic)9781532359521
Publication statusPublished - 2020
Event10th Annual International IEOM Conference, IEOM 2020 - Dubai, United Arab Emirates
Duration: 10 Mar 202012 Mar 2020

Publication series

ISSN (Electronic)2169-8767


Conference10th Annual International IEOM Conference, IEOM 2020
Country/TerritoryUnited Arab Emirates


  • Literature review
  • Lean
  • Six Sigma
  • Healthcare
  • Hospital


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