Readiness level assessment for lean Six Sigma implementation in the healthcare sector

Purpose The purpose of this study is to identify the critical readiness factors (CRFs) that mainly affect the implementation of Lean Six Sigma (LSS) in an organization and their interactions, and to develop a model that allows the management to assess the Lean Implementation Readiness Level. Design/methodology/approach The methodology is separated into two main parts: the literature review and the assessment model development. In the literature review, the main CRFs and their interactions for LSS implementation in Scopus Data Base were identified. The second part of the methodology is the model development. It was built on a stepwise framework that considers the relations among the CRFs and their importance. Moreover, it was used fuzzy-based linguistic variables given by the experts working in the company to consider the actual performance rating of each CRF. The model has been validated in the healthcare sector in nine hospitals. Findings From the model application, it is possible to note that the most frequent level among the nine hospitals interviewed is “Average Ready”. Also, the most extreme level of readiness occurred ones while the most extreme level of not readiness never occurred. Results show that in 78% of the cases, there would have been a high probability of implementation failure. Also, it was possible to identify for each hospital if the CRFs are good, if they are weak and need to change or if another factor needs to be improved before it and what this factor is. Originality/value This work proposes a new methodology that eliminates the negative aspects and limitations of the total interpretive structural modeling methodology and the fuzzy logic approach currently applied to evaluate the LSS readiness of a company. The present methodology lies in the fact that it provides a solution not only by defining the weak CRFs but also by giving an indication of priority as it identifies the weak antecedent factors that inhibit the preparedness of the depending factors.