Continuous Improvement and it’s Approaches (Case Studies)

Continuous improvement is vital for an organization’s sustainability.

Discussion on continuous improvement to include meaning, kaizen vs breakthrough, benefits, and goals of continuous improvement.

Identification of main approaches for CI including TQM, Lean six sigma, and LSS. Evaluation including description, aims, where they work best, benefits, limitations and commonality of approaches

Understanding of application and case study presentation with analysis.

Introduction 3

Continuous Improvement 3

Kaizen Vs Kaikaku 4

Approaches for continuous improvement 6

Lean 6

Six Sigma 8

Total Quality Management 10

Commonality and differences (TQM, Lean, Six Sigma) 11

Lean Six Sigma 12

Case Study 1 13

Case Study 2 18

Conclusion 23

References 24

Introduction

Numerous studies have been conducted to differentiate between two well-known approaches to improvements which are categorized as continuous and breakthrough. Also, researchers have been analyzing and publishing the implementation pattern of these two strategies within different case scenarios. Despite all this plethora of knowledge, ambiguities still exist. This coursework has been prepared in the context of addressing those issues. In the first part, the difference between continuous and breakthrough improvements have been identified. The goals and benefits of continuous improvements have been discussed. The importance of continuous improvements has been analyzed for organizational sustainability. Approaches to continuous improvements have been critically evaluated after a brief discussion of continuous improvement itself. The goals and aims of Lean, six sigma, and TQM have been discussed and compared to analyze which approach is suitable to small, medium, and large enterprises. In the last part of this coursework, two case studies have been identified who have implemented lean. Their implementation pattern, pro, and post lean (Positive changes) conditions have been compared, analyzed, and discussed. Throughout this study, arguments have been backed by the use of published journal articles related to that particular area to validate some critical points in the discussion.

Continuous improvement

Continuous improvement as the name suggests is an ongoing effort to improve processes, services, and products through continuous incremental improvements (Asq.org, 2017).

· A continuous stream of incremental improvements in all processes for a better business performance involving everyone in the organization (Ljungström and Klefsjö, 2002).

· Continuous improvement means that improvement activities never end (Liker and Meier, 2013).

By the above definitions and from the perspectives of researchers, it is evident that continuous improvement is not something which is a onetime project but it is a never-ending cycle that requires an understanding of the processes, teamwork, and commitment on regular basis to optimize productivity.

Goals

· CI is a culture of sustained improvements that aim for waste removal and improved quality in all processes of an organization (Bhuiyan and Baghel, 2005).

One should strive for getting better every day, which is a philosophy and teachings of Continuous improvement. Aims and goals of CI are to

Ø Eliminate waste

Ø Improve occupational safety

Ø Improve the Quality of products and services

Ø Improve processes

Ø Improve Productivity

Ø Improve Employee’s morale

Ø Improve customer satisfaction

Improvement Types

1. Continuous Improvement (Kaizen)

2. Breakthrough Improvement (Kaikaku)

Kaizen vs. Kaikaku

Kaizen (Evolutionary / stepwise improvement) is a Japanese term made up of two words KAI (Good) and Zen (Change) which means gradual and continuous improvement in an orderly manner (Kaur, 2014). Imai was the frequent and known proponent of Kaizen. He wrote a book named Kaizen-The Key to Japan’s Competitive Success (Berger, 1997). It’s a principle of improvement initiatives which must

Ø Be Continuous

Ø Be Incremental

Ø Involve everyone in an organization.

It’s not just a tool; it’s a mindset and culture of an organization. It’s about seeing opportunities for improvements in daily work activities so it does require effort from every person in an organization and especially from those employees who are directly related to that particular process, product, or service in anyways. The belief that shop floor personals know best about their processes is one of the main reasons that usually improvements ideas and initiatives are expected from them.

PDCA, a simple yet systematic approach that has been widely used as a symbol and application for Kaizen improvements among many others. The beauty of this tool is that it’s a never-ending wheel that strives for continuous improvement and this is the essence of Kaizen as well (Imai, 1991).

Figure 2 shows the involvement of every individual in an organization against their job functions. Kaizen remains everyone’s job in an organization irrespective of their job functions from top-level management to below every employee in an organization. That’s how a culture of continuous improvement gets promoted.

Kaikaku (Revolutionary / Breakthrough improvement) is a Japanese term used for introducing radical change or improvement in an organization. In contrary to Kaizen (Continuous, incremental, people-oriented), Kaikaku advocates for intermittent occurrences, development of new radical innovations, and require top-down initiatives (Yamamoto, 2010).

Ideally, Kaizen can be comparable to a ramp function, whereas breakthrough with the step functions. As you can see from figure 3, many small incremental improvements initiatives (Kaizen) can lead to a breakthrough and radical changes so kaizen is extremely important even to achieve breakthrough improvements in an organization.

Figure 2: Job functions perceived by Japanese Managers

Source: (Dragan Sutevski, 2017)

Figure 3: Incremental vs. Radical Improvement

Source: (Elsheikh, 2017).

Comparison

(Karkoszka and Szewieczek, 2007) pointed out the comparison of both improvement types which clearly defines the pros and cons of both techniques.

Table 1: Comparison of Continuous with Breakthrough Improvement.

Source: Author’s design

Benefits

Why continuous improvement is vital for organizational sustainability? In today’s competitive environment, it is essential to have continuous improvement strategies in an organization. Not only, these strategies are important to implement but the method of gauging the performance is also essential.

· Among many benefits of working with CI, Companies can increase the quality, reduce lead time, and have fewer errors than would result in cost reduction and improved quality (Janee Ali, Islam, and Poon Howe, 2013).

Apart from the above stated organizational advantages, employees can also be benefited from continuous improvement implementation. Employee’s commitment to an organization can be achieved by empowering them in their respective areas and hence this would be an ideal win-win situation for all the stakeholders.

· Managers and employees should get themselves involved in CI work so that improvements can be made by the commitment of everyone (Ward, 1994)

Approaches for Continuous Improvement

The need for an organization to continuously excel on a larger scale became imperative and for this purpose, several CI methodologies have been developed comprising of basic concepts of process and quality improvements. Among many approaches, lean, six sigma, and Total Quality Management (TQM) have faced much acceptance and criticism as well in different types of enterprises. These techniques complement each other even though they all differ up to some extent in their respective approaches.

Lean

Description

· An “antidote” to Muda (Waste) is what Lean thinking is (Womack and Jones, 1996)

· Through continuous improvement, identification, and elimination of waste, product flow on customer demand to achieve perfection. (NIST, 2000)

Aims

Lean thinking is customer-focused. Identification of value-added activities comes from thinking with the end customer’s perspective and that’s how wastes can be removed. Figure 4 shows five basic principles of lean which are generally acknowledged (Andersson, Eriksson and Torstensson, 2006).

Types of waste

In both, the above descriptions of lean, “waste” is a common term that has been used. So what is a “waste”? Waste comprises all those things that increase costs without any value addition for the end-user. Taiichi Ohno identified Muda (waste) which is explained in figure 5.

Where they work best

With “solution is known” problems, Lean methodology should be used. Where someone is sure about what needs improvement and they want it to happen in less time and cost. It often enables us to make rapid improvements with minimal data (Hoerl and Gardner, 2010). Lean is an appropriate approach for small scale industries as it doesn’t require much budget for its implementation like six sigma (Sareen, Laux and Marshall, 2014).

Figure 4: Principles of Lean

Source: http://www.nevilleclarke.com

Benefits

Forty Companies reported getting benefits (Operational, strategic, administrative) after implementation of Lean methodology (NIST, 2003). It focuses on the removal and elimination of waste by analyzing value and processes (Bendell, 2006).

Limitations

Lean needs a stable platform as it becomes susceptible to the impact of changes. Dynamic conditions are difficult to deal with because of less capability to react to new circumstances (Dove, 1999). JIT methodology cause supply chain’s congestion which leads to delay, workers shortage, etc (Cusumano, 1994).

Figure 5: 8 Types of Wastes

Source: Genesyslab.

Figure 6: Benefits of lean

Source: www.hiringsmart.com

Six Sigma

Description

· A business process that allows companies to improve their bottom line by analyzing and designing everyday activities in a way that waste gets minimized and customer satisfaction gets improved (Magnusson, Bergman and Kroslid, 2003).

· Six sigma could also be described as an improvement program for reducing variation in products or services to achieve customer satisfaction (Andersson, Eriksson, and Torstensson, 2006).

Aims

Six sigma aims to make 999996.6 customers satisfied out of 1 million which means only 3.4 customers would remain unhappy (Magnusson, Bergman and Kroslid, 2003). The methodology used to improve processes can be divided into five phases (DMAIC) (Pyzdek, 2003)

Figure 7: DMAIC Methodology for six sigma

Source: Pinterest

Where they work best

Six sigma gathers data for the improvement projects and this purpose, experienced and trained staff gets hired like project leaders, black belts, and green belts certified professionals and also they need to give training to internal employees up to yellow level because those would assist them in the understanding of the process. Undoubtedly, this requires capital and resources. Because the medium-sized enterprises aren’t too small or large, data can be gathered well for implementing six sigma (Sareen, Laux, and Marshall, 2014). Profit up and cost down, six sigma approaches can be a good methodology for the firm which are in transition towards becoming a large enterprise (Bendell, 2006).

Benefits

Volvo car claims that six sigma contributed to over 55 million euros to bottom-line within 2000 and 2002 in Sweden (Magnusson, Bergman and Kroslid, 2003). Ericsson in Bora°s, around 50 Black Belt and 200 Yellow Belt projects have been executed during1997 and 2004 reported a total saving of around 200–300 million euro between 1997 and 2003 (Andersson, Eriksson and Torstensson, 2006).

Figure 8: Benefits of Six Sigma

Source: www.6sigma.us

Limitations

Since it’s a data-driven systematic approach, which has advantages as well as disadvantages. Not much criticism has been reported as it showed financial improvements in many big enterprises. Limitation includes that it doesn’t include everyone like TQM; the focus is more on reducing variations and costs rather than customer satisfaction and lacks a holistic approach (Andersson, Eriksson and Torstensson, 2006). Six sigma fails to include everyone as TQM emphasized in its methodology (Klefsjö, Wiklund and Edgeman, 2001).

Total Quality Management

Description

· A cooperate culture is distinguished by improved customer satisfaction via continuous improvement having active participation from every employee (Dahlgaard, Kristensen and Kanji, 1998).

· A continuously expanding management system comprising of methodologies, values, and tools, aiming to increase internal or external customer satisfaction with fewer amount of resources (Hellsten and Klefsjo, 2000).

Aims

Refer to Figure 1 to see the details of the PDCA Cycle. TQM aims to improve the flexibility and effectiveness of a business. People, processes, systems, and tools and techniques are the foundations of TQM.

Figure 9: TQM Values

Source: www.smartsheet.com

Where they work best

As per the description of Total quality management, the appropriate culture, and involvement of every employee is a very important thing to implement TQM practices. Not only in TQM but in even in Lean and six sigma, continuous improvement culture is required. TQM can be implemented in any organization provided it fulfills the prerequisites of it to achieve desired results.

Benefits

A link between TQM practices and the company’s performance has been studied by GAO (The General Accounting Office). The study showed that companies improved their operating results, employee relations, customer satisfaction, increased profitability, market share, and operational procedures (GAO, 1991). TQM leads to an improved profit margin for 60 companies who have shown a commitment to TQM for at least five years (Lemak, Reed, and Satish, 1997).

Limitations

To define TQM is the same as trying to shoot a moving target. The more it is practiced widely and different initiatives emerge, the emphasis on other aspects gets changed (Boaden, 1997). One criticism of TQM is that there is confusion related to the meaning and essence of TQM (Boaden, 1997).

Commonality and differences (TQM, Lean, Six Sigma)

Lean, Six Sigma, and TQM have the same origin from the quality evolution in Japan but the concepts have been developed differently. TQM also has elements of having no defects and waste elimination but they all come under the umbrella of internal and external customer satisfaction with a lesser amount of resources (Hellsten and Klefsjo, 2000). In TQM, like six sigma and lean, there is also an emphasis on processes. Many similarities between six sigma and TQM like improvement cycle. PDCA and DMAIC, both are cyclic and phases are almost similar. DMAIC can be regarded as an advanced version of PDCA. Lean principles are not cyclic. Tools used in lean are more analytical as compared to more statistical tools used in TQM and Sixsigma (Andersson, Eriksson and Torstensson, 2006). Lean by reducing lead time tends to increase customer satisfaction which is the main aim of TQM but it’s a secondary one in six sigma after the economical benefits of the company. TQM with the larger framework regards six sigma as a methodology (Klefsjö, Wiklund, and Edgeman, 2001). Lean and six sigma provide a clear roadmap for business excellence but to succeed, company culture and human factors should be addressed (Dahlgaard and Mi Dahlgaard‐Park, 2006).

Figure 10: Benefits of TQM

Source: Slideplayer.com

Table 2: Comparison (TQM, Six Sigma and Lean)

Source: (Andersson, Eriksson and Torstensson, 2006).

Lean SixSigma

Lean six sigma altogether is another methodology to improve business processes by the amalgamation of Lean and six sigma approaches (George, 2003). Where lean is about efficient work processes, six sigma is more about the precision and accuracy of those processes.

Benefits

Conformance of services/ products to customer needs, waste removal, defective transactions/product reduction, and delivering product/services right the first time are some of the many benefits of using lean six sigma altogether.

Note: As lean and six sigma separately have already been discussed in this paper, the above introduction of lean six sigma altogether as one approach should be sufficient to get an idea of this methodology.

Case Study 1: Lean transformation in the pure service environment: the case of the call service center

Background

In recent times, a fundamental shift has been seen in the world’s economy, the service sector is dominating when it comes to employing people on a larger scale in developed economies (Hills and Hill, 2012). Quality of service has been deteriorating in the vast majority of services organizations (DICKSON, FORD, and LAVAL, 2005). Much research work has been carried out for manufacturing companies in the “Lean” context; the need to focus on the services sector became essential. In this opted case study, researchers compared the performances of three financial services call centers, pre, and post “Lean” implementation. The main reason to conduct this research was to explore the applicability of Lean principles and practices in the pure services sector. For this purpose, three call services centers of financial industries were chosen (Figure 13). Each company is a large-scaled operation having hundreds of staff in the call center, different products, and actual customer services so that’s why the focus of the study was a common operations process (Claims procedure) of all three different organizations (Piercy and Rich, 2009). Multiple cases allow triangulation in research up to some extent (Easterby-Smith, Thorpe, and Jackson, 2012). The Independent consultancy team implemented lean improvement activities at each company.

Drive for improvement

Ø Each company was experiencing the same problem with the same processes. Problems like increasing

· Call volumes

· Lead time to resolve issues

· Referrals for special processing

· Staff costs

Ø Poor customer service (during a call)

Ø Higher staff absentees and turnover

Ø Less customer satisfaction

Ø Work-in-progress

All of these companies were facing management pressure for a reduction in

· Operation costs

· Customer complaints about poor Quality

Approach

Research team

The team was working as an observer of an improvement process. Observations like

· Briefing sessions with the company’s management

· Change teams & Senior management Training

· Meetings & discussions with each change teams

They also interviewed managers and change teams in an informal (unstructured) manner before, during, and after the lean implementation process.

Process Improvement team

The team comprised of ten people from claims processing units, immediate internal customers, and suppliers have been made. These teams along with senior management underwent training (Figure 14) on the rationale and nature of lean activities so that support would come from management uninterrupted to the change teams. Process mapping, value delivery to the customer, and improvement techniques were the agenda of training followed by problem solving and system thinking structured approach with the service improvement process teams. The idea behind the training was to provide tools to redesign the claim process by contrasting conceived future states with the present state to tackle service failures.

Methodology

Five universally accepted Lean principles (Figure 4) have been used in this case.

Pre Lean Operations

Using the VSM technique, real issues in processes have been explored.

Problems identified at three stages during the call

Ø Class 1: Entry

· The customer selects inappropriate options (by mistake or absence of a suitable option in the routing system).

Ø Class 2: Processing

· The customer leaves the system due to long waiting times.

· The customer routed back to queuing and menu routing by operatives unable to resolve issues.

Ø Class 3: End

· Lack of information by operatives transferred customers to buffer zone (Later processing) to experienced staff.

Figure 11: Claim value stream

Source: (Piercy, N. and Rich, N. 2009).

Root Causes

Ø Increased referrals back to the queuing system

· Not enough operatives in department

· Customers wrong selection

· Rigidly enforced script

· Failure demand

Ø De-motivated staff

· Dysfunctional department structure

· Wrongly defined performance measures e.g. Time to answer a call and Per employee-customer throughput

Successes

Improvement initiatives

· One operative to serve one customer

· Removing of a call routing system

· Multi-skilled training to staff to fully resolve query without referrals

· Elimination of narrow job descriptions

· Redesigning performance measurements (Customer requirement satisfaction)

· The reward for good customer service

· Transformation into a single organizational unit

· A central base for technical and claims process staff

· Identification of future training needs by monitoring the interaction of employees with customers on call.

Initiatives outcomes

Refer Figure 12 for detailed system indicators.

· The increased trust of front line staff in management

· Reduced absentees and high morals of employees

· A massive reduction in WIP

· Reduced failure demand and rework

· Improved productivity and reduced cost

· Improvement in “right first time” claims processed

· Reduction in calls, emails as no reduction in multiple contacts by customers

· Days reduced to 84 from 310 in resolving customer claim (Claim)

· Reduced customer lead time of 44 and 36 percent in PolicyCo and Banko respectively

· Reduced staff time

· Increased customer satisfaction

Lesson Learned

The lean improvement program brought dramatic improvements with little investment and training in just nine months period. It just requires a commitment of continuous improvement and results would be amazingly beneficial. The lean toolkit has been applied in this complex scenario of the call service center. Lean principles start with determining customer value (one-stop-shop in a call center) leading to process mapping techniques that helped in assessing value and waste in current operational processes. Mapping processes identified hindrances in flowing value to customers. Ensuring sufficient capacities to respond to customer queries to achieve smooth flow (Pull system). Continuous improvement includes identification of future needs to train the staff by monitoring customer calls.

Figure 12: System indicators, pre & post lean implementation

Source: (Piercy and Rich, 2009)

Figure 13: Details of three call services centers

Source: (Piercy and Rich, 2009)

Figure 14: Training details

Source: (Piercy and Rich, 2009)

Case Study 2: Implementing “Lean” Principles to Improve the Efficiency of the Endoscopy Department of a Community Hospital

Background

The service sector has been studied in the previous case. This case study is selected based on its uniqueness as it comes under the banner of the service product bundle. Researchers described how “Lean” methodology and tools transformed an endoscopy department of a community hospital in a better way. Few hospitals have been looked at. Elimination of wastes and redundancies has been performed using Lean tools from manufacturing industries which proved that lean is also a suitable approach to implement in pure services and service bundle organizations.

Figure 15: Flow of information & resources Endoscopy department

Source: (Laing and Baumgartner, 2005)

Drive for improvement

Below mentioned are those reasons based on which the endoscopy department selected for the implementation of Lean methodology (Laing and Baumgartner, 2005).

· Need for more staff time and equipment utilization due to spikes in the daily census of client

· Physicians were frustrated with patient flow and turnover times of rooms

· Not being able to accommodate the increasing demand for patient

· Physicians want to increase their volumes of procedure

· Departmental staff and space was not enough to meet the growth projection of the year 2004

· Nursing staff were frustrated of not always knowing the exact patient’s location during the process (Admission to procedure till recovery)

· Nursing staff were not getting break time for longer periods

Goals

· Improvement in the process flow for patients to ensure quality service with timely results and information.

· Consistent procedural times (start & end) for physicians in line with community standards.

· Availability of sufficient supplies and nursing staff in times of need.

· Underlying everything, aim to eliminate waste that leads to increased lead times, waiting for times excess inventory and unnecessary movements (Liker, 2004).

Approach

Research team

The authors used to meet with staff every week and updated with strategies for the week from start to finish. The results of these meetings were those ideas which staff used to share. Outcomes of the meetings were also registered and posted for further implementation. Update sessions used to be organized with the vice president who was also responsible for the care section. Apart from assistance and support, approvals used to be given by the vice president for some critical activities in the workplace.

Process Improvement team

The team comprised three experienced nurses, one manager and gastrointestinal technician from the endoscopy department along with a facilitator (outside) from performance excellence. The team used to meet many times within a week for two months to lead a department in the project “lean”.

Methodology

The primary tool used in this case were visual management control including 5S (Sort, Set, Shine, Standardize, Sustain), Standardization, Pull, and replenishment.

Pre Lean Operations

Using the voice of the customer (Physicians and patients), the feedback has been gathered.

Problems / Concerns

Ø Behind schedule

Ø Unable to find patient (had to ask health unit coordinator and nurse)

Ø Physicians wanted to hire more nurses

Ø Not meeting the standard cycle time of patients (feedback from physicians and benchmarking with another hospital)

Ø Cycle time was of 130 minutes in comparison to other hospitals having 70 minutes.

Ø Obtaining test results

Ø Patients wanted to be treated in a friendly manner as friendliness decrease anxiety.

Ø Waste of waiting at each step (admission, procedure, discharge)

Ø Excess inventory

Ø Unnecessary motion to retrieve required supplies and to locate patients within the department.

Ø Not well-defined roles and responsibilities

Ø Not being consistent with the use of resources

Success

Improvement Initiatives

Ø A wall-mounted system having small bins got introduced to replenish supplies in time of need.

Ø Kanban alert staff to replenish the same number of items which have been used

Ø Establishment of standard definitions for keeping track of time in the documentation system

Ø Establish standardized processes and role descriptions for each step (admission, procedure, discharge)

Ø Development of standard functions for roles of charge nurse and surgical technicians

Ø Recreation of a standard erasable whiteboard (figure 16) to follow patients from admission to discharge

Ø Designed board categorized patients into three phases (admission, procedure, discharge) having corresponding room numbers against each phase telling patients location.

Ø Details like procedure room nurse, physician and planned discharge time were also mentioned

Ø PAR level system was established in the rooms.

Ø Storage bins (figure 17) were labeled and barcoded

Ø GI technician developed directory having an identification of supplies and location in an orderly manner

Ø Call light system has been installed to let GI technician know that room is read for a turnover

Figure 16: whiteboard before (upper) & after (lower) lean

Source: (Laing and Baumgartner, 2005)

Improvement outcomes

Ø Elimination of large storage room due to a significant reduction in inventory

Ø Storage room got converted in the Staffroom (much needed)

Ø Nurse’s station is organized and free from clutter (figure 18)

Ø Staff can eat lunch and relax in their small break room between procedures

Ø Cycle time got decreased by 17 minutes

Ø Teamwork capabilities, trust, and realization of common goal have been developed by the lean activity

Ø Decreased linen cost

Ø Savings of $7000 under budget

Ø Reduction in suture supplies by one third (one time saving of $1000)

Ø Reduction in on hands supplies by two-third

Ø More efficient staff utilization despite the resignation of one member on personal reasons

Lesson learned

Before the initiation of this project, there were misconceptions regarding operational processes. As described, staff used to think that they are short of members, and this chaotic system for turnover of patients was deteriorating the conditions. They were wrong about the number of staff members yet correct with the realization that the processes are not streamlined and standardized. With little effort and commitment, huge benefits have come across. Pre lean operations were full of wastes and no one could be able to think about the way of removing inventories. Lean proved that excess inventories hide waste and deteriorate performances in terms of high costs and low productivity. Nothing extra work has been assigned to staff but a systematic way has been introduced of dealing with day to day activities using a holistic approach of lean.

Table 3: Comparison of approaches, successes

Source: Author’s designed

Savings of $7000, reduction in suture supplies leads to one time savings of $1000, low inventory, reduced cycle time, more space for staff members, low linen cost

Source: Author’s designed

Figure 17: Storage room before (upper) & after (lower) Lean

Source: (Laing and Baumgartner, 2005)

Figure 18: Nurse Station before (upper) & after (lower) Lean

Source: (Laing and Baumgartner, 2005)

Lean Adoption (Organization A vs. Organization B)

The financial services call center and endoscopy department of a hospital are two different entities as one is a pure service organization and the other one is the service bundle. Both organizations have managed to implement lean and get better results from it, in terms of productivity, work efficiency, employee morale, and customer satisfaction. Case study A is related to three call centers that were facing almost the same issues in their daily operations. There were many loopholes in their system due to which they were facing low employee morale and hence less customer satisfaction. Using value stream mapping, they have identified value in terms of a customer perspective and prioritized to resolve the issues which customer would appreciate at once. Within nine months, they have managed to streamline their operations with the implementation of lean principles in their daily routine work. Low % of failure demand, low WIP, and high employee’s morals and customer satisfaction were some of the many benefits that they have managed to obtain. Whereas in the endoscopy department of a hospital, things were not that bad but yes improvements were required in many areas. They simply used Lean as a visual management tool and started analyzing their process using process mapping. It was not a difficult task to map the process and soon they came to know that how by doing small things, bigger improvements can be achieved e.g. usage of kanban, designed board to see the current status of the patient and call light system. They have reported saving $8000 as well. Staff is more content and satisfied with their responsibilities. Overall efficiency got increased in no time. That’s how lean proved to be an important approach to both organizations in the context of continuous improvement.

Conclusion

From all of the above discussion, it is quite evident that continuous improvement is an incremental improvement which can lead to a breakthrough improvement after careful consideration and improvement in daily routine work. It’s all about getting better every day. There are some events when breakthrough improvements can occur straightaway. Lean, Six, and TQM come under the banner of approaches related to continuous improvement. Each approach has some benefits and limitations inherent to it. Organizations should assess the current performance and resources of their Company and should be able to decide which approach is suitable for their particular organization. Appropriate culture of continuous improvement is an important aspect to have when we talk about the implementation of Lean, six sigma, and TQM because it’s an ongoing process of improvement and one time changes would not bring long-lasting results. We have also seen how both different organizations (Pure services, service bundle) implemented lean in their daily operations and how they are enjoying benefits of it. The not only system gets better with the continuous improvement culture, but it also instills a sense of pride among employees.

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