Co-existing with concepts of management control, Lean implementation has various implications for management accounting systems. Evidence suggests that Lean should be implemented as an integrated management control system (Nielsen et al., 2018 Fullerton, Kennedy, and Widener 2014). One school of thought argues that, to fully realize the benefits of Lean transformation, traditional control systems should be modified to suit Lean practices (Tillema and van der Steen 2015). Prior studies suggest that management control mechanisms can either hinder or facilitate the outcomes of Lean implementations (Fullerton, Kennedy, and Widener 2014). Similar techniques are affiliated with management control mechanisms (Dahlgaard et al., 2019).
LSSs apply statistical process control techniques that use data as evidence of knowledge to improve operational processes. Conversely, Lean is recognized as a complementary management control philosophy consisting of interdependent practices and is found to be fitting with an organization’s management control mechanisms (Nielsen et al., 2018 Fullerton, Kennedy, and Widener 2014). Present-day management accountants integrate flexible, non-financial control systems with traditional financial management control mechanisms to achieve challenging organizational goals (Alsharari, 2019). They do this by providing information for planning, control, performance measurement, and decision-making process (Wanderley 2019 Alsharari, 2019). Management control systems play an essential role in organizing and monitoring organizations’ resources and processes. Healthcare organizations are in an ecosystem that necessitates a system of management control due to its complexity and the dynamic nature caused by differing objectives (e.g., quality of patient care, efficiency, and cost containment) fulfilled by a multitude of actors (e.g., clinicians and administrators) who work together (Morelli and Lecci 2013). Numerous healthcare organizations have attempted process improvements using LSS to increase efficiency and effectiveness (Stanton et al., 2014 Laureani, Brady, and Antony 2013 de Koning et al., 2006). There is, in fact, a tendency to combine the two approaches into Lean Six Sigma (LSS) (Henrique and Godinho Filho 2018). Among the improvement methods successfully deployed in the manufacturing sector, Lean and Six Sigma have gained the most prominence in healthcare. Such methods include process redesigning, which aims to provide care to patients and achieve higher service quality (Chartier et al., 2019). In a context of resource restraints amid rising demand for services, private and public healthcare systems pursue various methods for continuous improvement. Many healthcare organizations are challenged by the demands of an increasingly ageing population, rising rates of obesity, and the intensification of lifestyle diseases such as diabetes, heart disease, osteoarthritis, and certain cancers, coupled with inadequate government funding on already strained healthcare organizations (Al-Balushi et al., 2014 Sohal et al., 2021). Specified CSFs and the method used to identify these will benefit managers of continuous improvement projects. This study contributes to the management control, operations management, and healthcare literature by identifying CSFs of continuous improvement projects and introducing a relatively unique, rigorous, and practically proven evaluation method applied via an industry and academic partnership. The findings confirm that all eight CSFs identified are significantly correlated to project success. Finally, the correlations of each factor rating against project success were analyzed to validate the relationship between each success factor and project success. Success was measured against whether the project met its stated aim and achieved the Key Performance Indicators that had initially been identified.
The success of the 62 completed projects was assessed against each of the eight CSFs on a five-point Likert scale.
Six sigma success story series#
A series of brainstorming sessions and workshops helped to narrow down and revise all the CSFs present in each of the 62 LSS projects to eight CSFs. Using a grounded theory approach, numerous success factors were initially identified. 62 LSS projects completed by Green Belts in consultation with Black Belts were analyzed for project success by a review team of practitioners (Black Belters) and academics. This study, based at a large public tertiary healthcare organization, identifies CSFs in implementing Lean Six Sigma (LSS). Despite the availability of manufacturing-related literature, studies on CSFs in more dynamic and complex healthcare-related operations are scarce.
Identifying critical success factors (CSFs) of continuous improvement projects is crucial for management control and operations management domains.
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