The past decade spotlighted a trend, which is that of individual users taking the role of innovators and physically creating their own products by explooting model additive manufacturing techniques. This trend emphasized the need for facilities able to serve as a platform for passionate makers to share knowledge, meet others and provides opportunities to realize their ideas. One of these platforms is Karlskrona Makerspace (KMS). KMS is located at Blekinge Institute of Technology (BTH) and provides 3D printing service, CNC milling machine and other facilities to help companies and individuals build physical prototypes. The purpose of this thesis is to expand the business of KMS and offer their service to more people. The study collects customer needs from potential KMS customers and aims at obtaining a viable business model after ranking risks. The main methodology used for building a business model is Running Lean Methodology to clear up complex associations in a business. The result shows that the business model identifies target customers, and clarifies the solutions to increase funding for KMS.

Submitted by Joana Azevedo (joanad@id.uff.br) on 2018-01-15T18:26:41Z No. of bitstreams: 1 Dissert Jose Luiz da S Perna.pdf: 2352003 bytes, checksum: e3052489505bf8f206dfee3da28c5a52 (MD5) / Approved for entry into archive by Biblioteca da Escola de Engenharia (bee@ndc.uff.br) on 2018-01-16T12:33:05Z (GMT) No. of bitstreams: 1 Dissert Jose Luiz da S Perna.pdf: 2352003 bytes, checksum: e3052489505bf8f206dfee3da28c5a52 (MD5) / Made available in DSpace on 2018-01-16T12:33:05Z (GMT). No. of bitstreams: 1 Dissert Jose Luiz da S Perna.pdf: 2352003 bytes, checksum: e3052489505bf8f206dfee3da28c5a52 (MD5) Previous issue date: 2017-12-18 / Um dos principais desafios das organizações públicas é gerenciar setores que possuem carência de pessoas, prazos e recursos, impedindo a construção de um serviço que traga efetividade para os cidadãos. A Metodologia “Lean”, consagrada na literatura científica se aplica perfeitamente a este cenário trazendo soluções com pouco custo financeiro e rápida resposta às mudanças necessárias na cultura da organização e na busca de melhores resultados na prestação de serviço público. Avaliou-se a implantação da Metodologia “Lean” na Prefeitura de uma instituição de ensino localizada na cidade do Rio de Janeiro, RJ, verificando a ocorrência da Melhoria Contínua através da eficiência e produtividade dos serviços realizados com a redução de desperdícios e/ou tempo após a implantação. A pesquisa utilizada para a avaliação se caracteriza como um experimento de campo com a introdução da variável independente, Metodologia “Lean”, sendo que inicialmente houve uma fase de observação da realidade encontrada, denominada Análise e Diagnóstico para em seguida serem aplicadas, ao longo de três anos, vinte e duas ferramentas desta filosofia, com avaliação coletiva e individual destas ferramentas nos setores subordinados à Prefeitura. Foi também analisada a variável dependente, Melhoria Contínua, com a análise de quatorze indicadores para verificar a ocorrência, após a implantação da Metodologia “Lean”, de mudança significativa na evolução dos serviços, gerando aumento constante de eficiência e produtividade nos setores de Manutenção, Merenda, Limpeza, Segurança, Portaria, Almoxarifado e Despensa. O tempo de pesquisa foi de seis semestres, iniciando em janeiro de 2014 e terminando em dezembro de 2016. Os resultados encontrados relativos à implantação da Metodologia “Lean” confirmaram a literatura do tema e, a avaliação da aplicação das Ferramentas “Lean” foram positivas contribuindo para o sucesso da implantação da Metodologia “lean”. Os resultados coletados com os indicadores de Melhoria Contínua fortaleceram as avaliações obtidas na variável independente, mostrando aumento de eficiência e produtividade em todos os setores estudados, havendo mudança de comportamento e cultura dentro da Prefeitura do campus. Como reforço aos dados apresentados, foi feita análise estatística utilizando-se o teste do Qui-quadrado, com grau de liberdade igual a 5 e nível de significância igual a 0,01, na qual em doze dos quatorze indicadores o resultado obtido teve relevância em relação a melhoria contínua e em dois indicadores não houve a melhoria esperada, mas contribuíram para obtenção de eficiência na Prefeitura. Os resultados apresentados por esta pesquisa reforçam os conceitos da literatura sobre o método de processos implantado, contribuindo para mudanças na cultura do setor avaliado, com melhora da capacidade técnica e laboral dos colaboradores e gestores envolvidos bem como do da eficiência e produtividade dos serviços prestados. Esta dissertação atinge um de seus objetivos de fornecer farto material teórico e prático para futuras pesquisas dentro e fora da instituição. / One of the main challenges of public organizations is to manage sectors that lack people, deadlines and resources, preventing the construction of a service that brings effectiveness to citizens. The "Lean" Methodology, enshrined in the scientific literature, applies perfectly to this scenario by bringing solutions with little financial cost and rapid response to the necessary changes in the culture of the organization and in the search for better results in the provision of public service. The implementation of the "Lean" Methodology in the Prefecture of a teaching institution located in the city of Rio de Janeiro, RJ, was verified, verifying the occurrence of Continuous Improvement through the efficiency and productivity of the services performed with the reduction of waste and / or time after implantation. The research used for the evaluation is characterized as a field experiment with the introduction of the independent variable, Lean Methodology. Initially, there was a phase of observation of the reality found, called Analysis and Diagnosis, to be applied later. Three years, twenty-two tools of this philosophy, with collective and individual evaluation of these tools in the sectors subordinated to the Prefecture. The dependent variable, Continuous Improvement, was also analyzed, with the analysis of fourteen indicators to verify the occurrence, after the implementation of the Lean Methodology, of a significant change in the evolution of services, generating a constant increase of efficiency and productivity in the Maintenance, Maintenance, Cleaning, Security, Concierge, Warehouse and Pantry. The research time was six semesters, beginning in January 2014 and ending in December 2016. The results found regarding the implementation of the "Lean" Methodology confirmed the literature on the subject and the evaluation of the application of the Lean Tools were positive contributing to the successful implementation of the Methodology. The results obtained with the indicators of Continuous Improvement strengthened the evaluations obtained in the independent variable, showing an increase of efficiency and productivity in all sectors studied, with a change of behavior and culture within the Campus Prefecture. In order to reinforce the data presented, a statistical analysis was performed, using the Chi-square test, with a degree of freedom equal to 5 and a level of significance of 0.01, in which, in twelve of the fourteen indicators, the result obtained was relevant in In relation to continuous improvement and in two indicators there was no expected improvement, but contributed to achieving efficiency in the Prefecture. The results presented by this research reinforce the concepts of the literature on the implanted process method, contributing to changes in the culture of the sector evaluated, improving the technical and labor capacity of the employees and managers involved as well as the efficiency and productivity of the services provided. This dissertation achieves one of its objectives of providing a wealth of theoretical and practical material for future research inside and outside the institution.

Background: Heart failure (HF) is the leading cause of hospitalization among older adults in the United States. Health systems target readmission rates for quality improvement and cost reduction. Local Problem: Heart failure core measure (CM) scores at our medical center were lower than the national average, and methods for capturing the appropriate documentation on HF patients to ensure CM compliance were not clear. Methods: An interdisciplinary team determined barriers to increasing CM scores, gathered baseline data, and identified gaps in the existing process. Interventions: The team implemented an accurate reporting system and error-proofing process, redesigned the process for identifying patients admitted with a HF diagnosis, and developed a patient appointment section before discharge in the electronic medical record. Results: There was a decrease in readmissions within 30 days of implementation from 12% to 8%, and HF CM compliance score increased from 88% to 100%. The percentage of HF patients not identified during hospitalization decreased from 17% to 0%. Heart failure patients discharged with a 7-day follow-up appointment increased from 88% to 98%. Conclusion: Through implementation of an interdisciplinary-led process improvement and lean methodologies, metrics and CMs were achieved.

No description available.

No description available.

El siguiente proyecto de tesis se encuentra conformado por 4 capítulos. En el primer capítulo, se presenta el marco teórico investigado de fuentes con journals indexadas y respaldadas por autores especialistas con los temas de procesos, restricciones y herramientas Lean. En el segundo capítulo, se analiza el diagnóstico actual del caso de estudio del sector automotriz, mapeando sus procesos, analizando el Árbol de Problemas y evaluando sus causas raíz de la problemática principal. En el tercer capítulo, se muestra la propuesta de solución con respecto al diagnóstico que se realizó y al marco teórico investigado. Se aplicarán herramientas Lean, como el Value Stream Mapping, Operator Balance Chart (OBC), donde se calcularán los tiempos de ciclos, el takt time y serán evaluados con todas las áreas de trabajo, para así poder obtener un trabajo estandarizado. Por último, en el capítulo 4, se realizará una simulación para validar la propuesta y se mostrarán las conclusiones y recomendaciones, a partir de la propuesta de solución. / The following thesis project is made up of 4 chapters. In the first chapter, the researched theoretical framework of sources with indexed journals and supported by specialist authors with the topics of processes, restrictions and Lean tools is presented. In the second chapter, the current diagnosis of the case study of the automotive sector is analyzed, mapping its processes, analyzing the Problem Tree and evaluating its root causes of the main problem. In the third chapter, the proposed solution is shown with respect to the diagnosis that was made and the theoretical framework investigated. Lean tools will be applied, such as the Value Stream Mapping, Operator Balance Chart (OBC), where the cycle times will be calculated, the takt time and will be evaluated with all the work areas, in order to obtain a standardized work. Finally, in Chapter 4, a simulation will be carried out to validate the proposal and the conclusions and recommendations will be shown, based on the proposed solution. / Trabajo de Suficiencia Profesional

Similar to other healthcare systems worldwide, Kuwait faces challenges of increased demand and cost while trying to operate with constrained resources. There are some data suggesting that Lean methodology, first used by Japanese car manufacturer Toyota, could improve system efficiency or flow by waste elimination, may be useful in addressing some of the challenges found in healthcare. Lean has so far not been used in Kuwaiti primary healthcare centres. This thesis explores the case for using Lean in Kuwait by examines issues around diabetes, as Kuwait rank the six highest in the world. In Kuwait, patients with diabetes are mainly managed in primary healthcare centres. The case for using Lean was explored across five interrelated studies which are summarised below: Study 1 involved a review of the literature which found that Lean tools have been used mostly in hospital settings without any rigorous evaluation and with little or no attention paid to primary healthcare or in developing countries. Study 2 was a systematic documentary review of the challenges facing the healthcare system of Kuwait. In Kuwait, expenditure on healthcare services is expected to double within five years. Life expectancy is increasing, while the percentage of the elderly population is growing, leading to increasing demand of services to treat non-communicable disease such as diabetes. Kuwait still sends many of its patients overseas for treatment. Currently, 10 mega projects worth approximately 2 billion Kuwaiti Dinar are being constructed in Kuwait that will result in a doubling of the bed capacity. However, the average occupancy rate between 2006 to 2015 was 63.6%, which is considered low compared to the average occupancy rate in European Union countries. Study 3 sought the views of Kuwaiti healthcare leaders about Lean and challenges facing the healthcare system of Kuwait. The key findings were: (1) Most leaders agreed that the current healthcare system in Kuwait faces difficult challenges and needs to change its management approach; (2) Lean as a management approach is considered a new concept among leaders of Kuwaiti healthcare organisations; (3) They did not have adequate knowledge regarding Lean but were willing to support any future Lean improvement initiatives. Study 4 explored the knowledge of Healthcare Workers regarding Lean within Kuwait’s primary healthcare centres through a cross-sectional survey in four primary healthcare centres. Only 11% of participants were familiar with Lean. None of the participants were involved or had an ongoing Lean initiative or project but 80% of participants were willing to be involved in future Lean initiatives. Study 5 mapped the flow of patients with type 2 diabetes in primary healthcare centres to identify potential waste and make recommendations for improvement. Patients with type 2 diabetes typically visit their General Practitioner at least every two months for a review appointment. When a blood test is required to monitor blood sugar levels, three more visits are required, involving the blood test, collection of test results by the patient and a review of the results with the general practitioner. Four potential improvements were identified: using point of care testing, the posting of laboratory results to general practitioner computer systems, the introduction of guidelines that standardise the practice for the patient’s visit and permitting the general practitioner to prescribe medication that will last four months. The process map of patients with type 2 diabetes has highlighted waste and improvement suggestions that may reduce workload, enhance patient satisfaction, avoid unnecessary visits, enhance the timeliness of laboratory testing, improve communication between and across departments and minimise the use of resources without undermining the quality of care. These suggestions, if implemented on the national level, could bring tremendous benefits but still need to be rigorously evaluated. The thesis concludes by noting that there is considerable potential in adopting Lean to improve the healthcare services in Kuwait, but further work is required to implement the changes and rigorously evaluate them.

Context: Software testing is a crucial area in software development. It has been found that there is little evidence on how testing is performed in software automotive domain. Challenges in this domain have not yet been fully evaluated. Furthermore, interactions between test procedures, and other activities of software development are left unexposed. Assessment of test process is an important part of improvement initiatives. Objectives: In this study we perform an in-depth investigation to identify challenges which lead to wastes in test process in the context of automotive software domain. To this end, we also identified strengths that add value in test process. Methods: We performed a Case study at a Sweden based large automotive organization. To this end, we conducted semi-structured interviews and used Grounded Theory method for interview data analysis. We used Value Stream Mapping (VSM), a Lean methodology tool for test process assessment. Furthermore, we conducted Systematic Literature Reviews to look for evidence of similar problems and solutions offered in peer-reviewed literature. Results: We grouped the identified challenges and strengths into 10 and 4 categories respectively. We also identified 7 kinds of waste and 4 kinds of values based using VSM. Based on systematic literature reviews, we proposed 7 solution proposals, an agile process model with practices. Conclusions: We conclude that VSM is an efficient tool in eliciting improvement potentials in software testing context using qualitative data. In regard to solution proposals, we propose further empirical work to evaluate the solution proposals themselves and tailor to company needs. However, the results obtained through this study can be compared to test processes at other companies in automotive domain. / kasoju.abhinaya@gmail.com

Context: Over the recent years, ‘Lean Software Development’ (LSD) has been emerging as a significant practice in the Software Industry. The inherent nature of ‘Lean’ to efficiently handle frequently changing customer needs by minimizing ‘Waste’ is a major success factor in practicing it in the context of ‘Software Engineering’. In simple words, Lean Software Development is the true translation of Lean Manufacturing and Lean IT principles to Software Engineering. This work presents an in-depth analysis on the implication of lean methodologies from both ‘State of Art’ and ‘State of Practice’ in the context of Software Engineering. Objectives: The prime objective of the study is to investigate what methodologies were considered & adopted under lean philosophy and to present relevant evidence on the implication of lean methodologies in reference to what defines ‘lean’ in Software Engineering. An extensive literature review was aimed to find the existing challenging factors that negatively influenced the success of software projects and the respective lean mitigation methodologies that were employed by various software organizations to appease their negative impact. Industrial interviews were conducted by interviewing lean experts, with a motive to find the current state of lean implementation in software industry. The outcomes from the systematic literature review (State of Art) and the industry (State of Practice) are comparatively analysed to explore the similarities and differences on the state of lean implication. Finally, a set of guidelines are recommended that would benefit an Industrial Practitioner/Stakeholder/Academic Researcher in practicing the appropriate lean methodology in the context of software engineering. Methods: We conducted a ‘Systematic literature review’ (SLR) by systematically analyzing relevant studies and then interviewed industrial experts to validate our findings. The systematic literature review was conducted according to the guidelines proposed by Dr. Barbara Kitchenham stated in ‘Guidelines for performing Systematic Literature Reviews’ article. The thorough review helped us in identifying various challenging factors that negatively influenced the success of software projects and the respective lean mitigation methodologies that were practiced in the context of software engineering. The associated benefits of practicing the lean methodologies are also presented. The extensive review included peer reviewed articles from electronic databases such as IEEE Explore, Inspec, Scopus and ISI. In addition to this, we conducted snowball sampling on the references of the selected articles to avoid the potential risk of losing relevant and valuable information. Also, other potential sources of information such as books, theses/dissertations, white papers and website/blog articles are included as a part of Grey Literature. In this study, the articles related to the implication of lean methodologies in the context of software engineering were considered. The review included 72 primary studies published between 1993 and 2012. The primary studies were selected based on the following criteria: If they presented the challenging factors that negatively influenced the success of software projects. If they depicted the implication of lean mitigation methodologies (Tool/ Technique/ Method/ Process/ Practice/ Principle) that appeased the negative impact of the identified challenging factors that hampered the success of software projects. If they depicted the implication of lean methodologies (Tool/ Technique/ Method/ Process/ Practice/ Principle) in general or for a specific development/ Management/ Maintenance improvement activities that lead to the success of software projects in the context of software engineering. If they presented the benefits of practicing lean methodologies in the context of software engineering. The study quality assessment was done based on the quality criteria defined in the ‘Quality assessment criteria checklist’. The data such as Article ID, Article Title, Literature type (Peer- reviewed, Non-peer reviewed), Context of validation of the lean methodology (Industry/Academia), Subjects considered for the study (Researchers/students, Industrial practitioners), Type of article publication (Conference/ Journal/ Books/ Thesis Reports/ Doctoral dissertations/ Other), Research method used in the study (Case Study/ Experiment/ Experience Report/ Not stated/ Secondary Data Analysis/ Literature Review), Context of conducting the research (Industry/ Academia/ Not stated/ Both), Context of validation of the study (Strong/ Medium/ Weak), Publication date & year, Source of the publication, are extracted as a part of Quantitative analysis. The secondary data analysis for both ‘State of Art’ (Systematic literature review) and ‘State of Practice’ (Industry) was carried by performing a generic data analysis designed to answer our research questions. The more specific data such as the challenging factors that negatively influenced the success of software projects, the type of lean contribution presented i.e., the methodology being a Tool, Technique, Practice, Principal, Process or a Method, along with the benefits associated on their implication that helped us to answer our research questions are extracted as a part of qualitative analysis from the selected studies. The industrial interviews were conducted by interviewing potential lean experts who had decent experience in lean software development, to find the current state of lean implication in the software industry. In the end, a comparative analysis was performed to clearly understand the state of convergence and divergence between the results from extensive literature review and the industry with respect to the implication of lean methodologies in the context of software engineering. Results: A total of 72 primary articles were selected for data extraction. 56 articles were selected from the electronic databases that clearly depicted lean implementation in the context of software engineering. 9 articles were selected by conducting snowball sampling i.e. by scrutinizing the references of the selected primary studies and finally the grey literature resulted in 7 articles. Most of the articles discussed about lean implication in the context of software engineering. The depicted lean methodologies were validated in either Industry or Academia. A few articles depicted regarding lean principles and their benefits in the context of software engineering. Most of the selected articles in our study were peer- reviewed. Peer reviewing is a process of evaluating one’s work or performance by an expert in the same field in order to maintain or enhance the quality of work or performance in the particular field. This indicates that the articles considered for data extraction have been reviewed by potential experts in the research domain. Conclusions: This study provided a deeper insight into lean implication in the context of software engineering. The aim of the thesis is to find the challenging factors that negatively influenced the success of software projects. A total of 54 challenges were identified from the literature review. The 72 primary articles selected from various resources yielded 53 lean methodologies. The lean methodologies were grouped into Principles, practices, tools and methods. Mapping between the identified challenges and the mitigation lean methodologies is presented. Industrial interviews were conducted to find the current state of lean implication in software engineering. A total of 30 challenges were identified from the industry. A total of 40 lean methodologies were identified from the interviews. Comparative analysis was done to find the common challenges and mitigation lean methodologies between the State of art and State of practice. Based on the analysis a set of guidelines are presented at the end of the document. The guidelines benefit an industrial practitioner in practicing the appropriate lean methodology. Keywords: Lean Methodology, Lean software development, lean software management, lean software engineering, Systematic literature review, literature review. / Context: Over the recent years, ‘Lean Software Development’ (LSD) has been emerging as a significant practice in the Software Industry. The inherent nature of ‘Lean’ to efficiently handle frequently changing customer needs by minimizing ‘Waste’ is a major success factor in practicing it in the context of ‘Software Engineering’. In simple words, Lean Software Development is the true translation of Lean Manufacturing and Lean IT principles to Software Engineering. This work presents an in-depth analysis on the implication of lean methodologies from both ‘State of Art’ and ‘State of Practice’ in the context of Software Engineering. Objectives: The prime objective of the study is to investigate what methodologies were considered & adopted under lean philosophy and to present relevant evidence on the implication of lean methodologies in reference to what defines ‘lean’ in Software Engineering. An extensive literature review was aimed to find the existing challenging factors that negatively influenced the success of software projects and the respective lean mitigation methodologies that were employed by various software organizations to appease their negative impact. Industrial interviews were conducted by interviewing lean experts, with a motive to find the current state of lean implementation in software industry. The outcomes from the systematic literature review (State of Art) and the industry (State of Practice) are comparatively analysed to explore the similarities and differences on the state of lean implication. Finally, a set of guidelines are recommended that would benefit an Industrial Practitioner/Stakeholder/Academic Researcher in practicing the appropriate lean methodology in the context of software engineering. Methods: We conducted a ‘Systematic literature review’ (SLR) by systematically analyzing relevant studies and then interviewed industrial experts to validate our findings. The systematic literature review was conducted according to the guidelines proposed by Dr. Barbara Kitchenham stated in ‘Guidelines for performing Systematic Literature Reviews’ article. The thorough review helped us in identifying various challenging factors that negatively influenced the success of software projects and the respective lean mitigation methodologies that were practiced in the context of software engineering. The associated benefits of practicing the lean methodologies are also presented. The extensive review included peer reviewed articles from electronic databases such as IEEE Explore, Inspec, Scopus and ISI. In addition to this, we conducted snowball sampling on the references of the selected articles to avoid the potential risk of losing relevant and valuable information. Also, other potential sources of information such as books, theses/dissertations, white papers and website/blog articles are included as a part of Grey Literature. In this study, the articles related to the implication of lean methodologies in the context of software engineering were considered. The review included 72 primary studies published between 1993 and 2012. The primary studies were selected based on the following criteria: If they presented the challenging factors that negatively influenced the success of software projects. If they depicted the implication of lean mitigation methodologies (Tool/ Technique/ Method/ Process/ Practice/ Principle) that appeased the negative impact of the identified challenging factors that hampered the success of software projects. If they depicted the implication of lean methodologies (Tool/ Technique/ Method/ Process/ Practice/ Principle) in general or for a specific development/ Management/ Maintenance improvement activities that lead to the success of software projects in the context of software engineering. If they presented the benefits of practicing lean methodologies in the context of software engineering. The study quality assessment was done based on the quality criteria defined in the ‘Quality assessment criteria checklist’. The data such as Article ID, Article Title, Literature type (Peer- reviewed, Non-peer reviewed), Context of validation of the lean methodology (Industry/Academia), Subjects considered for the study (Researchers/students, Industrial practitioners), Type of article publication (Conference/ Journal/ Books/ Thesis Reports/ Doctoral dissertations/ Other), Research method used in the study (Case Study/ Experiment/ Experience Report/ Not stated/ Secondary Data Analysis/ Literature Review), Context of conducting the research (Industry/ Academia/ Not stated/ Both), Context of validation of the study (Strong/ Medium/ Weak), Publication date & year, Source of the publication, are extracted as a part of Quantitative analysis. The secondary data analysis for both ‘State of Art’ (Systematic literature review) and ‘State of Practice’ (Industry) was carried by performing a generic data analysis designed to answer our research questions. The more specific data such as the challenging factors that negatively influenced the success of software projects, the type of lean contribution presented i.e., the methodology being a Tool, Technique, Practice, Principal, Process or a Method, along with the benefits associated on their implication that helped us to answer our research questions are extracted as a part of qualitative analysis from the selected studies. The industrial interviews were conducted by interviewing potential lean experts who had decent experience in lean software development, to find the current state of lean implication in the software industry. In the end, a comparative analysis was performed to clearly understand the state of convergence and divergence between the results from extensive literature review and the industry with respect to the implication of lean methodologies in the context of software engineering. Results: A total of 72 primary articles were selected for data extraction. 56 articles were selected from the electronic databases that clearly depicted lean implementation in the context of software engineering. 9 articles were selected by conducting snowball sampling i.e. by scrutinizing the references of the selected primary studies and finally the grey literature resulted in 7 articles. Most of the articles discussed about lean implication in the context of software engineering. The depicted lean methodologies were validated in either Industry or Academia. A few articles depicted regarding lean principles and their benefits in the context of software engineering. Most of the selected articles in our study were peer- reviewed. Peer reviewing is a process of evaluating one’s work or performance by an expert in the same field in order to maintain or enhance the quality of work or performance in the particular field. This indicates that the articles considered for data extraction have been reviewed by potential experts in the research domain. Conclusions: This study provided a deeper insight into lean implication in the context of software engineering. The aim of the thesis is to find the challenging factors that negatively influenced the success of software projects. A total of 54 challenges were identified from the literature review. The 72 primary articles selected from various resources yielded 53 lean methodologies. The lean methodologies were grouped into Principles, practices, tools and methods. Mapping between the identified challenges and the mitigation lean methodologies is presented. Industrial interviews were conducted to find the current state of lean implication in software engineering. A total of 30 challenges were identified from the industry. A total of 40 lean methodologies were identified from the interviews. Comparative analysis was done to find the common challenges and mitigation lean methodologies between the State of art and State of practice. Based on the analysis a set of guidelines are presented at the end of the document. The guidelines benefit an industrial practitioner in practicing the appropriate lean methodology. Keywords: Lean Methodology, Lean software development, lean software management, lean software engineering, Systematic literature review, literature review. / 0091-8375920473

The concept of Shifting the Balance of Care was first introduced to NHS Scotland in 2005 through the Kerr Report. The key messages from the report were to: ensure sustainable and safe local services, which are supported by the right skills, change the emphasis of care into the community, provide preventative reactive care, and fully integrate the system to tackle the changes, use technology more effectively, and involve the public in finding solutions to change. Following the report, a framework was developed which highlighted and prioritised eight areas of improvement. These areas for improvement are the focus by which this research examines if Operational Research (OR), specifically OR models, can have a positive impact in Shifting the Balance of Care. The research utilises underlying OR methodologies and methods and provides evidence from the literature of the ability of nine selected models to facilitate the Shift in the Balance of Care. A contributing factor to the research is the barriers to implementation of OR models into the NHS. With reference to the literature, the common barriers to implementation of OR models are categorised and used to provide direction to modellers where implementation barriers are more prevalent in some models than in others. The research also provides empirical evidence of three selected models’ (the Lean Methodology, Process Mapping and Simulation, developed over two Case Studies) ability to address and influence the prioritised Improvement Areas, with the addition of a newly developed model: SoApt. The development of SoApt follows the Principles of Model Development derived as a guide to modellers who wish to develop a new model. SoApt is also empirically explored in a Case Study and provides some evidence of the models ability to aid Decision-makers, faced with limited budgets, to choose between options which will Shift the Balance of Care. OR methods and methodologies are examined to ascertain the Roles of Models for each model explored in the Case Studies. Examination of the Roles of Models against the Improvement Areas provided evidence of a models’ ability to address more than one of the priority areas and that models can be used together or sequentially. In addition, with reference to OR methods and methodologies, a theoretical Evaluation Framework is proposed which suggests the User and User Satisfaction is key to the evaluation of a model’s success; positive experiences of the User and Use of the model may help to eliminate some of the barriers to implementation.