The concern of society about the environmental impact mainly post-consumer waste is increasing every day. The degradation that the environment suffers from the dump this waste and the lack of sustainability that the current economic model predicts, are factors that influence the search for alternatives to solve or minimize these effects. The objective of this paper is to present the application of Lean Six Sigma in packaging reverse logistics activities in a soft drink industry. The Reverse Logistics has become important in organizations because it deals with the reverse flow of resources among members of the traditional supply chain. Can help the most points explored by organizations: maximize profit while minimizing costs. The Lean Philosophy and Methodology Six Sigma are two important and innovative trends in business and the joint application of the two methodologies can bring significant benefits to organizations. The research methods were Bibliographic Search, Documentary Research and Case Study. Applied to Lean Philosophy in the process to reduce waste and also applied up to the practical Six Sigma reduce variability. After the diagnosis of waste and variability, we applied the solutions proposed in the improvement plan and the gains were the reduction of operating costs and reduced lead time of the process. The conclusion was that Lean Six Sigma process improvement and provided significant financial gains for the organization. / A preocupação da sociedade com o impacto ambiental principalmente dos resíduos de pós-consumo vem aumentando a cada dia. A degradação que o meio ambiente sofre com o despejo destes resíduos e a ausência de sustentabilidade que o atual modelo econômico prevê, são fatores que influenciam a busca por alternativas que solucionem ou minimizem esses efeitos. O objetivo deste trabalho é apresentar a aplicação do Lean Seis Sigma nas atividades de Logística Reversa de embalagens em uma indústria de refrigerantes. A Logística Reversa tornou-se importante nas organizações, pois trata do fluxo reverso de recursos entre os integrantes da cadeia produtiva tradicional. Pode auxiliar nos pontos mais explorados pelas organizações: maximizar o lucro ao mesmo tempo minimizando custos. A Filosofia Lean e a Metodologia Seis Sigma são duas importantes e inovadoras tendências no mundo dos negócios e a aplicação conjunta das duas metodologias pode trazer benefícios significativos para organizações. Os métodos de pesquisa foram a Pesquisa Bibliográfica, a Pesquisa Documental e o Estudo de Caso. Aplicou-se a Filosofia Lean no processo para reduzir os desperdícios e aplicou-se também as praticas Seis Sigma para reduzir a variabilidade. Após a realização do diagnóstico dos desperdícios e da variabilidade, foram aplicadas as soluções propostas no plano de melhorias e os ganhos obtidos foram a redução do custo operacional e diminuição do lead time do processo. A conclusão foi que o Lean Seis Sigma proporcionou melhoria do processo e ganhos financeiros significativos para organização.

This thesis analyzes the current situation in company Očenášek. On the basis of the process maps, chronometrical results and computer simulations is compiled value stream mapping current status, which highlights the trouble spots of the process. The proposed solution is drawn up a new value stream mapping, which serves as the basis for evaluation of the proposed solution.

To improve their services and maintain patients’ satisfaction, healthcare organisations have adopted and applied different quality tools and models in recent times, with some even developing their own quality-based initiatives. For example, the approach of Lean Six Sigma (L6σ) has recently been gradually and slowly implemented in healthcare institutions. However, the nature and complexity of healthcare environment which directly impact on humans require leaders to carefully apply appropriate Quality Management (QM) systems suitable for this critical environment. The aim of this research project is to develop a Knowledge Based System (KBS) to assist healthcare managers and practitioners during decision-making process in the context of achieving excellent benchmark and action plans prioritisation. The system will be built based on a conceptual framework for Quality Management in Healthcare Environment (QMHE) which will be modified into a model. The KBS will be developed from this model with the integration of Gauging Absence of Pre-requisite (GAP) method for benchmarking and Analytical Hierarchy Process (AHP) method for prioritisation. The contribution of this research is the use of KBS with GAP and AHP to develop an integrated Knowledge-Based Lean Six Sigma (KB-L6σ) in QMHE. This will accomplish the necessities of investigating quality problems and recommend suitable solutions according to international best practices. It will use a systematic approach that can be applied multiple times, follow defined steps to secure consistency in the approach and integrate different healthcare management levels to maintain strategic decision-making alignment. It consists of 964 KB rules that have been produced via a knowledge acquisition process from the literature and interviewing experts in the field of QM and L6σ in healthcare environment. Feedback from conferences and system testing were used for the verification of the model, whilst validation was carried out through three case studies implementation at three tertiary hospitals in Oman. The analysis of using the KB system in these hospitals has shown clearly that the developed system is a consistent and reliable methodology for assisting decision-makers in designing, planning, and implementing L6σ for QMHE.

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Yes / Purpose– This paper develops a Knowledge-based (KB) System for Lean Six Sigma (LSS) Maintenance in environmentally Sustainable Buildings (Lean6-SBM). Design/methodology/approach– The Lean6-SBM conceptual framework has been developed using the rule base approach of KB system and joint integration with Gauge Absence Prerequisites (GAP) technique. A comprehensive literature review is given for the main pillars of the framework with a typical output of GAP analysis. Findings– Implementation of LSS in the sustainable building maintenance context requires a pre-assessment of the organisation’s capabilities. A conceptual framework with a design structure is proposed to tackle this issue with the provision of an enhancing strategic and operational decision making hierarchy. Research limitations/implications– Future research work might consider validating this framework in other type of industries. Practical implications– Maintenance activities in environmentally sustainable buildings must take prodigious standards into consideration and, therefore, a robust quality assurance measure has to be integrated. Originality/value– The significance of this research is to present a novel use of hybrid KB/GAP methodologies to develop a Lean6-SBM system. The originality and novelty of this approach will assist in identifying quality perspectives while implementing different maintenance strategies in the sustainable building context. / Ministry of Defence Engineering Services (Sultanate of Oman)

Σκοπός της διπλωματικής είναι η ανασκόπηση της βιβλιογραφίας και η ανεύρεση των κυριότερων θεωρητικών – εννοιολογικών μοντέλων σχετικά με τη πολιτική ποιότητας 6σ. Ωστόσο ο σημαντικότερος σκοπός ήταν η κατασκευή ενός πλήρους και τεκμηριωμένου ερωτηματολογίου που να ανταποκρίνεται στο περιβάλλον που λειτουργούν οι ελληνικές επιχειρήσεις. Μεθοδολογία: ανασκόπηση της βιβλιογραφίας και πιο συγκεκριμένα των διεθνών ακαδημαϊκών βιβλιοθηκών (emerald) όπου έγινε αναζήτηση άρθρων χρησιμοποιώντας ως λέξεις κλειδιά: 6 σίγμα, κρίσιμοι παράγοντες 6σ, οφέλη του έξι σίγμα, εμπόδια και δυσκολίες του έξι σίγμα, το έξι σίγμα στη παροχή υπηρεσιών, λόγοι εφαρμογής – λόγοι μη εφαρμογής, η απόδοση του έξι σίγμα, εργαλεία και τεχνικές που χρησιμοποιούνται στη πρωτοβουλία έξι σίγμα, το έξι σίγα και η σύνδεσή του με άλλες προσεγγίσεις ποιότητας (TQM, BE, ISO) και lean έξι σίγμα. Αποτελέσματα: η παρούσα εργασία παρουσιάζει τα κυριότερα εννοιολογικά μοντέλα πάνω στη πολιτική ποιότητας 6σ. Επίσης εξετάζει τα μοντέλα αυτά από την πλευρά των επιχειρήσεων παροχής υπηρεσιών και το πώς αυτά εφαρμόζονται επιτυχώς από αυτές. Το τελικό αποτέλεσμα της εργασίας είναι ένα τεκμηριωμένο ερωτηματολόγιο το οποίο προορίζεται για τις επιχειρήσεις παροχής υπηρεσιών και εξετάζει το κατά πόσο η πρωτοβουλία έξι σίγμα είναι γνωστή στα ελληνικά δεδομένα. Περιορισμοί: η εργασία παρέχει μόνο μία ανασκόπηση της βιβλιογραφίας και όχι ερευνητικά αποτελέσματα. Πρακτικές εφαρμογές: η εργασία παρέχει μία πλήρης εικόνα πάνω στα θεωρητικά - εννοιολογικά μοντέλα για την πολιτική ποιότητας έξι σίγμα στις επιχειρήσεις παροχής υπηρεσιών και μπορεί να χρησιμοποιηθεί ως βάση για μελλοντικές εργασίες. Καλύπτει το κενό που υπάρχει στην κατασκευή ενός πλήρους και καλά τεκμηριωμένου ερωτηματολογίου Πρωτοτυπία – αξία: η εργασία αυτή καλύπτει σημαντικά το κενό που υπάρχει στην ελληνική βιβλιογραφία σχετικά με τη πολιτική ποιότητας έξι σίγμα. Συμβάλλει στη παροχή ενός εννοιολογικού πλαισίου για τη πολιτική ποιότητας έξι σίγμα από την πλευρά των επιχειρήσεων παροχής υπηρεσιών. / The purpose of the current thesis is to review the literature and finding the main theoretical - conceptual models on the quality policy 6s. However the most important goal was to build a complete and documented questionnaire to respond to the environment that Greek companies operate. Methodology : literature review and in particular searching at international academic libraries (emerald) of articles using keywords such as: six sigma critical success factors, six sigma benefits, obstacles and difficulties of six sigma, six sigma in the service sector, implementation reasons – reasons for no implementation, the performance of six sigma, tools and techniques used in the six sigma initiative, the six sigma’s connection with other quality approaches (TQM, BE, ISO) and lean six sigma. Results: This paper presents the main conceptual models on the quality policy 6s. Also considers these models from the perspective of service providers and how they apply them successfully. The final outcome of this study is a well documented questionnaire intended for service firms, which examines whether the six sigma initiative is known in Greek service sector. Limitations: The paper provides only an overview of the literature rather than research results. Practical applications: this study provides a complete overview on the theoretical - conceptual models for the quality system of Six Sigma in the service sector and can be used as a basis for future studies. It covers the gap that exists in providing a complete and well- documented questionnaire. Originality - value: this study covers the major gap in Greek literature on Six Sigma quality policy. It provides a conceptual framework for six sigma quality policy on the part of the service providers.

The complexity of sustainable building maintenance environment requires managers to define and implement appropriate quality benchmark system suitable for this function. Lean Six Sigma (LSS) is one of the most effective process improvement and optimization philosophy that maintenance organisations can implement in their environment. However, literature review has shown that 90% of failures in LSS implementations are due to lack of readiness to change, the unawareness of the required benchmark organisation capabilities, and improper control of priorities. The contribution of the current research approach is in developing a hybrid Knowledge-Based (KB)/GAP/AHP System, consisting of three stages (Planning, Designing and Implementation) and containing over 2500 KB rules. The KB System can assist the decision-makers in identifying the obstacles behind the organisation readiness to change into a benchmark LSS maintenance environment. Thus the KB System will be used to achieve benchmark standards by determining the gap existing between the current environment and the benchmark goal, and then suggest a detailed plan to overcome these hurdles in a prioritised and structured manner, thus achieving cost benefits. To ensure its consistency and reliability, the KB System was validated in three Oman-based maintenance organisations, and one published case study for a UK-based organisation. The results from the validation were positive with the System output suggesting list of top priorities and action plans for achieving benchmark LSS standards for these organisations. The research concludes that the developed KB System is a consistent and reliable methodology for assisting decision-makers in designing, planning, and implementing LSS for benchmark sustainable building maintenance.

A new reality, where human labor is replaced by automated machines is causing production management to rethink how they can steer the production to meet their customers demand. There is a gap of values, techniques and tools to communicate with the processes existing in the new modern factories, where data sometimes is the single output. This thesis purpose was to develop a model out of Lean and Six Sigma, as an answer to how modern factory could work with an information system, reaching the ideal state.   Through a theoretical analysis, Lean and Six Sigma differences in values, techniques and tools were weighted by the ideal state and recommendations from literature. Through a unstructured interview and system design review with a logistic group at a Swedish Modern Factory (SMF) a concept of an information system was developed. A project to test the model was initialized, where Define, Measure and Analyze phase was conducted. The model was thereafter modified from the projects implications.   The result was a Lean Six Sigma model which values are customer focus, ideal state, result orientation, committed leadership, education and involvement. The technique follow a DMAIC cycle and continuous improvements through a current to future state approach. The used techniques were considered Six Sigma heavy, where Leans principles are considered into the models values. The information system supports the model in setting the processes of the factory in either stability or potential state, where they differ in Measure and Analyze phase. The test at SMF developed several assignable causes to variation on the component As lead time. The model adapted after the test to involve a Measurement System Analysis (MSA), before setting the next current state of the process. / En ny verklighet där människor byts ut mot automatiska maskiner får produktionstekniker att fundera hur det ska styra produktionen för att möta kunders behov. Det finns en brist av värderingar, tekniker och verktyg till att kommunicera med processer i de moderna fabrikerna, där data ibland är det enda att analysera. Examensarbetets syfte var att utveckla en Lean och Six Sigma modell, som ett svar för hur moderna företag kan arbeta med ett informationssystem, för att nå det ideala stadiet.   Genom en teoretisk analys har Leans och Six Sigmas skillnader blivit vägda mot rekommendationer från litteraturen och det ideala stadiet. Genom en ostrukturerad intervju och en genomgång av systemets design hos en logistikgrupp, på ett svenskt företag (SMF), har ett koncept av ett informationssystem framtagits. Ett projekt för att testa modellen påbörjades, där Define, Measure och Analyze fasen var genomförda. Modellen blev därefter modifierad genom de implikationer projektet stött på.   Resultatet av den teoretiska analysen gav en Lean Six Sigma modell, vilka värdering är kundfokus, ideala stadiet, resultatorientering, engagerat ledarskap, utbildning och medverkande. Tekniken följde en DMAIC (Define, Measure, Analyze, Improve, Control) cykel och kontinuerliga förbättringar, från nuläge till ett framtida tillstånd. Teknikerna blev Six Sigma tunga, där Leans principer var beaktade i modellens värderingar. Informationssystemet var en supportfunktion av modellen och skapar en status för fabrikens processer, antingen i stabilitet eller potential stadiet, där de skiljer sig åt i mät – och analys fasen. Testet på SMF genererade flera grundorsaker till variation för komponents As ledtid. Modellen anpassades till att innehålla en mätsystemsanalys (MSA), innan nuläget av processen bestäms.

Introduction: Falls are the leading cause of death due to injury among the elderly. Every 24 minutes an older adult dies from a fall related injury. Studies using 3 different methods were performed at a large urban, academic medical center in the US. Aim #1: Understand the advantages and disadvantages of QI methodologies (Lean and Six Sigma) and HFE when applied to fall prevention in the acute care setting: o Evaluate the contribution of QI and HFE to fall prevention with a focus on reducing falls with serious injury. o Use studies with different methodologies (Lean, Six Sigma) to develop and implement an intervention with the goal of decreasing total falls and falls with injury. o Compare methodologies (Lean, Six Sigma and HFE) to understand their benefits and limitations. Aim #2: Develop recommendations for fall prevention: o Investigate interventions and assess success of fall prevention. o Develop an understanding of interventions that prevent falls resulting in injury. Methodology and Results: Study #1 (Method = Lean, Intervention = Standard Work): Study #1 used Lean techniques such as standard work to improve fall risk assessment and intervention selection. Total falls decreased by 22%. At first glance this appears successful but a deeper evaluation of the serious injuries revealed more improvement is needed. There were still 15 falls with serious injuries that occurred among the three oncology divisions. These rare but serious injuries result in a longer hospital stay and increased cost of treatment that is not reimbursed. Due to a climate of increasing financial pressure further reduction of serious injury was desired. Study #2 (Method = Six Sigma, Intervention = Patient Partnering: Study #2 used Six Sigma tools to investigate root causes of falls. An intervention called Patient Partnering was developed to encourage patients to call for help and participate in preventing their own falls. There were no falls with serious injury for over 14 consecutive months. However, the intervention was difficult to sustain due to resistance from nurses and patients. Falls with injuries resumed as the intervention ceased. Study #3 (Method = Qualitative HFE, Intervention = Patient Interview): Study #3 was a qualitative study based on Human Factors principles to understand patient s perception of fall risk. It was found that patients did not think they would fall and felt particularly safe and protected while in hospital. They found it difficult to get around with IV tubes and crowed spaces. They wanted information and assistance when they need it, in the format they prefer (customized for each individual patient). Impact on society: Falls prevention interventions need to be designed for all the stakeholders (patients and staff). Patients think nurses will keep them safe and are willing to participate with fall prevention if they feel it is tailored to their needs. Until all perspectives are taken into account it is unlikely that there will be sustained and embedded improvements. Key message: Falls with injury are rare events with complex root causes that require agile solutions with constant revision to align with rapidly changing conditions and interactions. Reducing injury will take a balance between safe environment, organization, processes, tasks and behaviors from staff and patients.

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