Lean Six Sigma implementation and sustainability roadmap for reducing medication errors in hospitals

Yaifa Trakulsunti, Jiju Antony*, Jacqueline Ann Douglas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Purpose: The purpose of this study is to propose a Lean Six Sigma (LSS) roadmap to guide healthcare practitioners in the implementation of LSS along with a customized LSS tool kit for reducing medication errors. Design/methodology/approach: The authors initially critically reviewed several frameworks/roadmaps of Lean, Six Sigma and LSS which have been proposed in healthcare sector from the existing literature. This review has led to an understanding of key characteristics, limitations and reasons behind the development of such frameworks/roadmaps. A conceptual roadmap was developed and then validated by a number of LSS experts and a healthcare practitioner. Based on the previous studies and taking LSS experts’ opinions into account, a revised roadmap for reducing medication is presented. Findings: The roadmap for LSS in reducing medication errors is developed. This roadmap includes three phases: Phase 1 cultural readiness for LSS employment in reducing medication errors; Phase 2 preparation, initialization and implementation; and Phase 3 sustainability. Research limitations/implications: The roadmap has been tested with only a handful of practitioners of LSS. Moreover, only two case studies have been carried out in a Thai hospital setting which followed the roadmap. In order to improve the validity of research, more case studies need to be executed and more people should be used for testing the roadmap with varied cultures. Originality/value: This is the first attempt in the development of a LSS roadmap that healthcare practitioners can follow to reduce medication errors using LSS methodology and sustaining LSS in their organizations.

Original languageEnglish
Pages (from-to)33-55
Number of pages23
JournalTQM Journal
Issue number1
Publication statusPublished - 13 Jul 2020


  • Framework
  • Lean six sigma
  • Medication errors
  • Roadmap
  • Six sigma

ASJC Scopus subject areas

  • General Decision Sciences
  • Business and International Management
  • General Business,Management and Accounting
  • Strategy and Management


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