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Cost reduction is a current topic within healthcare. This article aims to show how Lean Six Sigma can be applied to make the orthopedic outpatient clinic within a hospital more cost-effective. The approach can, of course, also be applied to other departments.

We did a pareto analysis to select the project with the greatest potential. The most expensive and time-consuming activity is repeat consultations; these number around 7,500 per year and are all performed by the orthopedic surgeon. This limits the number of appointments available for new patients. Moreover, the hospital gets a fixed amount of money for each new patient. Therefore, reducing the number of repeat consultations is beneficial to both the patient and the hospital.

Based on data analysis, we found that the number of repeat consultations performed by orthopedic surgeons can be reduced by 19.5%. An additional 10.8% can be performed by phone, which will probably save the surgeons considerable time. The freed-up time can be used for new patients. Another result is that hospital visits by patients for repeat consults can be reduced by 20.3%. We believe that these efficiency improvements are also possible for other departments/processes. Finally, in the given case, the freed-up time for new patients could generate 465K euros.

This article shows that 20% of the care provided by the physicians (i.e. repeat consults) is omissible. While most projects focus on doing the same number of activities in a more efficient way, this paper shows that it is also possible to reduce the amount of medical care provided. We believe that it would be beneficial to take such a perspective when looking at other processes and departments within healthcare.

Current health care quality performance indicators appear to be inadequate to inform the public to make the right choices. The aim of this paper is to define a framework and an organizational setting in which valid and reliable healthcare information can be produced to inform the general public about healthcare quality.

To improve health care quality information, the paper explores the analogy between financial accounting, which aims to produce valid and reliable information to support companies informing their shareholders and stakeholders, and healthcare aiming to inform future patients about healthcare quality. Based on this analogy, the authors suggest a measurement framework and an organizational setting to produce healthcare information.

The authors suggest a five‐quality element framework to structure quality reporting. The authors also indicate the best way to report each type of quality, comparing performance indicators with certification/accreditation. Health gain is the most relevant quality indicator to inform the public, but this information is the most difficult to obtain. Finally, the organizational setting, comparable to financial accounting, required to provide valid, reliable and objective information on healthcare quality is described.

Framework elements should be tested in quantitative studies or case studies, such as a performance indicator's relative value compared to accreditation/ certification. There are, however, elements that can be implemented right away such as third party validation of healthcare information produced by healthcare institutions.

Given the money spent on healthcare worldwide, valid and reliable healthcare quality information's value can never be overestimated. It can justify delivering “expensive” healthcare, but also points the way to savings by stopping useless healthcare. Valid and reliable information puts the patient in the driver's seat and enables him or her to make the right decision when choosing their healthcare provider.

To describe how The Red Cross Hospital in Beverwijk, The Netherlands implemented an ISO 9000 quality management system throughout the entire organisation, obtained an ISO 9002:1994 and subsequently an ISO 9001:2000 certificate.

First, a global implementation plan was written concerning the process obtaining in each department. Once improved, each process was subjected to a procedure, and specific protocols effected. On completion the Quality Manual was put together. Quality management was completed by implementing an internal audit system involving 50 co‐workers.

A number of advantages are found from using ISO. The focus on patients has been re‐established. All processes are identified and subject to continuous improvement. Performance measurements were introduced and give an integrated picture of results. Measurements subsequently lead to improvement of quality of care and to quality system improvements. The documentation system serves the organization's needs without leading to bureaucracy. Positive effects on patient safety could be demonstrated compared with ten other hospitals.

Given the need for adequate quality management tools in health care and the need for demonstrating quality, the positive effects reported in this article show how ISO is expected to become more prevalent in health‐care organisations.

Lean Six Sigma (LSS) is a continuous improvement methodology used to increase the efficiency and effectiveness of processes. Although there are several articles published, only two have analyzed the literature from a bibliometrics perspective. The purpose of this paper is to analyze the LSS literature by bibliometrics, identifying its state of the art, scientific gaps and research trends.

Articles published up to 2016 in the database Scopus were investigated to identify the most significant articles, authors, journals, institutions and countries based on citation counting as well as the most frequent keywords and subject areas on LSS. Articles published in 2014, 2015 and 2016 were analyzed to point out scientific gaps and to identify eight main research trends on LSS.

The research trends are: “LSS implementation”, “Healthcare”, “LSS tools”, “Human factors”, “Expansion of results”, “SME”, “LSS combined with other methodologies” and “Education”. The research outcomes also point out the most significant articles, authors, journals, institutions and countries in LSS literature.

This research contributes to develop the state of the art of LSS and helps professionals as well as researchers to identify which issues new studies should address.

The performance of the literature is measured based on the number of citations and not on the number of published papers, and the bibliometric analysis covers the highest number of articles so far (319 articles). Besides, the identification of the main research trends on LSS is exclusively based on the most recent studies.

The purpose of this paper is to explore the key ingredients that people analytics teams require to contribute to organizational performance. As the information that is currently available is fragmented, it is difficult for organizations to understand what it takes to execute people analytics successfully.

To identify the key ingredients, a narrative literature review was conducted using both traditional people analytics and broader business intelligence literature. The findings were summarized in the People Analytics Effectiveness Wheel.

The People Analytics Effectiveness Wheel identifies four categories of ingredients that a people analytics team requires to be effective. These are enabling resources, products, stakeholder management and governance structure. Under each category, multiple sub-themes are discussed, such as data and infrastructure; senior management support; and knowledge, skills, abilities and other characteristics (KSAOs) (enablers).

Many organizations are still trying to set up their people analytics teams, and many others are struggling to improve decision-making by using people analytics. For these companies, this paper provides a comprehensive overview of the current literature and describes what it takes to contribute to organizational performance using people analytics.

This paper is designed to provide organizations and researchers with a comprehensive understanding of what it takes to execute people analytics successfully. By using the People Analytics Effectiveness Wheel as a guideline, scholars are now better equipped to research the processes that are required for the ingredients to be truly effective.

This study aims to examine the effect of human resource management (HRM) in mitigating negative effects of Lean management and Six Sigma (LM&SS) on employee well-being in health care. The authors subdivide well-being into three components: happiness, trust and health.

This is a cross-sectional, multisite survey study in internal service units of hospitals. Data analyzed using multivariate regression come from a sample of 1,886 survey respondents (42 units, N = 218 supervisors, N = 1,668 employees) in eight Dutch academic hospitals that have implemented LM&SS.

The present study findings show no or weak effects of LM&SS on the happiness and health component of employee well-being. In addition, the authors found a significant but weak direct positive effect (ß = 0.07) of the LM&SS bundle on the trusting relationships component of well-being. Therefore, moderating effects of HRM practices on the relationship between LM&SS and employee well-being seem less relevant because an existing relationship between LM&SS and employee well-being is a prerequisite for moderation (Hayes, 2009). There were unexpected side effects. Inspired by research that discusses direct effects of HRM on employee well-being, the authors tested this relationship and found that HRM has a direct positive effect on trust and happiness of employees in health care. For the health component of well-being, the present results show a weak negative effect of HRM.

This study results in a cautiously optimistic view about LM&SS in health care, provided that it is applied in a targeted manner (to improve the performance of their processes) and that HRM is strategically aligned with the goals of LM&SS to improve employees’ happiness and trusting relationships.

Unique features of the study are the focus on the consequences for employees’ well-being related to LM&SS in health care, the role of HRM in regard to this relationship and the participation of all eight Dutch academic hospitals in this research.

This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.