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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.

As reimbursements fall and costs for services climb, organizations are forced to follow the painful motto of doing more with less. A solution could be the adaptation of industrial business process improvement (BPI) methods such as Lean to the hospital setting (HS). The purpose of this paper is to analyze if Lean approaches related in the literature provide sufficient methodological support for other practitioners to reproduce the reported results.

The authors analyzed the published Lean literature in the HS using a methodological maturity-level framework and what the authors defined as the 11 characteristic activities of BPI.

The literature analysis reveals that a Lean approach with a high-methodological maturity level that includes the 11 characteristic activities of BPI has never been reported. Considering this, the paper suggests a meta model for a high-methodological maturity-level Lean method based on the characteristic activities of BPI.

This is the first study on the Lean approach in the HS that evidences the absence of a robust Lean methodology in the literature. For Lean to be adopted and implemented by hospital practitioners a structured robust method should be provided.

The purpose of this paper is to create actionable knowledge, thereby supporting and stimulating practitioners to improve processes in the financial services sector.

This paper is based on a case base of improvement projects in financial service organizations. The data consist of 181 improvement projects of processes in 14 financial service organizations executed between 2004 and 2010. Following the case‐based reasoning approach, based on retrospective analysis of the documentation of these improvement projects, this paper aims to structure this knowledge in a way that supports practitioners in defining improvement projects in their own organizations.

Identification of eight generic project definition templates, along with their critical to quality flowdowns and operational definitions. An overview of the distribution of improvement projects of each generic template over different departments and the average benefit per project for each department. The generic templates give people with knowledge about the process under improvement the ability to use their knowledge effectively in the form of an improvement project.

Due to increasing international competition, financial service organizations must continuously improve in order to secure a competitive advantage. This paper turns continuous improvement from an abstract concept into something tangible and achievable, by giving practitioners with local knowledge tried and tested templates to identify promising themes for process improvement, and to make effective project definitions.