Mapping Lean Six Sigma in Healthcare: A Bibliometric Analysis Revealing Research Gaps in Developing Countries

Area of Science:

• Healthcare Management
• Process Improvement
• Operations Research

Background:

• Lean Six Sigma (LSS) offers significant potential for optimizing healthcare processes, particularly in resource-constrained developing countries like India.
• Despite its benefits, LSS adoption in Indian healthcare is hindered by underexplored critical success factors (CSFs).

Purpose of the Study:

• To investigate global research trends and thematic interconnections of LSS in healthcare.
• To identify geographical disparities in LSS research, with a specific focus on the underrepresentation of developing nations like India.
• To explore critical success factors for LSS implementation in healthcare settings.

Main Methods:

• A bibliometric analysis was conducted on 262 English-language articles from Scopus, PubMed, and Web of Science (Jan 2012-Apr 2024).
• Keyword co-occurrence analysis was performed using VOSviewer to map research themes and interconnections.
• A qualitative systematic review of 8 selected studies was conducted to identify universal CSFs.

Main Results:

• Global LSS research shows a central cluster of "Service Quality," "Lean," and "Six Sigma," linked to "CSFs" and "patient safety."
• Significant geographical disparities exist, with developing countries, including India (0.38% of publications), being underrepresented.
• Key CSFs identified include Leadership, Communication, Training, Organizational Culture, and Organizational Readiness, with Western nations dominating research.

Conclusions:

• There is a critical research gap in LSS implementation within developing economies, necessitating India-specific studies.
• Western nations dominate LSS research, potentially overlooking context-specific barriers and solutions for resource-constrained environments.
• Future research should focus on cost-effective solutions, longitudinal assessments, and integrating factors like technology and employee retention for enhanced LSS adoption in diverse healthcare settings.