Impact of lean six sigma methodology on healthcare quality in Saudi Arabia: A systematic review

In Saudi Arabia, where healthcare modernization is a key priority under Vision 2030, Lean Six Sigma (LSS) is being increasingly adopted to address healthcare challenges. This systematic review aimed to evaluate the impact of LSS methodology on healthcare quality. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Specific databases were searched (PubMed, ScienceDirect, Google Scholar, and the Saudi Digital Library) for studies published between January 2016 and December 2023. The inclusion criteria were peer-reviewed English-language studies assessing LSS interventions in Saudi healthcare settings, with measurable outcomes related to quality improvement. Studies focusing solely on Lean or Six Sigma, outside the healthcare sector, or lacking empirical data were excluded. Two reviewers independently screened studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diverse Research (QuADS) tool. Data were synthesized qualitatively. This review included 13 studies from diverse Saudi healthcare settings. The methodological quality of included studies was generally high, exceeding the 70% quality threshold. LSS interventions consistently improved operational efficiency (e.g., reduced wait times and streamlined workflows), patient safety (e.g., fewer medication errors and hospital-acquired infections), medication management (e.g., reduced prescription errors), and resource utilization (e.g., cost savings and resource allocation). However, limited workforce expertise, resistance to change, and insufficient organizational support are the challenges to LSS implementation. LSS positively impacts healthcare quality in Saudi Arabia. Targeted training and robust support structures are essential for sustaining LSS-driven improvements as a valuable tool for healthcare transformation.