Lean Six Sigma and quality performance in Italian public and private hospitals: a gender perspective

Purpose - Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences. Design/methodology/approach - A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction. Findings - The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true. Research limitations/implications - This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation. Practical implications - This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcaremanagers should spend time understanding Lean Six Sigma as a strategic orientation to promote the "lean hospital", improving processes and fostering patient-centredness. Originality/value - This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.