You are on page 1of 30

See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/232907318

Case study analysis of Six Sigma implementation inservice organisations

Article  in  Business Process Management Journal · November 2012


DOI: 10.1108/14637151211283384

CITATIONS READS

27 1,895

2 authors, including:

Ayon Chakraborty
Indian Institute of Management Tiruchirappalli
53 PUBLICATIONS   355 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Lean Six Sigma in the Financial Services Industry: A Global Study View project

IMS implementation in SMEs View project

All content following this page was uploaded by Ayon Chakraborty on 20 May 2014.

The user has requested enhancement of the downloaded file.


Business Process Management Journal
Emerald Article: Case study analysis of Six Sigma implementation in
service organisations
Ayon Chakraborty, Kay Chuan Tan

Article information:
To cite this document: Ayon Chakraborty, Kay Chuan Tan, (2012),"Case study analysis of Six Sigma implementation in service
organisations", Business Process Management Journal, Vol. 18 Iss: 6 pp. 992 - 1019
Permanent link to this document:
http://dx.doi.org/10.1108/14637151211283384
Downloaded on: 30-10-2012
References: This document contains references to 53 other documents
To copy this document: permissions@emeraldinsight.com

Access to this document was granted through an Emerald subscription provided by QUEENSLAND UNIVERSITY OF TECHNOLOGY

For Authors:
If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service.
Information about how to choose which publication to write for and submission guidelines are available for all. Please visit
www.emeraldinsight.com/authors for more information.
About Emerald www.emeraldinsight.com
With over forty years' experience, Emerald Group Publishing is a leading independent publisher of global research with impact in
business, society, public policy and education. In total, Emerald publishes over 275 journals and more than 130 book series, as
well as an extensive range of online products and services. Emerald is both COUNTER 3 and TRANSFER compliant. The organization is
a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive
preservation.
*Related content and download information correct at time of download.
The current issue and full text archive of this journal is available at
www.emeraldinsight.com/1463-7154.htm

BPMJ
18,6 Case study analysis of Six Sigma
implementation in service
organisations
992
Ayon Chakraborty
Science and Engineering Faculty, Queensland University of Technology,
Brisbane, Australia, and
Kay Chuan Tan
Department of Industrial and Systems Engineering,
National University of Singapore, Singapore

Abstract
Purpose – The aim of this research is to explore the implementation of Six Sigma in service
organisations. The focus of the investigation is on identifying critical success factors (CSFs), critical-to
quality (CTQ) characteristics, tools and techniques and key performance indicators (KPIs), and also to
understand the issues emerging from the implementation process.
Design/methodology/approach – Exploratory empirical evidence is provided through four
in-depth case studies of organisations mainly in Singapore. They include a hospital, a public
service organisation, a consultancy service and a hotel.
Findings – The major findings include an understanding about the suitability of Six Sigma
implementation in service organisations. Management support and team member support emerged as
primary success factors. The CTQs include time and cost, while use of soft tools instead of rigorous
statistical tools are preferred by service organisations. At the project level, KPIs are understood more
as CTQs. Additionally; various interesting practical difficulties emerged from the case studies.
Research limitations/implications – A main limitation of this study is the small number of
organisations studied and that are mainly from a single geographical location. Furthermore, the
exploratory nature of the study demands rigorous in-depth studies. The practical difficulties identified
will have major implications for managers. The framework including the CSFs, CTQs, KPIs, and tools
and techniques, will be a useful guide for both practitioners and academicians.
Originality/value – There are limited studies about Six Sigma implementation in service
organisations. This paper provides a framework and a paradigm shift from viewing its
implementation through a manufacturing lens.
Keywords Six Sigma, Service organizations, Case study, Critical success factors, Singapore
Paper type Research paper

Introduction
Since, its introduction in the 1980s by Motorola, Six Sigma as a quality improvement
methodology has gained importance both in manufacturing and service organisations
(Basu, 2004). The initial success stories are mainly from the manufacturing sector and
included organisations such as Raytheon, Texas Instruments and Honeywell. The success
Business Process Management story of General Electric in the 1990s, catapulted Six Sigma into several manufacturing
Journal and service organisations. In the last decade or so, service organisations in the finance
Vol. 18 No. 6, 2012
pp. 992-1019 and banking sector such as Citibank and American Express, and health sector such as
q Emerald Group Publishing Limited Baxter Health and Mount Carmel Hospital have registered success through Six Sigma
1463-7154
DOI 10.1108/14637151211283384 implementation (Jones Jr, 2004; Sehwall and De Yong, 2003; Young, 2001; Rucker, 2000).
Six Sigma implementation in service organisations though mainly limited to health Six Sigma
care and finance in the initial years, is slowly getting recognized by other services such implementation
as information technology, call centers and education. According to Does et al. (2002) and
Mortimer (2006) Six Sigma applicability is for all types of organisations throughout
the world. This reflects in the growing influence of Six Sigma in countries such as
Singapore where it is extensively implemented in public service organisations such as
Alexandra Hospital, Singapore Power, and Singapore City Gas (Inozu et al., 2006; Pheng 993
and Hui, 2004).
An extensive literature review on Six Sigma implementation in service organisations
by the authors (Chakrabarty and Tan, 2009, 2007) resulted in understanding several
aspects. First the literature talks mainly about critical success factors (CSFs),
critical-to-quality (CTQ) characteristics, key performance indicators (KPIs), and a set
of tools and techniques (STTs). There is ambiguity in understanding about KPIs both in
the literature and in practice at the level of Six Sigma implementation. It is also observed
that there is lack of rigor in the studies about Six Sigma in services. Authors such as
Nonthaleerak and Hendry (2008) and Schroeder et al. (2008) stressed the need for rigorous
research and theory development in studies related to Six Sigma implementation.
Based on the identified gaps, this study aims to develop a framework and identify
major factors that a play a role in Six Sigma implementation at the project level.
The overall study includes data collection both qualitatively and quantitatively. The
qualitative data collection is through multiple case studies in different service
organisations. This paper presents results from four main case studies done as a part of
the overall research. The results are presented through interpretation of the data
collected through various techniques. On the Six Sigma implementation aspect at project
level and also as part of the overall framework, the study focused on CSFs, CTQs, KPIs,
and STTs. The practical issues explored are the difficulties and concerns of the
practitioners regarding Six Sigma implementation in service organisations.
The rest of the paper is organized into six sections. The next section provides a
literature review and focus on Six Sigma implementation in manufacturing and
services. The third section discusses the derived research questions. This is followed
by two sections on case study data collection techniques and four case studies and their
analysis. In the final section, the paper concludes with possible implications and
limitations of the study.

Literature review
Six Sigma originated in industry. But in recent times, it has inspired a considerable
amount of academic literature. This review of the literature covered a timeframe of
12 years (2000-2011).

Scope and research methods


The review focused on papers published in journals, magazines, conference proceedings,
and excludes articles published on web sites of Six Sigma communities, such as
isixsigma.com. The aim of such articles is to share ideas and best practices among
members of the community. But this may be vague from an academic point of view
(Hendry and Nonthaleerak, 2005). The search was derived from database ABI/INFORM,
spanning a time period of 2000 through 2011. Seven descriptors were used: Six Sigma,
Six Sigma in services, Six Sigma in manufacturing, quality initiatives in services,
BPMJ quality initiatives in manufacturing, Six Sigma and quality control, quality
18,6 management and Six Sigma. A total of 180 articles related to Six Sigma were
identified and covered in the review. The text of each article was reviewed in order to
eliminate those, which were clearly not related to Six Sigma. Overall, it is not claimed
that the list of articles included is exhaustive, only that the associated databases serve as
a reasonably comprehensive list for understanding Six Sigma related research.
994
Framework – article analysis
This section, characterizes the database of articles using statistics derived from the
classifiers as described in Table I. The goals include the identification of trends
including those that relate to the authorship of articles and the subjects addressed.
Results focusing on success factors, CTQs, and KPIs are discussed.
1. Literature trend. Figures 1 and 2 show the number of articles published about
Six Sigma against the years, in manufacturing and services, respectively. Based on the
number of articles, there is little doubt that the subject is actively reported in
manufacturing. The plots suggest the following findings:
.
First, in case of manufacturing the publication started from very early period and
is initially dominated by authors from industry. A similar trend is observed for
articles related to Six Sigma implementation in services. For manufacturing the
number of articles by industrial authors peaked in 2006, whereas for services

S. no. Descriptor

1 Industrial sector: manufacturing (M), service (S), or general (G) (Zain et al., 2001)
2 Research approach: case study (CS), comparative (C), survey (S), literature review (LR),
or theoretical with application (TA) (Zain et al., 2001)
3 Authorship: industrial (I), academic (A), or both (I, A) (Brady and Allen, 2006)
4 Success factors: all combination of possible success factors (Brady and Allen, 2006)
Table I. 5 Journal impact factor: 0-9.723 (SCI)
Descriptors used to
classify articles Source: Adapted from Brady (2005)

Figure 1.
The yearly number of
Six Sigma articles
in manufacturing and
their authorship
Six Sigma
implementation

995

Figure 2.
The yearly number of
Six Sigma articles in
services and their
authorship

the domination is declined for industrial authors from 2003 onwards. This trend in
authorship from industry dominated to academic dominated is not surprising
because of industrial origins of Six Sigma.
.
Second, at the same time interest among academics started to grow for Six Sigma
implementation in manufacturing. But same cannot be said about
implementation in services. Over the entire search period, 44 percent of the
authors had industry affiliations and 56 percent had academic affiliations in the
case of the manufacturing related literature. Over the same period, for services,
62 percent of the authors had industry affiliations and 38 percent had academic
affiliations. It can be anticipated that growing interest in Six Sigma
implementation in services from the academic arena would add rigour and
theoretical understanding to the subject.
.
The third observation is about the publication in different industry sectors. It is
observed that most of the publications still discuss services in general. Figure 3

Figure 3.
Distribution of articles in
different industry sectors
BPMJ shows that of the reviewed articles, 42 percent talks about application in general.
18,6 24 percent is about articles in manufacturing. For services, the article distribution
is 26 percent. There are also limited publications in SMEs and supply chain.

2. Literature research topics and methods. Next, the topics and research approaches of
the articles in the databases are examined. We begin by focusing on the topics covered
996 and the dependence of the number of articles and scholarly impact on the authorship.
Then, the methods used in relation to scholarly impact are investigated.
Figure 4 shows number of articles associated with different research methods. Most
articles are review papers. The focus of review extends from Six Sigma methodology,
tools and techniques to CSFs. The second most articles are about direct application of
Six Sigma to different sectors. This is largely dominated by manufacturing with
applications ranging from chemical to pharmaceutical organisations.
It was noted that these types of articles mostly dealt with DMAIC methodology and
tools and techniques. They are not helpful in developing a model on how and why
Six Sigma works. The number of case studies in services is limited. Those published lack
rigour and do not add significantly to theory development about Six Sigma
implementation in services.
As discussed in the last section, journal impact factors were developed by the
Science Citation Index (SCI) to provide a rough measure of journal quality. Figure 5 is
distribution of the journal impact factors associated with either academic or industry
authors. It shows that, academic authors tended to publish in journals with high scholarly
impact. The articles related dealt mostly with technical level rather than the level of
practice, which is more helpful for decision makers in organizations looking for guidance.
Figure 6 is distribution of the journal impact factors associated with articles related
to manufacturing, services or of generic interest. The plot shows that for service related
publications, the impact factor varies from very low (0.25) to very high (5.093). This can
be attributed to limited Six Sigma implementation in services. Healthcare where Six

Figure 4.
Pareto chart of articles
in manufacturing
by research approach
Six Sigma
implementation

997

Figure 5.
Distribution of impact
factors of publications
associated to authorship

Figure 6.
Distribution of impact
factors of publications
associated to business
sectors
BPMJ Sigma has high rate of implementation, there are more articles with high scholarly
18,6 impact. This is because of the relatively greater impact associated with specific
journals related to healthcare.

Critical success factors


CSFs are the essential ingredients required for success of Six Sigma projects (Coronado
998 and Antony, 2002). There have been many studies on CSFs. One of the earliest is by
Harry (2000), who discussed about six success factors involving management’s
leadership, belt system, etc. Later on, Antony and Banuelas (2002) mentioned 12 success
factors which include management involvement and commitment, linking Six Sigma to
business strategy, etc. There are several other studies and all of them have at least one
common CSF, i.e. top management commitment. The discussion on CSFs by Antony
(2006) is the only one specific to service organizations.
The factors discussed above are equally applicable to services and manufacturing.
This literature review found that top management commitment, education and training,
cultural change, and financial benefits are the most important CSFs. Figure 7 shows the
importance of the CSFs as seen by each of the articles that were reviewed.

CTQ characteristics
CTQ is defined in different ways in the literature. But mostly it is agreed that CTQ is a
quality characteristic of a product or a service which is required to be improved on from
a customer’s point of view. In other words, CTQs are generated from critical customer
requirements derived from the voice of customer. CTQs are the key measurable
indicators of a product or process whose performance standards or specification limits
must be met in order to satisfy the customer. CTQs align improvement or design efforts
with customer requirements. In layman term, CTQs are what customers expect of a
product or service. They are the spoken needs of the customer (isixsigma/dictionary).

Figure 7.
Percentage of articles
mentioning each of
19 CSFs
Six Sigma focuses on process improvement, and improving the service process is a Six Sigma
major determinant of customer satisfaction. implementation
Key performance indicators
The term KPI is not well defined in the literature, and there exist different
interpretations. Mostly the literature discuss about it as performance metrics, i.e. it is a
measure of performance in terms of cost, quality, yield, and capacity (Basu and Wright, 999
2003; Hahn et al., 1999).
KPIs show actual data of a particular outcome. The outcomes of Six Sigma projects
are usually required to be expressed in financial terms. This leads to a direct measure
of achievement which is easy to understand (Goh, 2002). The majority of the KPI
literature on Six Sigma in services talks about financial benefits. Other KPIs include
expressions in terms of customer satisfaction and efficiency. Similar to CTQs, some
KPIs are common across services.

Tools and techniques


There is much literature available on tools and techniques used in Six Sigma. Tools are
mostly referred to as having a clearly defined role but narrow in focus, whereas
techniques have wider application and require specific skills, creativity, and training
(Antony, 2006). Similar to CSFs, CTQs, and KPIs; there is limited literature which discuss
about STTs specific to service organizations. Discussion on STTs is mostly on its usage
at different phases of the DMAIC methodology. De Koning and De Mast (2006) used seven
different literature sources and provided a summary of STTs used in the DMAIC phases.
Some other literature provide classification scheme for tools and techniques used.
Henderson and Evans (2000) discussed about tool sets in three groups; team tools,
process tools, and statistical tools. As for Six Sigma tools and techniques specific to
service organizations, Antony (2006) provides a grid as a guideline for services.
A number of classification schemes for STTs exists, the majority of which are based
on the DMAIC methodology. The classification schemes by the American Society for
Quality (ASQ) and by Nancy Tague (1995) called the tool matrix provide an exhaustive
list of tools and techniques which can be used during Six Sigma implementation. The
ASQ classification scheme and the tool matrix have almost similar categories. The only
difference being in the number of tools and techniques each category.

Summary
As the nature of research on Six Sigma is difficult to confine to specific disciplines,
relevant material is scattered across various publications. A search resulted in
identification of articles published between 2000 and 2011. Although this review cannot
claim to be exhaustive, it does provide reasonable insight into the state-of-the-art.
Further investigation still provides limited insight about Six Sigma implementation in
service organisations.
The review revealed that compared to manufacturing, Six Sigma is relatively new in
services. The publication of articles related to services started around 1999 and is now
dominated by authors having academic affiliation. The published articles so far are
mainly from Six Sigma implementation in healthcare (Heuvel et al., 2005; Woodard, 2005;
Young et al., 2004; Benedetto, 2003), followed by finance (Krupar, 2003; Rucker, 2000)
and others. This shows the limited Six Sigma implementation in services.
BPMJ There are more published case studies in manufacturing than in services for the period
18,6 of this review. The case studies are mostly descriptive in nature and lack academic rigor
which is important for theory development. Further there is conflicting evidence
regarding the applicability of Six Sigma in services. Does et al. (2002) found that Six Sigma
can be applicable to services with minor adaptations whereas McAdam and Lafferty
(2004) reported low success of Six Sigma in services. Therefore, it is necessary to
1000 investigate further this issue (Nonthaleerak and Hendry, 2008).
In the database, approximately 8 percent of the articles discussed about success
factors. But most of them do not attempt to determine a comprehensive set of CSFs for
services. Antony (2006) and Antony et al. (2007) provides a list of 13 CSFs specific to
services based on a literature review and survey.
Similar to CSFs, a discussion on tools and techniques used in Six Sigma projects is
descriptive in nature. There is also no conclusion on the differences in their application
between manufacturing and services. In addition there is a need to determine specific
issues in context. For example, if a certain CSF or tool is important then it is necessary
to question the nature and frequency of this involvement through in-depth case study
research (Nonthaleerak and Hendry, 2008).
The success of Six Sigma in services depends on the outcome of project and
initiatives. But there is little theory to explain the differences between successful and
unsuccessful efforts (Brady, 2005). What is required is to develop a framework which
will attempt to build a theory of how and why Six Sigma works in services.

Research questions
Based on the above discussion, the following exploratory research questions were
derived:
RQ1. What success factors are of importance for succeeding with a Six Sigma
implementation in service organizations? How do they impact its
implementation in services?
RQ2. How have service organizations successfully implemented Six Sigma, and
what difficulties emerged during the implementation process?
RQ3. What are the tools and techniques for Six Sigma implementation in services?
How they are selected?

Methodology
This type of study involves some issues which need to be addressed. One is the need for
sufficient data. The three-phase approach considered in this study will ensure that valid
and reliable interpretation are made while generating theories and in developing the
framework. Next is to have rich and detailed enough data to go beyond the limited depth
of explanation of the theories that occur in large-scale research. Practitioner involvement
is important to overcome this issue. Relationships, attitudes, and meaningful insights
have to be obtained from the practitioners’ views to build a discussion around them.
This will help to establish without misinterpretation the relationships and propagation
of Six Sigma in service organizations. Finally, the practitioner has to be challenged
so that the critically reflexive learning can be applied for Six Sigma implementation
to a wider range of service organizations.
In order to overcome these issues, an empirical study is developed using three-phase Six Sigma
approach. This approach is integrative. It uses a combination of different techniques at implementation
each phase as shown in Figure 8. This integrative phase by phase process of data
collection helps in developing an understanding of the phenomena over time, by
allowing each phase of the research to build on learning from previous phase(s)
(Gilmore and Carson, 1996).
This paper reports on the results emerging only from the case studies which are 1001
conducted in two phases. The discussion on surveys and their results are out of the
scope of this paper. The insights from case studies were rich and provide inputs for a
larger scale survey which was conducted later in this study.

Phase I
Macro study Exploratory case
studies

Action
Redefine/expand/refocus research agenda
Develop new ideas/directions
Outcomes
Phase II
Describe data to which the
Companies in similar industry or
company could specifically
in similar geographical location
respond with tangible actions
Experiential knowledge
Small scale Observation development of researcher
survey study Ongoing interpretive analysis,
allowing data to be initially
Conversations coded in several ways, then
with practitioners Case Studies reanalyzed and interpreted as
further data are gathered
Holistic perspective/
understanding of phenomena
Action
Add wider dimensions to agenda
Redefine/expand/refocus research agenda
Develop new ideas/directions

Phase III
Companies in similar industry in
different geographical locations/or
specific aspects within one company

Large scale In-depth


survey interviews

Content analysis
Conversations
of organization
with practitioners
materials
Figure 8.
Three-phase approach
Source: Adapted from Leonard and McAdam (2001) and Gilmore and Carson (1996)
BPMJ Case studies
The case study was chosen as the research method primarily due to the nature of the
18,6 research questions. Yin (1994) recommends this method as the most appropriate when
contextual conditions are believed to be highly pertinent to the phenomenon under
study. The case study method is also recommended when research questions embodies
an explanatory component such as in this study (i.e. how CSFs impact Six Sigma
1002 implementation in services) (Yin, 1994).
Sample selection
We opted for an intricate sample design (Harrigan, 1983). This is a design where the
sample is selected to coincide with sites that possess observable traits that are key
factors in the propositions to be examined (Sousa and Voss, 2001).
The process for selecting individual service organizations was based on publicly
available information and the respondents of a small-scale survey. An initial list of
20 service organizations was compiled. These organizations were likely to comply with
our research objectives. Eight of the organizations declined to participate. We started
by contacting the remaining 12 firms.

Unit of analysis
Except for single case versus multiple-case design possibilities, one can also
distinguish a case design separating and choosing between a single unit of analysis
and multiples unit of analysis (Yin, 1994). In the literature, a unit of analysis refers to a
great variety of objects of study, for example, a person, a program, an organisation, a
classroom or a clinic (Mertens, 1998), or a community, state or nation (Patton, 1987).
Other authors have considered the unit of analysis as interviews or diaries in their
entity, and the amount of space allocated to a topic or an interaction under study
(Downe-Wamboldt, 1992).
For our case studies, the overarching unit of analysis is the Six Sigma projects.
There were sub-units that were investigated to reveal the main unit as realistically as
possible. These sub-units are the experiences from different expertise (belt levels), the
difficulties faced, the tools and techniques used, which also counts for the opinions
among the actors involved in the implementation work. The reason behind choosing
different expertise is because of different roles of black belt (BB) and green belt (GB) in
Six Sigma project. BBs are the project leaders who are responsible towards project
management while GBs are involved in data collection and analysis process. Following
the experiences from different expertise will help in understanding the concerns from
different levels, about Six Sigma projects. Table II provides link between the research
questions of our study with the unit of analysis considered.
Therefore, during the case studies different expertise in Six Sigma are chosen, which
indicates that the chosen research design is an embedded multiple-case design. The
replication does not necessarily mean that each case study needs to be either holistic or
embedded (Hansson, 2003). When an embedded design is used, each individual case may
include the collection and analysis of high quantitative data including the use of surveys
within each case (Yin, 1994). During this study, each individual case in the multiple-case
design represented an embedded design. This unity between the individual cases was
chosen in order to discover possible differences between the respondent groups,
different levels of expertise and experience in Six Sigma implementation, as they
may not share the same experience from an implementation process.
Data collection procedure Six Sigma
Interviews implementation
We conducted structured interviews with all the informants. The structured
questionnaire involved questions on the Six Sigma initiative, project selection, Six
Sigma implementation process, and the learning experience. As a part of the Six Sigma
initiative, we asked the informants about the reason they prefer Six Sigma over other
initiatives, how the preparations were done to implement Six Sigma, and what was 1003
their approach to training. In project selection the informants were asked about the
criteria of selection of the projects, factors involved in success of a project, and reasons
behind unsuccessful projects. For the process of Six Sigma implementation, the
questions are about their considerations on CTQs, tool and techniques used at different
phases of DMAIC, selection criteria of STTs, and KPIs. We also asked the informants
about their learning experience on the basis of Six Sigma’s relevance to their
organization, problems faced during the implementation process, and how they
overcame those problems.
In total there were ten interviews; six formal and four informal. The informal
interviews were conducted with the staff nurses of the hospital. The questions asked
were mainly about their experience from the current projects due to their limited
knowledge on Six Sigma. All formal interviews were taped, transcribed, and coded.
The list of interviewees is provided in Table III.
Having already established a database from the literature review, initial
questionnaire survey, and exploratory case studies on different aspects of Six Sigma

Research questions Unit of analysis

RQ1. What success factors are of importance for succeeding Six Sigma project
with a Six Sigma implementation in service organizations? Different expertise
And how do they impact its implementation in services? CSFs
RQ2. How service organizations that have successfully Six Sigma Project
implemented Six Sigma worked and what difficulties have Different expertise
emerged during the implementation process? Difficulties faced Table II.
RQ3. What are the tools and techniques for Six Sigma Six Sigma Project Linking research
implementation in services? And how they are selected? Different expertise questions with unit
Tools and techniques of analysis

Organization description Interviewee

The hospital was one of the seven public service Director (quality management office); head
organizations to participate in the pilot phase of (department of emergency medicine); staff nurses
Singapore Government’s initiative of Six Sigma – four
implementation
Public service organization related to engineering Assistant director (corporate development
services is under Ministry of National division) SDO (department, technology
Development, championing the development of an development division)
excellent built environment for Singapore
Well recognized business solutions provider Consultant (corporate development office);
building manager (administration and building Table III.
management department) List of interviewees
BPMJ implementation in service organizations, phase three interviews were more focused
and directed. A protocol for conducting these interviews is shown in Figure 9.
18,6
Participation in projects
In the hospital case study, the authors participated as a team member for two Six
Sigma projects. This provided an opportunity to develop a partnership which lasted
1004 for six months. Combining retrospective and longitudinal study; as done in case
of healthcare service organization for the study enhances construct, external, and
Question Modules Objectives

Organizational – Type of service organization


Overview – Number of full-time employees in the
organization
– Business improvement initiatives implemented
in the organization

– Reason for preferring Six Sigma over other


Six Sigma Initiative
initiatives
– Initial preparations done to implement Six
Sigma
– Learning experience, after Six Sigma training
– Approach for training personnel in Six Sigma

– Criteria for selecting project


Project Selection
– Approach after project selection
– Factors helpful in successful completion of
projects
– Projects completed by the organization/
department
– Number of successful projects
– Reasons behind unsuccessful projects

Six Sigma – Quality characteristics that required to be


Methodological Issues improved
– Selection criteria for tools and techniques
– Tools and techniques used during different
phases of Six Sigma methodology
– List of performance indicators considered
– Factors leading to variation in tools usage

Learning Experience – Overall feeling about Six Sigma


– Six Sigma’s relevance to service organizations
– Reasons behind Six Sigma’s widespread usage
– Difficulties faced during Six Sigma
implementation
Figure 9. – Overcoming these problems
Interview protocol for the – Major learning from Six Sigma implementation
interviews
Source: Adapted from Nonthaleerak and Hendry (2008)
internal validity (Barton, 1990). Approaching the interviewees was not a problem, as Six Sigma
the authors visited the organization on regular basis. This helped in getting completed
answers on all questions and returning at a later date to seek clarification to questions
implementation
that arose. For the other two organizations though there is no participant involvement,
the interviewees were approachable when required. Overall, interviewees represent
different levels in terms of experience and expertise with Six Sigma. This helped to
avoid a bias or unqualified opinion which can be a problem in single respondent 1005
studies (Nonthaleerak and Hendry, 2008; Voss et al., 2002).

Documentation
The documentary evidences for information about these case studies is gathered
through various sources which include web sites such as Singapore Government
web site (PS21 – Public Service for twenty-first century), articles, interviews and
speeches from newspapers, magazines, and journals. Other sources of data are the
reports and presentations of the completed projects.

Multiple case study and qualitative outcomes


Brief description of cases
All the organisations of this study embarked on their Six Sigma journey with the help
of strong leadership from the chief executive officer (CEO). As mentioned by the senior
development officer (SDO) of engineering services:
CEO was one of the kin supporters for Six Sigma in 2004. He actually pushed this program.
Also, because of the support from PS21, Singapore government’s public service office.
The objective for implementing Six Sigma in the hospital is to provide patient-centered
quality healthcare that is accessible and seamless, comprehensive, appropriate, and
cost effective[1]. Improving patient turnaround time at the specialist outpatient clinic
(SOC) was one of the first projects to be completed as a Six Sigma initiative. Since then
the hospital has successfully completed 20-30 projects. Some of the completed projects
are tabulated in Table IV.

S. no. Project title Start date End date

P1 To improve in-patient admission turnaround July 2001 December 2001


time at the DEM
P2 To reduce turnaround time for stat laboratory July 2003 January 2004
results from SOC
P3 To improve appointment lead-time for SOC August 2003 January 2004
P4 To reduce waiting time and turnaround time for October 2003 April 2004
emergency patients
P5 Fewer lost calls, more happy customers at dental November 2004 October 2005
clinic
P6 To reduce door-to-reperfusion therapy time for March 2007 April 2007
ST-elevation myocardial infarction (STEMI)
P7 To improve the conversion process at DEM May 2007 October 2007
P8 To reduce the procedure turnaround time in DEM May 2007 October 2007 Table IV.
P9 To improve accident and emergency (walk in) – – Six Sigma projects
patient cycle time at the hospital
BPMJ For the engineering service organization, the objective for implementing Six Sigma is
18,6 to improve not only its own internal processes but also to work closely with industry
partners to improve their key processes and services[2]. The organization has
completed 10-20 projects with around 75-85 percent success rate. Some of the
completed projects are shown in Table V.
The implementation process at the consultancy service organisation started with BB
1006 and GB training. The BB training was conducted by the Singapore Quality Institute.
These BBs were then told to identify projects and also their team members. The selected
members for the projects then underwent in-house GB training. One of the initial
Six Sigma projects was by the finance department on cost reduction.
Starwood was the first major player in the hospitality industry to adopt Six Sigma.
Till date, the organization has successfully executed hundreds of Six Sigma projects
in areas involving productivity, menu redesign, resort concierge, e-mail marketing,
and sales. The purpose of implementing Six Sigma, according to Regional
Vice President for New England Operations, SWHR is:
Six Sigma gives us the tools to eliminate variation and improve efficiency. It has strong
record in manufacturing productivity, perhaps most visibly at General Electric. It’s also
extremely adaptable; since its introduction at SWHR, we’ve refined it dramatically to reflect
our focus on service quality and satisfying VOC (Isenberg School Alumni, 2005).
Some of the projects completed by Starwood in its Six Sigma journey are: green room
program; increase sales lead conversion; reduce room assignment defects;
implementation of an automated customer interaction recording and evaluation
solution; and reduction in accident rates.

Qualitative results
The data analysis is based on interviews, articles from various sources, presentations,
and project reports. In particular, we searched for CSFs, CTQs, STTs, and KPIs.

Critical success factors


We found strong evidence of management support as a CSF in all of our data sources
from different organisations, i.e. it was clearly mentioned in the interviews,
observations, and archival sources. As evidenced from the data of Starwood hotel:

S. no. Project title Start date End date

P1 Reduction of the number of suspensions in TOP/CSC June, 2003 November 2003


applications
P2 Improve CONQUAS assessment consistency June 2003 February 2004
P3 Improve electronic submission front-end services August 2004 May 2006
and user friendliness to customers
Table V. P4 Improve reliability of the lift’s automatic rescue – –
Six Sigma projects at device performance
construction and related P5 Reduce water seepage in wet area floors – –
engineering service P6 Improve the typical floor-to-floor cycle time for – –
organization private high-rise residential project
Sternlicht (CEO, Starwood) [. . .], [. . .] and bought the Six Sigma process improvement Six Sigma
program (made famous by General Electric CEO Jack Welch) to Starwood, where it
will be implemented right away in the convention services department of its major implementation
meetings properties.
The CEO also appointed a former GE executive as Executive Vice President, Six Sigma,
for Starwood having global responsibility for executing the strategy, designing the
tools, and overseeing the implementation of Starwood’s Six Sigma initiative. Thus, the 1007
initial thrust for Six Sigma is provided by top management followed by training of BBs
and GBs by external consultants.
In the case of CSF, the support of team members was the next most important as
observed from the interviews and other sources of data of all the case study
organisations. Support of team members includes both internal and external members.
External members here refer to employees who were not in the project but their
assistance is vital for the success of Six Sigma implementation. The third CSF is
cultural change which was mentioned by informants who were at higher management
levels. This was consistent for all the organisations studied. The list of CSFs observed
from the data of study organisations are summarized in Table VI.

CTQ characteristics
Examination of the data revealed time as the most important of CTQs and is consistent
throughout different sources of data of the study organisations. On close analysis of
data, it was found that the more specific CTQs are actually turnaround time and
waiting time. The analysis also provides some other CTQs but they are not common
across different data sources. For consultancy services, an additional CTQ observed is
service cost.
Starwood data revealed that there are several areas or processes, where Six Sigma
projects are done for improvement. These areas or processes (Table VII) provide
information about the CTQs considered during Six Sigma implementation.
As can be noted from the above table, there is a common CTQ, time (waiting time
and turnaround time) across different areas or processes. There are some CTQs specific
to particular areas or processes such as billing error, occupancy rate, etc. The analysis
also showed that some of the CTQs related to inventory reduction, wastage/pilferage
have similarities with those of manufacturing. Thus, it suggests that service
organizations can also have some projects similar in nature to manufacturing. List of
CTQs summarized from all the case study organisations are summarized in Table VIII.

Organisation Interviews Documentation

The hospital Management support, cultural change, support Management support, cultural
of team members change
Engineering Management support, support of team Management support, cultural
service members, cultural change, availability of change
resource, sufficient time to implement
Six Sigma
Consultancy Management support, support of team members Management support
service Table VI.
Starwood hotel Top management commitment List of CSFs
BPMJ
Front office operations/sales and marketing Food and beverage service/production
18,6 Reduce waiting time during peak check-in time To maintain optimal inventory
Reduce waiting time during peak check-out time Minimise wastage/pilferage
Eliminate billing errors and improve accuracy Standardized output of food and beverage
Reduce no shows Reduce the time from order to service
Increase occupancy Optimal utilization of current product mix (F&B/
1008 Optimal utilization of the current product mix Outlets) to increase revenue
(rooms) to increase revenue Accommodation operation (housekeeping)
Increase customer delight at the executive club Reduce the turnaround time of making/turning
Reduce/eliminate lost calls down a room
Accuracy of information Standardization of cleanliness across areas
HRs/personnel Purchase/stores
Accuracy of payroll Reduce inventory surplus
Documentation management Cost-benefit analysis between cost of inventory
Reduce the turnaround time of recruitment and cost of storage of products where prices vary
Reduce the turnaround time of relieving seasonally
Increase the employee satisfaction rate Standardize the operating procedure of issuance
Table VII. to various departments
Areas or processes where Reduce the turnaround time of issuance to various
Six Sigma is applied departments

Organisation Interviews Documentation

The hospital Time (service time, waiting Time (turnaround time), employee
time, cycle time, turnaround behaviour
time), employee behaviour,
timely information to customer,
clinical outcome
Engineering service Time (service time, waiting Turnaround time, ease of use,
time, cycle time), accurate assessment consistency
information to customer, timely
information to customer, time
to restore customer complaints,
time to respond to customer
complaints
Consultancy service Time (cycle time, turnaround Turnaround time, cost
time), service cost
Table VIII. Starwood hotel Time (waiting time, turnaround
List of CTQs time), billing errors, occupancy rate

Set of tools and techniques


For the hospital, the tools and techniques usage showed some inconsistency across
data sources. For example, the interview transcripts mention differences in tools and
techniques usage at different stages by the two BBs. We infer that this difference is due
to the familiarity and ease of an individual with a particular tool usage, even though
they have the knowledge of all tools. As can be observed from the response of one of
the informant from the engineering service organisation:
Project leaders or members use the tools they are more familiar with. They won’t use the tools
they are not confident with.
Another observation is consistency in tools and techniques usage across different Six Sigma
projects. The reason can be the nature of projects done in the organization, as all are
related to improvement in time (turnaround time, waiting time, and cycle time).
implementation
For the engineering service organisation, tools and techniques such as gage
repeatability and reproducibility, measurement system analysis, and hypothesis
testing, were used in the projects. The reason behind is the similarity of some projects
with that of manufacturing projects. 1009
Additional factors related to the use of tools and techniques emerged from the study
of consultancy services. They are the nature of business, the nature of projects, and the
nature of collected data. As can be observed from the response of one of the informants:
There are some tools we do not use like DOE. This is due to the nature of our business.
Certain tools we use are on data analysis and data organizations like bar charts, graphs, etc.
selection of tool depends on nature of project, on what kind of data is collected [. . .].
The complete list of tools and techniques are shown in Table IX.

Key performance indicators


During the interview sessions, customer satisfaction, financial benefits, and timely
delivery are mentioned as KPIs. Other data sources do not mention about KPIs. We feel
that since KPIs were explicitly asked in questionnaire so its existence is observed
during interview sessions. Thus, the analysis suggests that there is a need to
understand KPIs interpretation. Some of the KPIs identified are mentioned in Table X.

Difficulties in implementation
The analysis of hospital data is done through check list matrix. This helped to assess
the supporting conditions prior to executing a Six Sigma project in the hospital is
provided in Table XI.
The above table provides some useful information which helped us in
understanding the difficulties faced by the organization. The Six Sigma initiative
started in 2000 but as the time progressed and with change in top management the
approach to Six Sigma also changed. Initially, on Singapore Government’s initiation
and also encouraged by the top management, staff members were trained as BBs and
GBs. This trained staffs were then involved in most of the Six Sigma projects. As we
got involved in their current project we found that, Department of Emergency Medicine
is the only department currently involved in Six Sigma projects. The approach of
providing GB training prior to Six Sigma project has also changed and now the
approach is more towards learning through work on the project.
The four staff nurses who were involved in the project do not had prior experience
in other quality initiatives. They faced much problems while doing the Six Sigma
project. They have limited knowledge about the tools and techniques used in Six Sigma
implementation. But as one of the staff nurses puts it “knowing and understanding is
totally different thing”. This showed that there is a lack of understanding about Six
Sigma on their part. We feel that prior education and training is very important for
team members involved in Six Sigma projects.
As can be seen from the checklist matrix Six Sigma project team members faced
lack of support from other employees in the organization. The team members felt that
support of the employees in the organization is also vital for the project to succeed. The
following quote from a staff nurse helps us in understanding the importance:
18,6
BPMJ

1010

Table IX.
List of STTs
Organisation Interviews Documentation

The hospital Define Define


Project charter, VOC analysis, CTQ definition, process map, flow chart Project charter, process map, flow chart
Measure Measure
Pareto diagram, process Six Sigma calculation Pareto diagram
Analyze Analyze
Cause and effect diagram, brainstorming, process map, flow chart, data Cause and effect diagram, process map, flow chart
analysis, correlation and regression
Improve
Creative thinking
Control
Statistical process control, FMEA
Engineering Define Define
service Project prioritization, project charter, SIPOC diagram, VOC analysis, CTQ Project charter, process map/flow chart
definition, process map/flow chart Measure
Measure Descriptive statistics, gage repeatability and reproducibility analysis,
Pareto diagram, run chart, process capability, process Six Sigma calculation Pareto chart
Analyze Analyze
Cause and effect diagram, brainstorming, process map/flow chart, FMEA, data Box plot, process capability analysis, data analysis (descriptive
analysis, hypothesis testing, correlation and regression statistics), ANOVA, hypothesis testing, FMEA, cause and effect diagram
Improve Improve
Creative thinking, force field analysis, five why analysis Brainstorming
Control Control
Statistical process control Control charts
Consultancy Define Define
service Project charter, process map/flow chart, stakeholder analysis Project charter
Measure Measure
Pareto diagram, control chart Pie chart, histogram, line chart
Analyze Analyze
Cause and effect diagram, brainstorming, process map/flow chart FMEA, data Brainstorming, fishbone diagram, affinity diagram, root cause analysis
analysis Improve
Improve Force field analysis, FMEA, cost-benefit analysis
Creative thinking, force field analysis, five why analysis, cost-benefit analysis Control
Control Control charts
FMEA, continuous monitoring
[. . .] success of the project depends on our colleagues also [. . .] project involves a survey, for Six Sigma
this survey all our staffs have to help us out, they have to understand the survey form and
give us accurate information to analyze. implementation
In order to understand the problems faced by the team members in a better manner, we
feel that a context chart (Miles and Huberman, 1984) will be helpful. This chart
(Figure 10) will assist in understanding the interrelationships among the roles of
different members involved in a Six Sigma project. This chart is specific to the two 1011
current projects in which I participated.
Looking at the lines of authority, we can see that Director, human resource (HR)
has direct authority over department head as they work on Six Sigma implementation.
The person is not only an advocate but also has high influence over implementation.
The department head on the other hand is also an advocate of Six Sigma
implementation and seems to have a license from the Director to do this. Because of the
department head’s involvement, it is the only department in the hospital to still carry
on Six Sigma projects.

Organisation Interviews

Engineering service Efficient service, timely delivery, customer


satisfaction, reduced variation, financial benefits Table X.
Consultancy service Reduction in cost, timely delivery, financial benefits List of KPIs

Condition Team leaders Team members

Top management commitment Strong commitment from top Strong commitment from
and involvement management initially respective department heads
Change in top management
resulted in limited commitment
Education and training Black belt training Green belt training for initial
cadres in 2000
Recent projects do not involve
prior training. It is learn while
you work based approach
Support of team members Strong support of team Strong support among team
members. They are the persons members
involved in actual data collection
Skills Skilled – undergone BB training Skilled – undergone GB training
No skills in Six Sigma tools and
techniques for those with the
approach of learn by work
Relevant prior experience Experienced with Six Sigma No experience in Six Sigma Table XI.
projects or other quality projects Checklist matrix:
initiatives Limited experience in other conditions supporting
quality initiatives preparedness for Six
Support of other staff members Not available Limited support – requires Sigma projects at the
of the organization repeated request hospital
BPMJ Director (Human Resource
18,6 Department)
SS
+*

1012 Head (Department of Emergency


Medicine)
+* SS

+ +

Staff Nurse 1 (Department of Staff Nurse 2 (Department of


Emergency Medicine) Emergency Medicine)
± + + ±

Staff Nurse 3 (Department of Staff Nurse 4 (Department of


Emergency Medicine) Emergency Medicine)
± ±

– –
– –
Other Staff Members of Department of Emergency Medicine not involved
in the project (0)

Figure 10.
Context chart for Six Legend + ± 0 within boxes: attitude towards Six Sigma
Sigma projects at + ± – between boxes: character of the relationship
department of emergency * high influence over Six Sigma implementation
medicine (DEM) SS
Six Sigma advocate or champion

The staff nurses who were involved in the project are rather ambivalent towards
Six Sigma implementation. Given, no prior training in Six Sigma and learning through
their first project their attitude towards Six Sigma is understandable. As one of the staff
nurses mentioned during interview “interested in the project to learn about Six Sigma”.
The relation between staff nurses and other staff members is negative because of
the problems faced during data collection. This negative relation is only related to the
Six Sigma project but overall the staff nurses have positive attitude towards other staff
members. This shows that Six Sigma awareness have to spread beyond the members
of the project to ensure an overall success.

Data collection
This is one of the most serious problems faced by the consultancy, and engineering
services organizations. In case of manufacturing the data is readily available in
hundreds or thousands but not so in case of services. As the SDO mentioned during the
interview session:
Biggest hurdle we face for our company is data collection [. . .] because in some cases one data
is one case [. . .] data collection can take years.
Similar concern is voiced by the Building Manager: Six Sigma
In service I think so far the most difficult is data collection, if you talk about manufacturing implementation
they have data around. Services are volatile [. . .] difficult to get data.

Insufficient resources
In manufacturing Six Sigma teams are independent and not associated with day-to-day
work. But in case of services the team is also responsible for carrying out their 1013
day-to-day work, i.e. Six Sigma projects are mostly done part-time. As evidenced from
the following response:
We are still holding on our jobs, this is our primary role. Normally we have to reach out of our
time, i.e. unlike manufacturing where they have full-time.
This part-time involvement in Six Sigma projects generally results in stretching the
resources such as time and manpower. Longer time is also required to see full
implementation of solution of a Six Sigma project.

Sustaining Six Sigma


In case of service organizations identifying projects every year is also very difficult.
There may be number of projects in initial years but there is a gradual decline in
projects with subsequent years. The reason behind is identification of projects which
are challenging, complex, and have greater impact to the organization. As one of the
informant noted:
[. . .] full blown success of Six Sigma will be good only when there is very challenging project.
Along with the above mentioned problems there are some others such as deciding upon
the scope of project, extension of project timeline, staff turnover, attaching incentives to
the successfully completed Six Sigma projects, and quantification of savings. In case of
public service organizations, it is difficult to quantify the savings from projects since
they are mostly done to reduce customer complaints, i.e. benefits directed towards public.
The analysis of data highlighted some of the practical difficulties faced by the
organization. This includes part-time involvement of team leader and team members in
Six Sigma projects, involving and convincing senior doctors and surgeons about the
importance of Six Sigma, and lack of support from the staff members who are not
involved in the project.

Discussion
The primary aim of this study was to explore the success factors, identification of CTQ
characteristics, tools and techniques, and the performance indicators which display
the improvements due to Six Sigma. This paper identifies different CSFs, CTQ,
and STTs which influence Six Sigma implementation.

Critical success factors


The work highlighted that top management commitment and involvement is indeed an
important CSF and continuity of Six Sigma very much depends on it. This is very
much evident through a comment by one of the respondents from our study:
7 projects in the first wave which are currently being resolved. Only 2 projects are scheduled
for second wave because our new CEO doesn’t believe in Six Sigma.
BPMJ Involvement of top management helps in “overcoming problems which the employees
18,6 at their levels are not able to solve” as evidenced from a quote by one of the interviewee
of one case study. Other CSFs such as education and training, customer focus, cultural
change, etc. also emerged from the case studies.
Previous research, see Nonthaleerak and Hendry (2008), Antony (2006), Brady and
Allen (2006), Coronado and Antony (2002) and Antony and Banuelas (2002) has talked
1014 about CSFs for Six Sigma implementation. The literature highlights several
CSFs required for successful Six Sigma implementation in organizations. The
drawback is lack of rigorous empirical research about CSFs and not being specific for
service organizations.
The strength of our work is providing empirical evidence and focusing on the
nature and frequency of certain CSFs. This helped in identifying the relative
importance of CSFs and the issues related to service organizations. One weakness of
our work is not able to concentrate on few CSFs and study there importance in
contexts. This is probably because our research is exploratory in nature and is focused
on building theory related to Six Sigma implementation in service organizations.

CTQ characteristics
Identification of process parameters for Six Sigma implementation in service
organizations is mentioned as a major difficulty in literature. This seems not to hold
true for the organizations which have already implemented Six Sigma. The CTQs
observed from our study is mainly related to time. This time is related to cycle time,
service time, turnaround time, waiting time, response time to customer complaints, etc.

Key performance indicators


The finding on KPI is an important aspect of our research. The literature review
highlighted the ambiguity about KPI and being sometime used synonymously with CTQ.
The case studies helped us understanding the two viewpoints of KPI. Majority is with the
strategic nature of KPI, where it is understood as KPI. KPIs are set internally and Six
Sigma is implemented in the organization if it links with the organizations’ KPIs. This
answers the reason behind high preference for linking Six Sigma with business strategy as
a CSF. The second interpretation of KPI is key process input. In Six Sigma implementation
this is the way KPI is interpreted by practitioners and that is where it becomes
synonymous with CTQ. So, to reduce ambiguity we suggest using the term measurable
process parameters instead of CTQ and financial benefit as performance metric, since it is
widely mentioned in literature and easily understood by practitioners (Goh, 2002).

Difficulties
Referring to previously conducted research on service organizations and Six Sigma,
one common argument is that service has inherent differences with manufacturing
(Hensley and Dobie, 2005; Antony, 2004; Benedetto, 2003; Sehwall and De Yong, 2003),
which negatively affects their conditions for a successful implementation. However,
the findings of our study do not point to inherent differences as an obstacle for service
organization’s Six Sigma efforts. The negative aspects to do with Six Sigma
implementation is part-time involvement in Six Sigma projects, staff turnover during
projects or after training, extension of project time line and in some cases data
collection.
Set of tools and techniques Six Sigma
The findings from our analysis indicate what tools and techniques are mainly used and implementation
how they are selected for Six Sigma implementation in service organizations. The
selection criteria of tools and techniques are mainly based on nature of project(s),
nature of data collected, etc. The important finding is the selection of tools and
techniques based on familiarity of BBs or project leaders with certain cluster of tools
and techniques and in some cases suggestion from external consultant. This implies 1015
the subjective nature of selection of tools and techniques in Six Sigma implementation.
The previous research see, Antony et al. (2007), Antony (2006), De Koning and De Mast
(2006) and Henderson and Evans (2000) has not focused much on selection criteria and
mainly limited to nature of project(s) and nature of data collection and lack empirical
evidence.
The strength of our research is in identifying a STTs which will be useful for Six
Sigma implementation in service organizations. Exploratory nature of our research
restricted concentration on specific tools and techniques.

Conclusion
Implications to research
We hope that this study encourages investigation of Six Sigma implementation in
service organizations and promote rigorous development and explicit articulation of
theories. It is necessary to increase theory development related to Six Sigma
implementation that is grounded on relevant established theories and empirical
evidences from related disciplines. So that empirical investigations of related
phenomenon can be integrated into the building and modification of useful and
interesting theories.
The case-based research draws attention to the existence of contingencies and the
need to further investigate the ambiguous role of contextual factors in affecting Six
Sigma implementation in service organizations. Studies by Nonthaleerak and Hendry
(2008), Schroeder et al. (2008) and Antony (2004) prescribes that Six Sigma can be
implemented in service organizations, our study suggests that the implementation and
impact of Six Sigma can be affected by contextual factors such as service types. In
summary, this research contributes to theory-grounded empirical research. This is a
worthwhile endeavour because contributions to valid and reliable measurements and
explicit theory development help lay a foundation for future Six Sigma implementation
studies. By identifying and testing theories we encourage the development of a stream
of cumulative research.

Implications to practice
This study offers conceptual clarity and specificity on Six Sigma implementation in
service organizations, managers can use a guideline for choosing the fundamental
practices that they can implement. We provide conceptual and empirical evidence on
CSFs, measurable process parameters, STTs, and difficulties faced by service
organizations. Thus, encouraging managers to plan and implement Six Sigma with a
systematic view of service environment. Furthermore, there is empirical evidence of the
importance of committed and involved leadership for implementation of Six Sigma in
service organizations. We also find that a general emphasis on company-wide Six
Sigma projects is significant in differentiating high and low performance.
BPMJ Notes
18,6 1. Ministry of finance – press statement (2002).
2. Annual reports from 2003 to 2006.

References
1016 Antony, J. (2004), “Some pros and cons of Six Sigma: an academic perspective”, The TQM
Magazine, Vol. 16 No. 4, pp. 303-6.
Antony, J. (2006), “Six Sigma for service processes”, Business Process Management Journal,
Vol. 12 No. 2, pp. 234-48.
Antony, J. and Banuelas, R. (2002), “Key ingredients for the effective implementation of
Six Sigma program”, Measuring Business Excellence, Vol. 6 No. 4, pp. 20-7.
Antony, J., Antony, F.J., Kumar, M. and Cho, B.R. (2007), “Six Sigma in service
organizations: benefits, challenges and difficulties, common myths, observations and
success factors”, International Journal of Quality & Reliability Management, Vol. 24 No. 3,
pp. 294-311.
Barton, D.L. (1990), “A dual methodology for case studies: synergistic use of a
longitudinal single site with replicated multiple sites”, Organization Science, Vol. 1 No. 3,
pp. 248-66.
Basu, R. (2004), Implementing Quality: A Practical Guide to Tools and Techniques: Enabling the
Power of Operational Excellence, 1st ed., Thomson Learning, London.
Basu, R. and Wright, J.N. (2003), Quality Beyond Six Sigma, Butterworth-Heinemann, Oxford.
Benedetto, A.R. (2003), “Adapting manufacturing-based Six Sigma methodology to the service
environment of a radiology film library”, Journal of Healthcare Management, Vol. 48 No. 4,
pp. 263-80.
Brady, J.E. (2005), “Six Sigma and the university: teaching, research and meso-analysis”,
PhD dissertation, Ohio State University, Columbus, OH.
Brady, J.E. and Allen, T.T. (2006), “Six Sigma literature: a review and agenda for future
research”, Quality & Reliability Engineering International, Vol. 22, pp. 335-67.
Chakrabarty, A. and Tan, K.C. (2007), “The current state of Six Sigma application in services”,
Managing Service Quality, Vol. 17 No. 2, pp. 194-208.
Chakrabarty, A. and Tan, K.C. (2009), “An exploratory qualitative and quantitative analysis of
Six Sigma in service organizations in Singapore”, Management Research News, Vol. 32
No. 7, pp. 614-32.
Coronado, R.B. and Antony, J. (2002), “Critical success factors for the successful
implementation of Six Sigma projects in organizations”, The TQM Magazine, Vol. 14
No. 2, pp. 92-9.
De Koning, H. and De Mast, J. (2006), “A rational reconstruction of Six Sigma’s breakthrough
cookbook”, International Journal of Quality & Reliability Management, Vol. 23 No. 7,
pp. 766-87.
Does, R., Heuvel, E., Mast, J. and Bisgaard, S. (2002), “Comparing non-manufacturing with
traditional applications of Six Sigma”, Quality Engineering, Vol. 15 No. 1, pp. 177-82.
Downe-Wamboldt, B. (1992), “Content analysis: method, applications, and issues”, Health Care
for Women International, Vol. 13 No. 3, pp. 313-21.
Gilmore, A. and Carson, D. (1996), “Integrative qualitative methods in a services context”,
Marketing Intelligence & Planning, Vol. 14 No. 6, pp. 21-6.
Goh, T.N. (2002), “A strategic assessment of Six Sigma”, Quality & Reliability Engineering Six Sigma
International, Vol. 18, pp. 403-10.
implementation
Hahn, G.J., Hill, W.J., Hoerl, R.W. and Zinkgraf, S.A. (1999), “The impact of Six Sigma
improvement – a glimpse into the future of statistics”, The American Statistician, Vol. 53
No. 3, pp. 208-15.
Hansson, J. (2003), “Total quality management – aspects of implementation and performance:
investigations with a focus on small organizations”, PhD dissertation, Luleå University of 1017
Technology, Luleå.
Harrigan, K. (1983), “Research methodologies for contingency approaches to business strategy”,
Academy of Management Review, Vol. 8 No. 3, pp. 398-405.
Harry, M.J. (2000), “Six Sigma: a breakthrough strategy for probability”, Quality Progress, May,
pp. 60-4.
Henderson, K.H. and Evans, J.R. (2000), “Successful implementation of Six Sigma: benchmarking
general electric company”, Benchmarking: An International Journal, Vol. 7 No. 4,
pp. 260-81.
Hendry, L. and Nonthaleerak, P. (2005), “Six Sigma: literature review and key future research
areas”, LUMS working paper series, June, pp. 1-66.
Hensley, R.L. and Dobie, K. (2005), “Assessing readiness for Six Sigma in a service setting”,
Managing Service Quality, Vol. 15 No. 1, pp. 82-101.
Heuvel, J., Does, R. and Bisgaard, S. (2005), “Dutch hospital implements Six Sigma”, ASQ Six
Sigma Forum Magazine, February, pp. 11-14.
Inozu, B., Niccolai, M.J., Whitcomb, C.A., Mac Claren, B., Radovic, I. and Bourg, D. (2006),
“New horizons for ship building process improvement”, Journal of Ship Production, Vol. 22
No. 2, pp. 87-98.
Isenberg School Alumni (2005), “Alumni profile: denise”, Commonwealth Magazine,
September/Fall.
Jones, M.H. Jr (2004), “Six Sigma: at a bank”, ASQ Six Sigma Forum Magazine, Vol. 3 No. 2,
pp. 13-17.
Krupar, J. (2003), “Yes, Six Sigma can work for financial institutions”, ABA Banking Journal,
September, pp. 93-4.
Leonard, D. and McAdam, R. (2001), “Grounded theory methodology and practitioner reflexivity
in TQM research”, International Journal of Quality & Reliability Management, Vol. 18 No. 2,
pp. 180-94.
McAdam, R. and Lafferty, B. (2004), “A multilevel case study critique of Six Sigma: statistical
control or strategic change”, International Journal of Operations and Productions
Management, Vol. 24 No. 5, pp. 530-49.
Mertens, D.M. (1998), Research Methods in Education and Psychology: Integrating Diversity With
Quantitative and Qualitative Approaches, Sage, Thousand Oaks, CA.
Miles, B.M. and Huberman, A.M. (1984), Qualitative Data Analysis: A Sourcebook of New
Methods, Sage, Beverly Hills, CA.
Mortimer, A.L. (2006), “Six Sigma: a vital improvement approach when applied to the right
problems, in the right environment”, Assembly Automation, Vol. 26 No. 1, pp. 10-17.
Nonthaleerak, P. and Hendry, L. (2008), “Exploring the Six Sigma phenomenon using multiple
case study evidence”, International Journal of Operations & Production Management,
Vol. 28 No. 3, pp. 279-303.
Patton, Q.M. (1987), How to Use Qualitative Methods in Evaluation, Sage, London.
BPMJ Pheng, L.S. and Hui, M.S. (2004), “Implementing and applying Six Sigma in construction”,
Journal of Construction Engineering and Management, Vol. 130 No. 4, pp. 482-9.
18,6
Rucker, R. (2000), “Citibank increases customer loyalty with defect-free processes”, Association
for Quality and Participation, Vol. 23 No. 4, pp. 32-6.
Schroeder, R.G., Linderman, K., Liedtke, C. and Choo, A.S. (2008), “Six Sigma: definition and
underlying theory”, Journal of Operations Management, Vol. 26, pp. 536-54.
1018 Sehwall, L. and De Yong, C. (2003), “Six Sigma in health care”, International Journal of Health
Care Quality Assurance, Vol. 16 No. 6, pp. 1-5.
Sousa, R. and Voss, C.A. (2001), “Quality management: universal or context dependent”, Journal
of Operations Management, Vol. 10 No. 4, pp. 383-404.
Voss, C., Tsikriktsis, N. and Frohlich, M. (2002), “Case research in operations
management”, International Journal of Operations and Productions Management, Vol. 22
No. 2, pp. 195-219.
Woodard, T.D. (2005), “Addressing variation in hospital quality: is Six Sigma the answer”,
Journal of Healthcare Management, Vol. 50 No. 4, pp. 226-36.
Yin, R.K. (1994), Case Study Research: Design and Methods, Sage, Thousand Oaks, CA.
Young, J. (2001), “Driving performance results at American Express”, ASQ Six Sigma Forum
Magazine, Vol. 1 No. 1, pp. 1-10.
Young, T., Brailsford, S., Connell, C., Davies, R., Harper, P. and Klein, J.H. (2004), “Using
industrial processes to improve patient care”, British Medical Journal, Vol. 328, pp. 162-4.

Further reading
Aboelmaged, M.G. (2010), “Six Sigma quality: a structured review and implications for future
research”, International Journal of Quality & Reliability Management, Vol. 27 No. 3,
pp. 269-318.
Carson, D. and Coviello, N. (1996), “Qualitative research issues at the marketing/entrepreneurship
interface”, Marketing Intelligence & Planning, Vol. 14 No. 6, pp. 51-8.
Oke, S.A. (2007), “Six Sigma: a literature review”, South African Journal of Industrial
Engineering, Vol. 18 No. 2, pp. 109-29.
Patton, F. (2005), “Does Six Sigma work in service industries?”, Quality Progress, September,
pp. 55-60.
Shewart, W.A. (1931), Economic Control of Quality of Manufactured Products, Van Nostrand,
New York, NY.
Sila, I. and Ebrahimpour, M. (2002), “An investigation of the total quality
management survey based research published between 1989 and 2000: a literature
review”, International Journal of Quality & Reliability Management, Vol. 19 No. 7,
pp. 902-70.

About the authors


Ayon Chakraborty is Postdoctoral Research Fellow in the BPM Research Group at the Faculty of
Science and Technology, Queensland University of Technology. He received his PhD degree
from National University of Singapore in the area of Service Quality. He has a Master’s degree in
Manufacturing Systems Engineering from BITS, Pilani, India and Bachelor of Production and
Industrial Engineering from University of Rajasthan, India. He has more than six years of work
experience. His work experience includes research, teaching and quality engineering in
electronics industry. His current research interests include Six Sigma, service management and
business process management. Ayon Chakraborty is the corresponding author and can be Six Sigma
contacted at: ayon.chakraborty@qut.edu.au
Kay Chuan Tan is an Associate Professor in the Department of Industrial and Systems implementation
Engineering at the National University of Singapore (NUS). He supervises the Department’s
Ergonomics Laboratory. He does research and teaches in the following subject areas: human
factors engineering and ergonomics, engineering statistics, quality planning and management,
engineering economy, and production and operations management. He is also Acting Director of
the Office of Quality Management at NUS. He is involved in the setting up of benchmarks 1019
for quality excellence in education as well as the day-to-day administrative quality
management of NUS.

To purchase reprints of this article please e-mail: reprints@emeraldinsight.com


Or visit our web site for further details: www.emeraldinsight.com/reprints

View publication stats

You might also like