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A case study for surgical mask production during the COVID-19 pandemic:
continuous improvement with Kaizen and 5S applications

Article in International Journal of Lean Six Sigma · December 2022

DOI: 10.1108/IJLSS-02-2022-0025

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Surgical mask
A case study for surgical mask production
production during the COVID-19
pandemic: continuous
improvement with Kaizen 679

and 5S applications Received 3 February 2022

Revised 15 May 2022
29 July 2022
Ezgi Aktar Demirtas, Ozgul Sevval Gultekin and Cigdem Uskup 16 September 2022
26 October 2022
Department of Industrial Engineering, Eskisehir Osmangazi University, Accepted 1 November 2022
Eskisehir, Turkey

Abstract
Purpose – With the emergence of the COVID-19 pandemic, the production shortage of personal protective
equipment (PPE), such as surgical masks, has become increasingly significant. It is vital to quickly provide
high-quality, hygienic PPE during pandemic periods. This comprehensive case study aims to confirm that
Kaizen and 5S applications reduce wastage rates and stoppages, which as a result, created a more efficient
and sustainable workplace in a small–mediumenterprise (SME) producing PPE in Turkey.
Design/methodology/approach – The method for this case is discussed with the help of a flowchart
using the DMAIC cycle: D-define, M-measure, A-analyse, I-improve and C-control.
Findings – The total stoppages due to fishing line, gripper, piston and yarn welding have decreased by
approximately 42.4%. As a result of eliminating wasted time and reduced changeovers, a total of 5,502 min
have been saved per month. This increased production of approximately 10.55% per month, led to an addition
of 506,184 units.
Originality/value – The use of lean manufacturing (LM), Six Sigma, Lean Six Sigma and continuous
improvement methodologies are not common in textile SMEs. Based on the current literature reviewed, to the
best of the authors’ knowledge, this is the first comprehensive case study that combines statistical tools,
such as hypothesis tests and LM practices, in the production process for a PPE company operating as a
textile SME.
Keywords Kaizen, Continuous improvement, 5S, Hypothesis test, Personel protective equipment
Paper type Case study

1. Introduction
Throughout the COVID-19 pandemic, it became critical to offer essential personal protective
equipment (PPE), high-quality surgical masks, to consumers as quickly and safely as
possible, while maintaining hygienic conditions during production. At the beginning of the
pandemic, N-95 masks were unavailable for health-care professionals as well as ordinary
civilians. There were long wait times and exorbitant monetary costs to get two and/or three-
layer surgical masks. The PPE industry, in the textile sector, was responsible for producing

The authors would like to thank Professor Fatma Pakdil, Professor Jiju Antony and the anonymous International Journal of Lean Six
referees for their valuable comments. The authors thank Katarina Turgeon for her help with editing. Sigma
Vol. 14 No. 3, 2023
At the same time, the authors would like to thank the employees and managers of the Tekkan Group, pp. 679-703
where the study was conducted. © Emerald Publishing Limited
2040-4166
Conflict of interest: No conflict of interest has been declared. DOI 10.1108/IJLSS-02-2022-0025
IJLSS surgical masks under tight constraints. Shortage of supplies, limited time deadlines and
14,3 high rates of cost and waste only name a few. Concurrently, the high-priced surgical masks
were not meeting customer needs. The complaints that were most frequent were the
breakage of the ear ropes, the inability to fully cover the nose and the lack of comfort with
long-term use. The labour-intensive nature, working with a short lead-time and high waste
rates from purchasing to delivery, caused an increase in losses and inefficiencies in the
680 textile and PPE industries. Thus, firms have to purify their processes from waste and
create an lean manufacturing (LM) system by reducing long production times (Adikorley
et al., 2017; Ajmera et al., 2017; Saleeshya et al., 2012).
The textile industry in the European Union (EU) consists mainly of small–medium
enterprises (SMEs), who make up a vital part of the EU economy. Under pressure by
challenging financial situations, SMEs need to become more efficient to remain competitive.
The same can be said for developing countries in and out of Europe. Although SMEs benefit
from quality management efforts (Assarlind and Gremyr, 2014), many textile SMEs have
not adopted new quality management concepts and lean practices for efficiency
(Manfredsson, 2016; Bhamu and Sangwan, 2014). For instance, according to results from
survey studies, textile SMEs using lean applications constitute only 3%–5% of all SMEs in
the UK, Turkey and India (Adikorley et al., 2017). After searching the databases of Web of
Science/Science Direct and Scopus using the keywords textile, apparel, garment, Kaizen, 5S,
continuous improvement (CI) and Lean Six Sigma (LSS), it has been observed that there is a
limited number of studies on the uses of lean tools in the textile sector and textile SMEs.
Hodge et al. (2011) have developed a framework for lean implementations in a textile
environment. They concluded that lean applies to both large- and small-scale businesses.
The papers of Achanga et al. (2006) and Assarlind and Gremyr (2014) also refer to the
characteristics of SMEs and critical success factors for lean implementation within SMEs.
In process industries such as textiles, it is more important to respond quickly to changing
market needs than to discrete or continuous processes. On the contrary, low productivity
and high waste rates increase the lead time and the cost of production (Ajmera et al., 2017).
The focus of textile companies should be to present high-quality products at reasonable
prices to customers in the shortest possible lead time. Even though the definitions of total
quality management (TQM), Six Sigma (SS) and LM differ from one another, the intentions
of these concepts are similar; minimize waste and resources while improving customer
satisfaction and financial results (Andersson et al., 2006). Lean Management and SS define
value from the customer’s point-of-view, focus on quality, speed and cost by eliminating the
amount of waste and aim to reduce variability (Drohomeretski et al., 2014). On the other
hand, LSS is a structured CI methodology that closes the critical gaps between LM and SS
(Sunder et al., 2020). If organizations can combine these concepts, there is a lot to gain,
according to Andersson et al. (2006). For this reason, many studies in which LM and LSS
methodologies that are used individually, or in combination with the values in TQM, have
been included in this publication. These concepts aim for maximum customer satisfaction
with the participation of all employees (Çelebi and Yıldız, 2021). In addition to the benefits of
non-defective and uninterrupted production, it increases competitiveness (Vinodh et al.,
2011). Thus, they maintain their existence because of the higher rates of customer
satisfaction and profit by focussing on concepts such as quality and conforming products,
an efficient workforce and an effective working environment. By eliminating wastes such as
overprocessing, waiting and downtimes, over-movement and defects, it will be possible to
reduce lead times, improve quality, increase productivity and use labour and production
resources more effectively (Sundar et al., 2014; Gupta and Jain, 2014). The environmental
and social benefits of lean practices were listed in the study of Cherrafi et al. (2016).
The achievements of practical tools such as Kaizen and 5S could not be ignored in any small, Surgical mask
medium or large-scale firms. Wastage is avoided using Kaizen applications and the quality production
of the entire process is increased by reducing the amount of waste. In this case, waste time
can be used for production, transportation/movement in the workplace can be reduced and
employee performance can be increased. Thus, instead of focussing on the result, CI is
aimed at the gradual changes made within the process. In addition, manager–employee
communication within the firm increases, corporate culture is formed and new ideas are
681
allowed to emerge in the implementation process, which leads to big gains achieved through
improved processes. On the other hand, with the 5S methodology, materials, equipment and
tools used in the working environments are classified and organized. A cleaner and more
efficient working environment is provided due to these principles being applied. Thus,
there could be an increase in employee performance. The permanence and sustainability of
the achievements will be guaranteed with the standardisation and discipline stages of 5S
(Randhawa and Ahuja, 2017; Khan et al., 2019). Despite the enumerated benefits of lean
practices or LSS in the service and manufacturing sector, the article of Antony et al. (2022a)
focuses on the critical factors that lead to LSS project failures. They have listed the main
reasons for failures to enable LSS, Lean and SS sustainability based on a systematic
literature review. Wiengarten et al. (2015) argues that one of the failure factors in lean
practices is the cultural structure. On the other hand, green deployment of LSS (Shokri et al.,
2022; Kaswan et al., 2022), LM and human resources (Koemtzi et al., 2022), integration of LSS
and Industry 4.0 and using big data in lean practices, has shown to have gained importance
for sustainability in recent years (Antony et al., 2021, 2022b).
After conducting a literature review, the conclusion is that the use of lean tools has not
been documented strictly for use in the PPE industry. Hence, this is the first comprehensive
case study about lean practices being used in the production process of high quality surgical
masks as a PPE product.
This study also aims to shorten lead times, increase efficiency and customer satisfaction
and improve the quality of a PPE firm (textile SME in Turkey). The use of lean tools such as
Kaizen and 5S in PPE production has never been observed before. Therefore, this study fills
the gap in the current literature. Although integration with LSS tools such as value stream
mapping (VSM) were not used, the steps of the project were created with logic that is in line
with the LSS philosophy in the present case. Basic quality tools and statistical analyses are
also included in the project steps. In SMEs with scarce resources, the use of lean tools, along
with various quality and process control techniques, is recommended to achieve success
(Ahmed and Hassan, 2003).
In the define and measure phases, a failure follow-up report of the surgical mask
production line, containing data between September 2020 and March 2021, has been used. A
Pareto Chart and a Fishbone Diagram were used for the brainstorming and analysis of
priority problems in the analyse phase. In the improve phase, Kaizen and 5S methodologies
were implemented to reduce wastage and downtime, increase the amount of production and
make the working environment more efficient. Due to the successful implementation of
Kaizen and 5S, an increase in the amount of production and a decrease in the quantity and
duration of stoppages have been reported. In the control phase of Kaizen studies, radar
charts are frequently used for monitoring the improvement efforts (Prasad et al., 2020). On
the other hand, hypothesis tests are statistical tools that are widely used as an alternative to
radar charts in the control phase of lean applications (Vinodh et al., 2011). In this project, a
two-sample t-test was used to test the difference in means for the production units and the
number of stops before and after the improvement efforts using Minitab 18. The significance
IJLSS of the improvement studies is proven statistically. The fourth and fifth steps of 5S
14,3 applications (standardise and sustain) are also discussed in the control phase.
The sections of the paper will be organized as follows. In Section 2, examples from the
current literature have been provided to discuss the recent studies related to lean practices:
Kaizen, 5S methodologies and CI, especially in the field of textile and apparel. In Section 3,
project steps are defined using a flowchart, theoretical background is established and
682 methodology are all presented while supporting the literature. In Section 4, the case has been
presented according to the flow chart prepared for this study. After providing information
about the PPE production process, the implementations in each step have been discussed.
The implications for practitioners and researchers, limitations and agenda for future studies
and conclusion have also been included in the sections 5 and 6.

2. Lean textile literature

Sarmiento et al. (2019) have studied the characterization of the textile SMEs’ processes in
Cundinamarca, regarding lean tools. The study provides necessary information about the
status of companies from the perspective of three fundamental pillars: Kaizen, Jidoka and
Just in Time. In the study carried out by 31 SMEs, it was observed that there are many
opportunities for companies to achieve high-quality levels and increase their production.
However, there is a need for knowledge transfer to catch these opportunities. In the paper of
Adikorley et al. (2017), Du Pont is one of the first textile companies to integrate SS into its
management strategies. The researchers mentioned success stories of LSS in the textile and
apparel sector. Several textile cases, in the field of LM and LSS in the past decade, have been
summarized in Table 1. The details from the papers are provided in the following
paragraphs.
The paper of Prasad et al. (2020) is a case study carried out in South India’s textile
industry. According to the authors, LM is a challenge for the textile industry because of

Authors/Year Title

Prasad et al. (2020)
Romero-Sanchez et al. (2019)
Sarmiento et al. (2019)
Tapia-Leon et al. (2019)
Ahmad et al. (2018)
Parkhan and Sugarindra
(2018)
Adikorley et al. (2017)
Ajmera et al. (2017)
Wickramasinghe and
Wickramasinghe (2016)
Lingam et al. (2015)
Table 1. Saleeshya et al. (2012)
LM studies about Utkun and Güner (2012)
textile and apparel
A framework for lean manufacturing implementation in Indian textile
industry
Process management model in dry cleaning and fabric finishes applying
Lean Manufacturing and Kaizen matrix for the textile sector
Characterization of the production processes of textile SMEs in
Cundinamarca
Improving the Order Fulfillment Process in a Textile Company using Lean
Tools
Improvement of overall equipment efficiency of ring frame through total
productive maintenance: a textile case
Productivity improvement in the production line with lean manufacturing
approach: case study PT. XYZ
Lean Six Sigma applications in the textile industry: a case study
Lean Six Sigma Implementation in Textile Industry
Effects of continuous improvement on shop-floor employees’ job
performance in Lean production The role of Lean duration
Cycle Time Reduction for T-Shirt Manufacturing in a Textile Industry using
Lean Tools
Lean manufacturing practices in textile industries – a case study
A rationalization Study About Six-Step Method Systematic and Lean
Manufacturing Technique for the apparel industry
highly inflexible, automatic machinery with low product varieties and high volumes. They Surgical mask
use a mixture of VSM, 5S, Kanban, Kaizen, Poka-Yoke and visual controls. The potential production
accomplishment of this method has been demonstrated using radar charts. This study is
similar to the work of Saleeshya et al. (2012), which summarizes the achievements as
reduced set-up and changeover times, use of colour-coding for volume-mix recognition,
increase in employee motivation and dissemination of the quality circles’ culture within the
company. The research of Tapia-Leon et al. (2019) aims to improve the order fulfilment
process with lean tools. Romero-Sanchez et al. (2019) presents a case study conducted in a 683
company where they used CI techniques such as a Kaizen matrix and 5S in the dyeing and
finishing processes, having high defect rates. At the end of the study, the amount of savings
was $184,320.42 by reducing the number of reworks by 8.14%.
Ahmad et al. (2018) have used total productive maintenance (TPM) as a lean tool for the
improvement of the overall equipment efficiency of ring frames, in a textile firm.
Wickramasinghe and Wickramasinghe (2016) designed a questionnaire and analysed the
results to measure the job performance of shop–floor employees in textile and apparel
enterprises engaged in LM. The researchers revealed that CI techniques significantly affect
the performance of employees and the duration of operations.
According to the case study conducted in the paper of Adikorley et al. (2017), the
changeover times of two different product lines and the contamination of a third line,
reduced in a firm that produces polyolefin and bi-component fibres for several industries
including health care, construction and automotive. The paper of Ajmera et al. (2017)
proposes an LSS framework to reduce the defects encountered in the final products. This
study integrates lean tools within the DMAIC methodology and has been implemented in
the textile industry.
The paper of Lingam et al. (2015) focuses on reducing the cycle time of T-shirt
production. VSM, Kaizen, FMEA and time-motion study are the tools used in the study. The
accomplishment is a 20% reduction in the cycle times, with 1,500,000 INR monthly savings.
Utkun and Güner (2012) have conducted a six-step methodology, cost-benefit analysis, using
lean techniques in the apparel industry. They used Kaizen and workflow mapping in the
preparation line, Poka-Yoke in the assembly line and Single Minute Exchange of Dies
(SMED), for the optimisation of the workflow.
In the literature regarding the textile and apparel sector, the lean tools, namely, Kaizen
(Prasad et al., 2020; Romero-Sanchez et al., 2019; Lingam et al., 2015; Saleeshya et al., 2012;
Utkun and Güner, 2012), 5S (Prasad et al.,2020; Saleeshya et al., 2012; Romero-Sanchez et al.,
2019), VSM (Prasad et al.,2020; Parkhan and Sugarindra, 2018; Lingam et al., 2015;
Saleeshya et al., 2012), flow mapping (Utkun and Güner, 2012) Poka-Yoke (Prasad et al.,2020;
Saleeshya et al., 2012; Utkun and Güner, 2012), Kanban (Prasad et al.,2020; Saleeshya et al.,
2012), SMED (Utkun and Güner, 2012), TPM (Ahmad et al., 2018) and FMEA (Lingam et al.,
2015) have been used by the researchers.

3. Methods
This study implemented the method shown in Figure 1. Project steps will be discussed in
detail in the case study. In this section, the lean tools used are introduced.
Kaizen, a Japanese term, was first introduced by Imai (Imai, 1986; Singh and Singh, 2015).
It is a combination of two Japanese words meaning KAI (change) and ZEN (better). It is
defined as CI where development studies are carried out with the full participation of senior
management and employees to reduce losses that cause waste and inefficiency in all
processes and machines (Chen et al., 2000). Kaizen is a structured and focused improvement
project using a cross-functional team to improve the targeted processes in an accelerated
IJLSS
14,3

684

Figure 1.
Flowchart of the
proposed method

period (Farris, 2006; Malik and YeZhuang, 2006). A successful implementation of Kaizen
results in an overall healthy atmosphere. Everyone in the organisation becomes aware of
key goals, objectives and success measures (Glover et al., 2014). Kaizen makes every
employee in the organisation smarter, by causing them to pay closer attention to details and
increase their usage of common sense (Imai, 2008). Kaizen Teian produces results within a
short time and only requires simple-level analysis and observation for resolution. It is used
for improvements that require quick action and encourages the participation of all
employees (Womack et al., 2007). The literal meaning of Kobetsu Kaizen, otherwise known
as Kaizen events, is “Focused Improvement Work” rather than simple and immediate ideas.
They are detailed, teamwork activities to realize improvement. It can arise from many
triggers including employee recommendations, performance reports and other arising
problems. It is usually concluded in the short/medium term. Its effects are observed more
clearly in the medium term. A specific roadmap is followed within this method, which is Surgical mask
based on moderate analysis and observation (Arcidiacono et al., 2012). Kaikaku and production
Kakushin (Radical Change and Innovation) are generally seen as the main mechanisms for
radical change and innovation, compared to other types (Muno, 2012; Yamamoto, 2017). It is
triggered by many interdisciplinary points such as strategic developments, business goals
and customer requests. It concludes in the medium or long term, in which period- advanced
analysis and statistical techniques are used. The lean tools, commonly used with Kaizen in
the literature, include VSM, Workflow Mapping, Cause–Effect Diagram, Pareto Chart, 685
Affinity Diagram, 5-Why Analysis, Takt Time Analysis, Histogram, SIPOC and Root–
Cause Analysis. In recent years, Kaizen studies using these tools have been encountered in
the aerospace/automotive industry (Cherrafi et al., 2019; Kumar et al., 2018a, 2018b;
Abdulmouti, 2015; Prashar, 2014), the energy sector (Goyal et al., 2019), heating-cooling
systems (Guo et al., 2019), textile industry (Parkhan and Sugarindra, 2018) and the food
industry (Vardhan and Gupta, 2014).
5S is an accomplished, Japanese philosophy for the continuous development of all types
of organisations around the world. 5S comprised five Japanese terms beginning with the
letter “S”: Seiri (sorting), Seiton (set in order), Seiso (sweep), Seiketsu (standardise) and
Shitsuke (sustain):
 Seiri: Eliminating needed tools, parts and instructions from unneeded materials.
 Seiton: Neatly arranging and identifying parts and tools for ease of use.
 Seiso: Cleaning the work area by conducting a clean-up campaign.
 Seiketsu: Standardisation step of 5S, schedules regular cleaning and maintenance.
 Shitsuke: Makes 5S a way of life.

5S was first used in Japan in the manufacturing sector in the mid-1950s (Korkut et al., 2009).
Implementation of 5S ensures CI in housekeeping and results in better environmental and
safety standards (Gupta and Jain, 2014). Benefits derived from implementing a lean 5S
program include improved safety, higher equipment availability, lower defect rates, reduced
costs, increased production agility and flexibility, improved employee morale, better asset
utilization and an enhanced enterprise image for customers, suppliers, employees and
management. When 5S is integrated into the management system, potential benefits from
the implementation increase (Narasimhan, 2009). Residential homes, schools, communities
and workplaces can be improved by 5S activities (Gapp et al., 2008). The implementation
steps, success factors and barriers in the implementation process are also in the foreground
for efficient 5S implementations in the papers of Gupta and Jain (2014) and Randhawa and
Ahuja (2017). The study of Randhawa and Ahuja (2017) presents a comprehensive literature
review on 5S and investigates possible gaps for researchers and practitioners. It highlights
the achievements from the deployment of 5S initiatives, critical barriers and success factors
for the sustainable implementation of 5S. The review paper of Singh et al. (2014) covers the
benefits of 5S implementation and its efficiency in product/service organisations. According
to the paper, 5S is an effective tool for the improvement of organisational performance,
regardless of the type and size of the organisation. Also, it supports the organisation’s
ability to improve performance and productivity. In the case study of Gupta and Jain (2014),
5S and Kaizen rules were implemented in small-scale manufacturing firms. It can be stated
that introducing the 5S and Kaizen principles brings immense changes to organisations by
increasing effectiveness and efficiency in the processes, improving visibility of the
processes, boosting morale and safety of the employees, reducing delays and searching time
and eliminating dangerous conditions. These powerful tools can be implemented in any
IJLSS micro, small, medium or large-scale firm. In the case study of Gupta and Jain (2015), the 5S
14,3 tool has been used to assist a small-scale firm, manufacturing scientific instruments at
Ambala, in which a Cause–Effect diagram had been used for shop floor analysis. Time spent
searching for tools on the shop floor has been reduced from 30 minutes to 5 minutes.
Additionally, the 5S audit score increased from 7 to 55 in 20 weeks. Sidhu et al. (2013) have
used the 5S strategy by Deming PDCA cycle to the improvement of the manufacturing
686 processes in the agriculture industry. The study of Khan et al. (2019) is the first to use the CI
techniques in an interior design company, where they used a Pareto Chart and a Fishbone
Diagram in the Analyse Phase, while Kaizen, 5S and a modified organisation chart have
been used in the Improve Phase. With the successful implementation of the methodology,
project time has been reduced from 16 weeks to 9 weeks, profit margin has increased from
25% to 27% and the sales-win ratio has increased from 11% to 32%. Habitually,
consistently having a clean, tidy and organized workplace has been developed among
workers.

4. Case study
The enterprise, having more than 250 employees, started PPE production during the
outbreak of the COVID-19 pandemic. They operate in the Kocaeli Organised Industrial Zone.
Fabrics with different sizes and weaving properties, which are used in the lower, middle and
upper layers of the surgical masks, are subjected to standardized tests. The wire that helps
grip the nose and elastic ear threads are used as semi-finished products. According to the
customer’s preference, masks are packed in two, three, four or five pieces and then placed
into unit boxes. Packages and unit boxes are considered semi-finished products.
There are three identical machines (M1, M2 and M3) in the surgical mask production line.
A packaging unit is connected to two of these machines. The working time of a machine is
34,560 minutes per month (six days and three shifts). An average of 92 surgical masks are
produced in one minute. When downtimes, changeover times and breaks are taken into
account, the total production for M1 and M3 is around 4,800,000 units per month. Since the
packaging machine has not been assembled on M2, the machine has not been included in the
calculations.
The machine sections are named St.10, St.20, St.30 and St.40, according to the production
stages a mask goes through:
 St.10: Production of the raw mask (without ear floss welding) is completed.
 St.20: Mask is conveyed to the short and long conveyors by the separator.
 St.30: Short conveyor section where ear floss welding is made.
 St.40: Long conveyor section where ear floss is welded.

4.1 Define, measure and analyse phases

In the define, measure and analyse phases, the failure follow-up report, containing the data
between September 2020 and March 2021, has been used. This detailed report, prepared as
an Excel data sheet for the PPE production process, consists of 2,500 lines. It includes failure
definitions, instant solution suggestions and visuals of the failures. Frequent failures cause
disruptions, stoppages and shipping delays. High wastage rates also lead to inefficiencies.
According to this report, the unorganized and unhygienic working environment makes it
difficult to access the necessary equipment and produce under proper conditions.
In the analyse phase, the Pareto Chart and the Fishbone Diagram were used. The Pareto
Chart helps prioritize efforts and focus on the major issues, whereas the Fishbone Diagram
supports isolating the cause of the identified problem (Uluskan and Oda, 2020; Ahmed and Surgical mask
Ahmad, 2011). The Pareto Chart highlights the reasons behind the major quality problems production
and helps management with decision-making (Khan et al., 2019; Hossen et al., 2017). The
Fishbone Diagram is a brainstorming tool used to identify the root causes of the problems. It
is one of the seven basic quality control tools (QC7) developed by Ishikawa, also called the
Cause–Effect Diagram. It can be used to categorize possible causes of a problem and classify
the ideas into useful categories. 687
According to the Pareto Chart in Figure 2, 80% of the inefficiencies are due to yarn
welding, gripper, yarn cutting, wire, edge welding and fishing line (nylon thread).
The primary and secondary causes of the major problems have been determined with the
help of the project team’s brainstorming and direct observation of the PPE production
process. The Fishbone Diagram helped categorise possible causes of the problems and
classify the ideas into useful categories. The possible causes, which constitute the basis of
Kaizen events, have been listed in the form of a Fishbone Diagram and given in Figure 3.

4.2 Improve phase – Kaizen events

In the improve phase, both Kaizen events and 5S implementations have been conducted,
simultaneously. Kaizen studies aim to reduce or eliminate downtimes, wastages and quality
problems. The achievements have been calculated monthly based on average values. Kaizen
events have been discussed under the following headings.
4.2.1 Kaizen for fishing line breakage. The mask is fixed to the machine with the help of
fishing line and a piston. Due to long-term use and various factors arising from the machine,
problems such as weld pressure on the line, line break and coming out of the slot as a result
of the loosening of the line, have been encountered.
As the packaging machine has not been assembled on M2, the ear folding apparatus has
not been assembled accordingly. The ear folding apparatus ensures convenient placement of
the ear floss in the pack. According to the follow-up report data, the total duration of the
stops caused by fishing lines is 387 minutes, on average per month. The average stoppage of
142 minutes is due to the M2 and has been ignored in the calculations.

Figure 2.
Pareto chart for the
surgical mask
production
 14,3

688
IJLSS

Figure 3.

downtime/waste
Fishbone diagram of
Yarn welding Yarn cung Edge welding

Interlining diameter reducon

Deviaon in angle and axis sengs The scissors have
Yarn length lost their funcon Tension of the cloth
Pallet centering
Welding group gear
Insufficient yarn quality and chain failure
Welding of aachment
Scissors
Yarn breakage Scissor sensor
Gliding of interlining
Thread coming off the yarn
Weak welding
Ionizer
Bolt loosening Scissor failure Tearing Welding pressure
Adhesion of wire the welding nozzle
Yarn omission of the gripper
Insufficient interlining quality
Small hole in the edge
Gear wear The sensor does not see the yarn Aached to the edge

downme/
Welding of aachment waste
Tearing
Gripper air Cloth thickness
Welding on the Rupturing
connector failure Wire throwing
nylon thread
Gripper sensor Wire press

Nylon thread coming Short circuit

out the chamber
Insufficient wire quality
Wire winding to
Gripper and half-moon
delivery combinaon
bolt cung
Nylon thread breakage Yarn gripper piston Misprint
and gear breakage
The sensor does not
see the wire

Nylon Thread Gripper Wire

It is expected that the mask will remain stable, without slipping, during mask fixing and ear Surgical mask
floss folding processes. To prevent the mask from slipping during the operations, the fixing production
pistons and fishing lines in St.30 and St.40 sections on Machine 1 and Machine 3 have been
cancelled, and a fixing bar has been mounted on the pallet edges.
Due to the improvements, the stoppages caused by the fishing line have all been
eliminated, while the 41-minute downtime in each of the M1 and M3 (total of 82 min.) has
been saved. During the saved time, 7,544 surgical masks, on average, have been produced,
creating an increase by 0.16% per month (Figure 4).
689
4.2.2 Kaizen for gripper and half-moon bolt cutting. It has been observed that there have
been 57 stoppages due to gripper and half-moon bolt cutting problems (averaging eight
stops per month). The time required to eliminate the downtime is 30 minutes. As a result, it
has been determined that the gripper and half-moon bolt materials are worn earlier than
expected due to their structure. To minimize repetitive downtimes, new gripper and half-
moon pieces made of durable material, which have a longer working life, have been supplied
to be used. Thus, during the application month, 22,080 surgical masks have been produced
in an average downtime of 240 minutes, resulting in a 0.46% monthly increase in the total
mask production (Figure 5).
4.2.3 Kaizen for gear problem. It is known that problems occur at 90-degree turns on
St.30 and St.40. According to the data obtained from the failure follow-up report, it has been
observed that there were 14 stops due to 90-degree rotation failure. It has also been
determined that the primary cause of the 90-degree rotation error is the wear of the gear
group made of steel. The gear group has been replaced with one made of hardened steel
material, to ensure a longer life. Thus, an average of 50-minute stops per machine, repeated

Figure 4.
Kaizen for fishing line
breakage

Figure 5.
Kaizen for gripper
and half-moon bolt
cutting
IJLSS every two months on average, has been eliminated (Figure 6). This corresponds to an
14,3 increase of approximately 0.1% in production.
4.2.4 Kaizen for shock absorber. There have been 51 stops due to piston failure,
according to the relevant data. The main reason for these stops is the air leakage due to the
deformation of the seals in the pistons. For this reason, shock absorbers have been cancelled
in the St.30 and St.40 stages of M1 and M3, and an electric axle with a servo motor has been
690 installed, instead of yarn-pulling pistons. Thus, an average of seven stops and 140 minutes
of downtime per month due to piston failures caused by air leakage and the shock absorber,
have been eliminated (Figure 7) to yield a monthly increase in the production of 12,880 units
(0.27%).
4.2.5 Kaizen for increasing yarn quality. The variation in length and breakage problems
of low-quality yarns, cause yarn weld failure. According to the data, there have been 126
stops caused by the yarn length problem.
As time passes, the length of the yarn shortens in the surgical masks. Customers have
reported complaints of uneven ear floss sizes and ear pain due to the inflexibility of the yarn
during long-term use. Better quality yarn bobbins were supplied as a result of numerous
customer complaints.
The yarn in the new bobbin can stretch from 100 mm to 300 mm. Thus, customer
complaints have been reduced and the scrap rate has decreased by 0.2%. Every month,
54 minutes of losses due to 18 stops have been eliminated, which means an increase of 4,968
units (0.10%).

Figure 6.
Kaizen for gear
problem

Figure 7.
Kaizen for shock
absorber
Downtimes are observed due to the winding error in the yarn bobbins. While the yarn is Surgical mask
moving in the machine, it cannot see the yarn when the sensor coincides with the joint. production
According to the data, it has been observed that there have been 27 stops caused by yarn
breakage. Corrective actions are expected to save 3 minutes per stop. To eliminate this issue,
an 8D form has been created and delivered to the supplier. After the preventive and
corrective actions (Figure 8), a monthly average of four stops and a 12-minute downtime
have been eliminated. Therefore 1,104 surgical masks (an increase of 0.02%) have been
produced during the saved time. 691
After the initial seven months of data (September 2020–March 2021) were examined, the
number of stops found were; fishing line (105), gripper (317), piston (89) and yarn welding
(424). After the Kaizen studies, observations were made for another seven months (May
2021–December 2021). The number of stoppages have been recorded as; fishing line (3),
gripper (250), piston (15) and yard welding (271). The total number of stops have decreased
from 935 to 539 in seven months, which means a decrease of 42.4%.
4.2.6 Kaizen for reducing interlining changeover times. During the interlining change,
the fixing apparatus is opened with an allen wrench, which causes an increase in the
machine’s stops. The use of wing bolts, instead of the allen kit during the changeover, saved
time by reducing labour hours. The changeover, which takes three minutes with the allen
kit, takes 1.5 minutes with the wing (butterfly-shaped) bolt. A decrease of 3,159 minutes and
an increase of 29,0628 products have been recorded per month due to the use of wing bolts,
which means the production increase rate is 6.01% (Figure 9).

Figure 8.
Kaizen for yarn
breakage

Figure 9.
Kaizen for interlining
changeover
IJLSS 4.2.7 Kaizen for reducing wire bobbin changeover times. The existing wire coils used in the
14,3 machines previously ran out every four hours, due to its weight. This caused an increase in
the number of stoppages during the wire changeover. By using a heavier coil, the downtime
was increased from four hours to 12 hours. Thus, a 1.58% increase has been achieved in
production (Figure 10).
4.2.8 Kaizen for yarn changeover without stopping the machine. The yarn coils in the
692 machines were previously changed every two hours. When the yarn in the bobbin was
running out, new thread from another bobbin was tied to the end, to prevent the need to stop
the machine. Thanks to the seamless changeover, a 1.81% increase has been achieved in
production (Figure 11).
After the Kaizen studies, downtime, losses and waste have been reduced or eliminated.
The achievements are listed in Table 2. The results show that a total of 5,502 minutes have
been saved per month (approximately 32.5%), and these savings increased production by
506,344 in total (10.55% increase).

4.3 Improve phase – 5S implementation

5S implementation steps include: classifying the tools and equipment used in the production
line, ensuring the order of the working environment, cleaning the workplace, standardizing
the mentioned works and sustaining discipline.

Figure 10.
Kaizen for wire
bobbin changeover

Figure 11.
Kaizen for yarn
changeover
Step 1-Seiri (Sort): The tools and equipment have been classified according to their Surgical mask
frequency of use, by an algorithm given in Figure 12. As unnecessary materials, tools and production
equipment have not been encountered within the boundaries of the workplace, no red-label
application has been made.
Step 2-Seiton (Set in Order): In this step, the classified materials, tools and equipment
have been properly positioned in the workplace. A desk has been designated for this area to
provide ergonomic conditions and labour time savings (Figure 13).
693

Kaizen studies for Time saved Production increase

Fishing line 82 min per month 7,544 units (0.16%)

Gripper 240 min per month 22,080 units (0.46%)
Gear 50 min per month 4,600 units (0.1%)
Shock absorber 140 min per month 12,880 units (0.27%)
Yarn quality 54 min per month 4,968 units (0.10%)
Winding failure 12 min per month 1,104 units (0.02%)
Interlining changeover 3,159 min per month 290,628 units (6.01%)
Wire bobbin changeover 820 min per month 75,740 units (1.58%) Table 2.
Yarn changeover 945 min per month 86,800 units (1.81%) Achievements of
TOTAL SAVING 5,502 min per month (decrease by 32.5%) 506,344 units (increase by10.55%) Kaizen studies

Figure 12.
Algorithm for Seiri
and Seiton

Figure 13.
The workplace of the
mask production
IJLSS The achievements of the new design are summarized below:
14,3  Masks are grouped into the categories of scrap/reject, rework and accept to
eliminate confusion.
 Clean products have been produced by preventing the unit boxes from falling onto
the ground.
 Easy access to unit boxes has been provided.
694
 The workplace has been cleared of parcels and organised properly.

Equipment such as scissors, wing bolts and allen kits, which are frequently used in
interlining and wire changeover, are not currently kept in a fixed place. Searching for these
tools during the change, leads to wasted time. Also, the loss of equipment in the workplace
brings additional costs.
Commonly used tools such as wing bolts, allen kits and scissors have been provided and
positioned close to the working area of the machines. Thus, employees have easy access to
tools, time is saved and the cost is reduced (Figure 14).
It has been observed that employees in the workplace may be exposed to various risks.
By Occupational Health and Safety (OHS) rules, protective covers have been fixed to the
machines (Plate 1) to ensure their safety and to prevent and/or minimize accidents in the
workplace.
The loss of spare parts and equipment used in the machines, searching for lost
equipment and the use of improper parts during production, caused over-movement and

Figure 14.
Arrangement of the
tools and equipment

Plate 1.
Protective covers
loss of time. Spare parts and equipment have been properly labelled to prevent over- Surgical mask
movement and loss of time. The spare-parts cabinet has been arranged (Plate 2). production
In a disorderly manner, disinfectants, surface cleaners and other cleaning materials used
for cleaning the machinery, have been scattered in the workplace. In order to organize all of
the materials, a cabinet with suitable storage has been ordered. Considering the pandemic
conditions, garment covers have been provided for the employees to keep their aprons clean.
The employee name tags on the garment covers have been prepared and affixed by 5S. To
provide easy access to the aprons and to prevent a mess in the closet, the garment covers
695
have been placed according to shifts. The glove boxes used by the employees were divided
into S, M and L categories.
Out of the unit boxes in which the masks are placed, the ones with defects are collected in
a container to be sent back to the supplier. It has been determined that the container will be
placed in front of the machine’s control and energy panels. The front face of the control and
energy panel of the machine has been cleaned out for troubleshooting, and the employees
have been informed about the issue (Figure 15).
When 12 boxes are completed, they are stretched and transported to the finished product
stock area on a pallet. Each of the pallets are left in an empty area to be used again in
production. It is necessary to determine the most convenient area for free pallets, to save
time. The pallets have been positioned close to the exit door to reduce unnecessary
transportation and over-movement. Necessary precautions have been taken to ensure that
the loaded pallets do not pose a danger to the employees on the transit route.
The wastages generated during production were not disposed of in proper recycling bins.
A board has been placed above the bins to ensure the proper classification of waste.
Recycling wastes, within the scope of the zero waste philosophy, will contribute to the

Plate 2.
The organized spare
parts cabinet

Figure 15.
Arrangement for the
front of machine
control and energy
panels
IJLSS reduction of environmental risks and the development of environmental protection
14,3 awareness (Figure 16).
Step 3-Seiso (Shine): It is known that a dirty workplace causes machine failures, defects,
inefficiencies and work accidents. Within the scope of Seiso, it has been planned that the
cleaning of the machines should be done by the workers specifically working on the
machines, while the cleaning of the working area will be done by the cleaning personnel on
696 Sundays. In addition, the working area will be cleaned daily by the workers in the area.
The last two steps (standardisation and sustain) of 5S implementation will be discussed
in the “Control Phase” of the project.

4.4 Control phase

After the project is completed, it is important to ensure the permanence of the improvement
work by preventing employees from returning to old habits. In the Control Phase of Kaizen
studies, Radar Charts are frequently used for visual monitoring of the improvement efforts
(Prasad et al., 2020). On the other hand, hypothesis tests are widely used statistical tools that
can be used as an alternative to Radar Charts in the Control Phase of lean applications
(Vinodh et al., 2011). In this project, a Two-sample T-test was used to test the difference in
means for the production amounts and the number of stops before and after the
improvement efforts. Furthermore, the significance of the improvement studies is proven
statistically. The fourth and fifth steps of 5S applications (standardise and sustain) are also
discussed in the Control Phase.
The activities in the Control Phase are listed in this section, via the last two steps of 5S
(standardise and sustain) and Kaizen achievements:
4.4.1 Control phase of 5S studies (hypothesis tests). Seiketsu (Standardise) aims to
preserve the previous steps by combining them in a holistic approach. For 5S practices to
become daily habits, all employees should be informed on the subject. If necessary, training
on this subject should be organised. In addition, documents such as instructions, workflows,
procedures and checklists should be kept up-to-date for the standardisation of the work.
Relevant documents will contribute significantly to smoother, new-employee orientation
and training for workers in mask production. The studies for the mask production line
should be spread throughout the firm and standardisation activities should be continued.
However, despite all these efforts, some employees may return to their old habits after a
while. For 5S practices to permanently ensure sustainability, the last step, Shitsuke
(Sustain), should be applied. For this purpose, internal audits should be planned and an
effective reward system should be implemented.
4.4.2 Control phase of Kaizen studies (hypothesis tests). The significance of the
improvements has been proven statistically with the help of hypothesis tests. The differences

Figure 16.
Boards prepared for
recycling bins
between both the average production quantities and the average number of stops, were tested Surgical mask
with two separate two-sample t-tests for the situation before and after the improvement. The production
results have been provided in Tables 3 and 4.
The company works in three shifts per day, six days a week. m1 represents the average
production amount for the seven months after Kaizen applications (data from 126 shifts
between May 2021 and December 2021) while m2 represents the average production amount
for the seven months before Kaizen applications (data from 126 shifts between
September 2020 and March 2021). According to Table 3, it can be stated that there is a 697
statistically significant increase in the amount of production at the 5% significance level
(p-value < 0.05).
In Table 4, m1 represents the average number of stoppages per month after the Kaizen
implementation while m2 represents the average number of stoppages per month before the
Kaizen implementation. According to the results in Table 4, there was a significant decrease
in the average number of monthly stoppages for fishing line, gripper, piston and yarn
welding after Kaizen studies (p-value < 0.05).

5. Limitations and agenda for future studies

This study has only examined one textile company that produces PPE products. The data
covers the seven-month period during which the project was carried out, and the seven
months after the improvement. The data for the first seven months has been obtained from
the follow-up report, and it has been understood to contain correct, unbiased information.
Hence, the results and findings of this study cannot be generalised to other industries and
sectors. These issues constitute the limits of the study.
Accurate and proper implementation of lean may be limited because of high
implementation costs. Developing and using a valid lean assessment tool will be helpful for
lean practitioners to understand where to focus to improve lean practices (Pakdil et al., 2018).
Especially in SMEs, where resources are limited and the process is highly affected by the
human factor, monitoring the improvement works with the help of lean practices and
statistical tools. It is extremely important in terms of effective use of labour, material and
energy resources. Although lean practices and other statistical tools are used in this

H0: m1 m2 =0
Ha: m1 m2 >0
Sample N Mean SD SE mean

1 126 73,500 3,500 312

2 126 66,700 2,500 223
Table 3.
Notes: Difference = m (1) m (2); Estimate for difference: 6,800; 95% lower bound for difference: 6,167; Two-sample t-test for
t-test of difference = 0 (vs >): t-value = 17,75; p-value = 0.000; DF = 250; Both use Pooled StDev = 3,041.3813 the production units

The source of failure Hypothesis T-value p-value Decision

Fishing line 12.22 0.000 H0 is rejected Table 4.

Gripper H0: m1 m2=0 4.05 0.001 H0 is rejected Two-sample t-test for
Piston Ha: m1 m2 <0 8.41 0.000 H0 is rejected the number of
Yarn welding 15.79 0.000 H0 is rejected stoppages
IJLSS research, a more comprehensive study integrating LM and LSS techniques in the PPE
14,3 production lines of this textile SME, will be beneficial in the long run.
The lean concept could be implemented throughout the textile supply chain from
purchasing and material acceptance, to the end customer. In recent years, it has been
observed that OHS-oriented CI studies have gained importance and the use of OHS-oriented
structure is also recommended for researchers in lean applications in the textile and PPE
698 industries. Digitalization studies have not started in textile SMEs in Turkey. However, with
the developing technology and digitalization, big data integration in lean applications is
recommended as a further research direction. For environmental sustainability, which gains
importance with the Green Deal, green deployment of LSS and LM is another important
research direction for the textile SMEs and PPE industry.

6. Conclusion
Public health and OHS of employees have regained importance during the COVID-19
pandemic. To reduce the risk of contamination of health labour and the public, it is critical to
quickly bring high quality PPE to market. In the manufacturing industry where mass
production, high waste rates and time loss is frequent, lean tools such as Kaizen and 5S were
developed to increase quality and find solutions for the problems of enterprises. Although
these are used in SMEs in various sectors, their use in textile SMEs is relatively rare. In the
current literature, lean processes have not been used in the PPE industry. To close this gap,
a comprehensive case study has been presented by discussing the mask production process
in a textile SME in Turkey.
The case has been handled as a project. In the define and measure phases, priority
problems and their causes were analysed. In the improve phase, with the use of 5S and
Kaizen studies, stoppages and delays in production have been reduced, while quality has
been improved by reducing scraps, rejects and customer complaints. Moreover, lost time
and waste arising from over-movement have been prevented. The efficiency of the
production line has been increased due to the establishment of a clean and safe workplace.
After the Kaizen studies, hypothesis tests have been used to determine whether there has
been a significant increase in the volume of production and a significant decrease in the
stoppages. Improvements made included: mounting a fixing bar on the pallet edges, durable
piston supply, hardened steel material in the gear group, removal of shock absorbers,
installation of servo motor electric axles instead of yarn pulling pistons, supply of new yarn
bobbins with improved quality, changing the interlining with wing bolts, use of a heavier
coil of wire and changing the yarn bobbin without stopping the machine. Instead of using
visual monitoring tools when measuring improvement efforts, the significant improvement
increases have been tested and approved statistically with the help of proper hypothesis
tests.
The results indicate that there has been an increase in production and a decrease in the
number of stoppages at the 5% significance level. The total number of stoppages due to
problems with fishing line, gripper, piston and yarn welding has decreased by
approximately 42.4%. As a result of eliminating loss times and reducing changeover times,
a total of 5,502 minutes have been saved per month. Overall, this lead to the creation of an
additional 506,184 units, or an increase of around 10.55%.
Implications for the practitioners in the current PPE process are summarized as follows:
The problems’ root causes can be investigated more reliably by designing a decision support
system in which the failure type, frequency, number of stops and durations are kept in a
database on a machine basis. The difference between the number of failures and stops per
machine can be investigated by using techniques such as Analysis of Variance.
 Vital issues for the sustainability of improvement studies include: a landmark in the Surgical mask
workplace, determination of the collection area, forming a pollution map and settlement production
plan, preparation of the 5S board and designing control forms. Labels by 5S should be
prepared for the cleaning materials. A checklist should be created for cleaning materials,
which should always be visible in the cleaning cabinet. Highly visible instructions should be
prepared to facilitate the adaptation of the production process for the employees. Necessary
ergonomic arrangements should be made within the framework of OHS rules. The
employees and managers are enthusiastic about improving work. Encouraging employees
699
to offer their suggestions has increased their motivation. Awareness of increased employee
motivation should be disseminated to further produce a positive atmosphere in the mask
production process throughout the firm.
The following implications are current concerns for researchers: The use of lean tools by
enterprises operating in the textile and PPE sectors is critical for increasing competitiveness
and achieving successful results. The methods and techniques in this case are not only used
in textile firms, but in a variety of different companies. With lean tools, instead of an
organization where waste is reduced and efficiency is increased only by reducing failures or
downtimes, it is possible to create an organization that has a structure that continuously
learns and improves itself. Many SME textile and PPE firms in Turkey need to enhance
their awareness of lean tools. LSS implementations will trigger a positive wave and increase
competitiveness across the textile sector. Textile firms experience high variations in their
processes, which leads to quality issues. Therefore, there is a wide scope for the
implementation of SS and LSS. Efforts should be made to reduce setup time, processing
time, production flow time and defects per unit production values by using the strength of
integrated LM and LSS. To reduce defect rates, the process should be followed using
statistical methods. An increase in first-time efficiency and overall equipment efficiency
should be targeted. With the usage of VSM, SMED, Andon, Poka-Yoke and TPM, effective
and sustainable results can be achieved. Due to the high costs of running textile machinery,
lean tools should primarily focus on cost reduction issues.
All studies should be carried out in a discipline with the support of senior management and
experts in their fields. It should be agreed upon that the corporate culture should be changed
throughout the entire organisation. According to the research, incompetent teams, inadequate
training and learning and poor communication are the most important causes for project
failures in developing countries, with a more collective profile. Developing the corporate culture
in a way that eliminates the causes of failure, will increase the percentage of success in projects.

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Further reading
ASQ-American Society of Quality (2022), “What are the five S’s of lean”, available at: https://asq.org/
quality-resources/lean/five-s-tutorial (accessed 23 January 2022).

Corresponding author
Ezgi Aktar Demirtas can be contacted at: eaktar@ogu.edu.tr

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