Abstract

Lean Manufacturing Implementation Initiatives

by

University, 2011

University, 2000

Doctoral Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Business Administration

University

[last month of quarter you plan to graduate] 201X

Abstract

Use the following guidelines when writing the abstract. Begin with a wow statement

illuminating the problem under study. Identify the design (case study, phenomenological,

quasi-experimental, correlation) Note: Do not mention the method

(qualitative/quantitative) in the abstract. Identify the study population and geographical

location. Identify the theoretical (quantitative) or conceptual framework (qualitative) that

grounded the study; in APA style, theory/conceptual framework names are lower case.

Describe the data collection process (e.g., interviews, surveys, questionnaires). Describe

the data analysis process (e.g., modified van Kaam method to identify themes in

qualitative studies or t test, ANOVA, or multiple regression in quantitative studies). Do

not mention software used. Identify two or three themes that morphed from the study

(qualitative). Present the statistical results for each research question (quantitative

studies). Describe how these data may contribute to social change (use the word social

change and identify who specifically may benefit). Ensure the first line in the abstract is

not indented. Ensure abstract does not exceed one page. Use plural verbs with data (e.g.,

the data were). Write all numbers as digits (i.e., 1, 2, 10, 20) and not spelled out unless at

the beginning of a sentence. Add an abbreviation in parentheses after spelling out a term

in full only if the abbreviation is used again in the abstract.

Lean Manufacturing Implementation Initiatives

by

University, 2011

University, 2000

Doctoral Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Business Administration

University

[last month of quarter you plan to graduate] 201X

Dedication

I want to dedicate this study to the workers of corporate America who slave

tirelessly to improve working conditions. To my co-workers and subordinates that

supported all of my efforts to make work an effortless thought, and a pleasurable place to

come to.

Acknowledgments

To my family and friends that supported me until I completed my doctorate, thank

you all. A special thanks to my children, Asia Hughes and Max Edwards. I hope I have

paved a path that you both will far exceed beyond my wildest dreams, just know that you

can accomplish your hearts desires. To my fiancé Heith Williams, thank you for all you

have done to lighten my load, the gratitude, and support given far exceeds my

expectations. I want to thank my parents Hazel W. Ulmer, Francis M. Ulmer, Reno L.

Wells, and Gerrard H. Davis (deceased) for believing in me, without you there would be

no me. To my creator, God, my Lord, and Savior Jesus Christ I want to thank you

because I am wonderfully made.

To my all of my colleagues, professors, administrators, and chairperson’s thank

you for your support, encouragement, patience, and understanding while on this journey.

Indebted thanks to my chair representative Dr. G. Velkova, I could not have completed

this without your guidance and support. I love you all!

Table of Contents

List of Tables......................................................................................................................

List of Figures......................................................................................................................

Section 1: Foundation of the Study......................................................................................

Background of the Problem...........................................................................................

Problem Statement.........................................................................................................

Purpose Statement..........................................................................................................

Nature of the Study........................................................................................................

Research Question (Quantitative Only).........................................................................

Research Question (Qualitative Only)...........................................................................

Interview Questions (Qualitative Only).........................................................................

Hypotheses (Quantitative/Mixed Method Only)...........................................................

Theoretical or Conceptual Framework..........................................................................

Operational Definitions..................................................................................................

Assumptions, Limitations, and Delimitations................................................................

Assumptions............................................................................................................

Limitations...............................................................................................................

Delimitations............................................................................................................

Significance of the Study...............................................................................................

Contribution to Business Practice (Heading Optional)...........................................

Implications for Social Change (Heading Optional)...............................................

A Review of the Professional and Academic Literature................................................

i

Transition.......................................................................................................................

Section 2: The Project........................................................................................................

Purpose Statement........................................................................................................

Role of the Researcher.................................................................................................

Participants...................................................................................................................

Research Method and Design......................................................................................

Research Method...................................................................................................

Research Design....................................................................................................

Population and Sampling (Quantitative Only).............................................................

Population and Sampling (Qualitative Only)...............................................................

Ethical Research...........................................................................................................

Data Collection Instruments (Quantitative Only)........................................................

Data Collection Instruments (Qualitative Only)..........................................................

Data Collection Technique..........................................................................................

Data Organization Technique (Qualitative Only)........................................................

Data Analysis (Quantitative Only)...............................................................................

Data Analysis (Qualitative Only).................................................................................

Study Validity (Quantitative Only)..............................................................................

Reliability and Validity (Qualitative Only).................................................................

Reliability..............................................................................................................

Validity..................................................................................................................

Transition and Summary..............................................................................................

ii

Section 3: Application to Professional Practice and Implications for Change..................

Introduction..................................................................................................................

Presentation of the Findings (Quantitative Only)........................................................

Presentation of the Findings (Qualitative Only)..........................................................

Applications to Professional Practice..........................................................................

Implications for Social Change....................................................................................

Recommendations for Action......................................................................................

Recommendations for Further Research......................................................................

Reflections...................................................................................................................

Summary and Study Conclusions................................................................................

References..........................................................................................................................

Appendix A: Title of Appendix.........................................................................................

iii

List of Tables

Table 1. A Sample Table Showing Correct Formatting......................................................9

When you update the List of Tables, the table number and title will come in

without a period between them; you will need to manually add that period after all table

numbers, as shown for Table 1. In addition, the title will retain the italics from the

narrative when the List of Tables is updated. Once your list is finalized, select the entire

list, and change it to plain type.

Note that tables are numbered in sequence beginning with 1. Do not number

tables according to the section in which they appear (Table 4-1, 5-2, etc.) In the List of

Tables, table numbers are followed by a period, not a colon or a dash. This applies to

figure numbers in the List of Figures as well.

iv

List of Figures

Figure 1. Figure caption, sentence case.............................................................................xx

The List of Figures is not set up to automatically update. If you have figures in

your document, type them in manually here, following the example above.

Alternately, follow the instructions in the Instructions for Using the Walden DBA

Template, which will allow automatic updating of the List of Figures.

v

1

Section 1: Foundation of the Study

Lean manufacturing originated with the Toyota Production System (TPS)

(Kosuge, 2014). The birth of lean manufacturing was attributed to Japan in the 1940s,

later becoming known as the TPS in the 1950s (Djekic, Zivanovic, Dragojlovic, &

Dragovic, 2014). The purpose of the lean manufacturing process is to produce products at

the time they are needed, in the quantities necessary to appease demand without

exceeding that demand, thus eliminating excess product inventories (Djekic et al, 2014).

According to Brecht (2012), lean manufacturing has become a way of life in

manufacturing organizations. The use of sustainable resources, including renewable

energy, and the increasing demand for materials has caused global production activities

to grow (Alam & Kabir, 2013). Sustainable development has become an essential part of

almost every company’s corporate policy, making lean manufacturing a part of many

organizational sustainable development plans (Brecht, 2012).

Background of the Problem

Lean manufacturing has been applied in many areas of manufacturing, and even

some areas of service delivery; yet in certain areas of industry, challenges still remain

(Brecht, 2012; Hong, James, & Rawski, 2012). One of these areas is within the field of

surgical tools. While lean principles have been applied with some success within the

operating room, the ability to apply such principles to the surgical tools themselves has

not always been met with success (Blackmore, Bishop, Luker, & Williams, 2013;

Farrokhi, Gunther, Williams, & Blackmore, 2013; Matos, Alves, & Tereso, 2016; Toro,

Patel, Lytle, Sweeney, Medbery…& Sarmiento et al., 2015). Sterile instrument

2

processing has worked to further such practices, decreasing the amount of available tools

necessary to have on hand, but due to the complications that may arise during a surgical

procedure, additional tools must still be on hand to combat potential concerns

(Blackmore et al., 2013). Research indicates that if the appropriate process of application

may be found, lean manufacturing will prove a boon to the surgical field as well (Hagg,

Suskovich, Workman-Germann, Scachitti, & Hudson, 2007). Lean instrument

intervention has allowed for a reduction in the number of instruments necessary for the

completion of many surgical procedures, but while these practices reduce the overall

amount of tools in use, they do not reduce the amount of each of those tools necessary for

the hospital to have on hand (Farrokhi et al., 2013). While the advent of 3D printing has

worked to increase the likelihood of lean manufacturing as applied to surgical

instruments, and has worked to decrease the overall cost associated with instruments, not

all supply companies are using this technology, which is still relatively new, and while

decreasing in price, is still moderately expensive (3D Medical Manufacturing, 2016). In

spite of such situations, some organizations are flourishing with the application of lean

manufacturing to surgical instruments, while others are failing due to decreases in profits

and a need to return to previous numbers on the budget sheet. Due to the recent

expansion of lean manufacturing into this area, there is limited research available on such

experiences, particularly in regard to the reasons that such initatives succeed or fail.

Problem Statement

The problem that this study seeks to address is the manner in which lean

manufacturing can be applied within the realm of surgical tools in such a way as to allow

3

for the maintenance of such initiatives without a decrease in profit. The challenge for

leaders of surgical product businesses is sustaining lean manufacturing initiatives after

initial implementation (Hong, James, & Rawski, 2012). Only 2%-3% of worldwide

manufacturers have successfully achieved their lean manufacturing initiative objectives

(Sisson & Elshennawy, 2015). The general business problem is when lean manufacturing

initiatives fail there is decreased profitability. The specific business problem is that some

manufacturing leaders of surgical products lack strategies to implement lean

manufacturing initiatives to increase profitability.

Purpose Statement

The purpose of this proposed qualitative single subject case study is to explore

some of the different strategies that leaders within the surgical product businesses in

South Florida have used to implement lean manufacturing initiatives for the purpose of

increasing profitability. The target population will be leaders from within a surgical

product manufacturing organization located in south Florida selected as a result of the

fact that they have successfully implemented lean manufacturing strategies within their

organization and have increased their overall levels of profitability. Data from this study

may contribute to social change by sharing the strategies leaders of surgical product

businesses in South Florida, allowing a more widespread application of such practices.

Nature of the Study

A qualitative research method was selected for this study in order to be able to

explore the strategies surgical product business leaders in South Florida have

implemented in order to increase the profitability of their organizations. The qualitative

4

methodology is ideal for this type of exploration as researchers often use a qualitative

research method to study real world settings (Yin, 2014). The application of the same will

provide additional insight on how businesses operate, while ensuring that the manner in

which such strategies may be applied successfully is explored in depth. Yin (2014),

suggested qualitative researchers might use a case study to explore a single case, a

process, a program, an activity, an event, or a case bounded by time and place. In

comparison, quantitative studies involve gathering a range of numeric data (Stoudt,

2014). In quantitative studies, researchers test preconceived hypotheses (Bishop &

Lexchin, 2013; Frels & Onwuegbuzie, 2013). As the purpose of this study is to explore

the applied strategies as related to lean manufacturing in the field of surgical instruments,

a qualitative study would, while providing fiscal data, not be sufficient toward

determining the reasons for the success of the strategy or understanding how those

strategies are applied within an organization. A mixed method study points to the desire

to link or integrate quantitative and qualitative data (Padgett, 2012). If the purpose of this

study was to explore the specific means through which the applied strategies had shown

the greatest improvements in terms of the metrics of the organization, a mixed

methodology study would be ideal. This is not, however, the purpose of the study and

quantitative data is not the ideal form of data for the collection of the sought after

information. Likewise, there are no variables to compare, or desire to integrate variables;

therefore, a quantitative method does not suffice.

The four main designs in qualitative research are phenomenology, ethnography,

grounded theory, and case study (Thomas & Stew, 2012). Phenomenology may involve

5

reviewing written statements and drawings by participants based on individual

experiences of a phenomenon (Hycer, 1995; Moustakes 1994). For this study, interviews

with participants, and written statements or drawings are not suitable. An ethnography

depicts the social sciences for a group who relate to one another maintaining a constant

theme (Malinowski, 2014). As themes within society are not being searched for, this

design is not ideal either. Grounded theory allows for alteration of research in the field

and flexibility, making this method best suitable for action research (Liska-Belgrave,

2014). Therefore, grounded theory is not appropriate when conducting interviews. The

case study method is suitable for studies where the researcher’s goal is to explore a given

construct within a specific context in an in depth manner by collecting data from various

sources (Yin, 2014). It is ideally suited for the type of information necessary to explore

the identified problem. A qualitative case study is suitable based upon the desire to obtain

an in depth understanding of the strategies some leaders within the field of surgical

products use to increase profitability. Utilizing a single case study design meets the need

of the study based upon the research question.

Research Question

The research question identified for resolution within the context of this study is:

What strategies do leaders of surgical product businesses in South Florida use to

implement lean manufacturing initiatives to increase profitability?

Interview Questions

The interview technique is a data collection technique available to qualitative

researchers (Yin, 2014). When utilizing this technique for data collection, qualitative

6

researchers develop a set of questions designed to illicit targeted responses from study

participants. Question 1 is an inquiry question, Questions 2-7 are sub-questions that

support the central question, and Question 8 is a conclusive question.

Interview Questions

1. What strategies do you use to implement lean manufacturing initiatives to

increase profitability?

2. What lean manufacturing initiative has had the most impact when it comes to

increasing profitability?

3. How do your lean manufacturing initiatives tie into other profitability initiatives?

4. What is your long-term strategy regarding lean manufacturing?

5. What are you current initiatives in lean manufacturing?

6. Please describe the processes that enhance or hinder the success of lean

manufacturing initiatives post initial implementation within your organization.

7. What are the challenges, if any, that occurred during the implementation of lean

initiatives in your organization, and how did/ do you overcome them?

8. How does lean manufacturing fit into your comprehensive long-term

manufacturing strategy?

Conceptual Framework

Systems theory evolved in the early 1900s, with the application of principles

stemming from and originating in the works of a noted philosopher, von Bertalanffy

(1972). This theory addressed three main aspects: scientific exploration, problems in

7

modern technology, and reorientation of worldview (von Bertalanffy, 1972). Hamersly

and Land (2015) used von Betalanffy’s general systems theory for their project

management frameworks and decomposition model of business processes. The

conceptual framework for this study is general systems theory. The conceptual

framework is the view in which the context of the research is understood (Galea, 2012).

Araújo, Sanches, Júnior, and Gomes (2015) stated general systems theory is as an

interdisciplinary theory within a current position. In order to better understand the role of

leadership in the implementation of lean manufacturing initiatives, it was necessary to

employ the use of general systems theory. Challenges may arise as a result of the manner

in which surgical supply leaders implement initiatives; systems theory allows for an

exploration of this concern as leaders have to implement many different strategies to

sustain profitability.

Operational Definitions

Some unfamiliar terms appear in the discussion of implementing lean

manufacturing initiatives. In the context of manufacturing environment, several terms

occur, and these terms are defined in alphabetical order to articulate and animate them.

5-S. 5-S is a workplace organization tool used in lean manufacturing. This is an

approach that may be applied in order to drive improvements in all areas of business. It is

an acronym for sort, set in order, shine, standardize, and sustain (Samuel, 2010).

Implementation. Implementation is defined as the process or road map, by which

an organization works to tackle improvement areas in order to bridge gaps between the

existing state and the proposed state of a manufacturing firm (Singh & Sharma, 2009).

8

Initiatives. Management initiatives such as Six Sigma, total quality management,

and lean manufacturing have the objective of increasing quality-productivity in the

processes of the organization through improvement projects (Vicencio-Ortiz & Kolarik,

2012).

Lean manufacturing. Lean manufacturing refers to the use of lean operations in

manufacturing, and is characterized by the elimination of obvious wastes occurring in the

manufacturing process, resulting in a facilitation of cost reduction (Vinodh & Chintha,

2011).

Non-value added. Non-value added is a term that is used to describe the

inefficiencies present within the manufacturing process; it may be used to describe

situations such as those incurred through the application of extra motion, or time spent

searching for data, information, or tools (Kattman, Corbin, Moore, & Walsh, 2012).

Six sigma. The Six Sigma model is a model of lean manufacturing that provides

various kinds of sustainability to companies in terms of quality enhancement, market

share enhancement, zero defect level, optimal production level and financial returns

(AlSagheer, 2011).

Sustainability. The concept of sustainability relates to the maintenance and

enhancement of environmental, social, and economic resources, in order to meet the

needs of current and future generations (Marosevic & Drvenkar, 2012).

Workplace. A workplace is a physical location or facility within which

professional activities take place and corporations pursue their profits (Lipton, 2011).

9

Assumptions, Limitations, and Delimitations

What follows is a discussion of the assumptions, limitations, and delimitations of

this study. Assumptions are facts researchers assume are true, but cannot verify (Fisher &

Stenner, 2011). Limitations are circumstances out of the researcher’s control.

Delimitations are the boundaries for set for the study by the researcher, referring to the

aspects that are in the control of the researcher.

Assumptions

Fisher and Stenner (2011) noted that assumptions are facts researchers assume to

be true, but cannot verify. The qualitative case study approach provides a means to

explore participants’ experiences, and to create new ideas and confirm assumptions

regarding communication strategies, consumer behavior, and policy instruments (Judson

& Maller, 2014). For this case study, three primary assumptions are present. The first

assumption is that the use of in-depth interviews as a data collection technique will

enable the researcher to collect rich and detailed data that will foster an understanding of

the strategies that some leaders within the field of surgical products use to implement

lean manufacturing initiatives with the result of increased profitability. The second

assumption is that the participants would provide open and honest responses to the

interview questions. Finally, the researcher assumed that participant responses to the

interview questions and the secondary data would provide enough information to answer

the research question in this study.

10

Limitations

Mitchell and Jolley (2010) noted that limitations are potential weaknesses that

have the potential to adversely affect a study. There are five limitations for this case

study. The first limitation is that only leaders of surgical supply companies are the

participants. Connelly (2013) stated that a selected number of interview participants

imposes the risk of not having diversification in perspectives. The second limitation is the

small sample size. Interviewing only a limited number of participants affects the depth

and breadth of the study results and has the potential to reduce the study’s overall

generalizability. The third limitation is researcher bias, which, according to Shepperd

(2015) can arise when selecting members that are more likely to generate desired results.

The fourth limitation is found in the determination of the trustworthiness of participant

responses.

Delimitations

Delimitations are restrictions or boundaries imposed by the researcher (Mitchell

& Jolley, 2010). According to Yin (2014), researchers conduct qualitative case studies to

identify a particular context in case study descriptions. The study population of business

leaders, sample size, and location are delimitations (Yin, 2014). The participants in this

study will be only leaders of medical product companies in South Florida with 1-2 years

of experience in manufacturing. Leaders of surgical supply companies located outside of

South Florida will be excluded from this research. Due to the limited time allocated for

the completion of this study, a single case study is appropriate for use to explore the

strategies that some leaders of surgical product businesses utilize to implement lean

11

manufacturing initiatives within their organizations for the purpose of increasing

profitability. A single case study is best for this research study due to limited time and

resources.

Significance of the Study

Some leaders of surgical supply products possess the ability to apply strategies to

increase the profitability of their manufacturing businesses using lean manufacturing

initiatives. Yet more than 90% of lean manufacturing initiatives fail in the world market

(Vienazindiene & Ciarniene, 2013). The beneficial strategies that contribute to the

applied success of lean manufacturing in surgical product business profitability in South

Florida are unknown. The challenge for business leaders is sustaining lean manufacturing

initiatives after the initial implementation, with the ability to do so in a manner that

increases profitability much more difficult than that (Hong, James, & Rawski, 2012).

This study may identify areas of improvement for the original implementation of lean

manufacturing within this field, allowing for increased profitability after that.

Contribution to Business Practice

The results from this study might afford some leaders within the field of surgical

products the businesses strategies necessary to implement lean manufacturing initiatives

and to ultimately increase profitability. Lean manufacturing, when appropriately applied,

has the ability to improve the manufacturing industry economy, financially, and socially

(Hadid & Afshin Mansouri, 2014). Lean manufacturing initiatives account for more than

50% of efficiency gains for organizations and provide both waste minimization and

increased profitability (Al-Ashraf & Rahani, 2012; Upadhye, Deshmukh, & Suresh,

12

2010). However, less than 10% of the businesses that implement lean manufacturing

processes achieve significant results (Vienazindiene & Ciarniene, 2013).

Christensen and Rymaszewska (2016) noted that business leaders implement lean

manufacturing initiatives in order to increase the profitability of an organization. Yet it is

not only important to work to increase the overall profitability of an organization, it is

also necessary, particularly in today’s day and age, to ensure increased sustainability

(Longoni & Cagliano, 2015). For these reasons, the results of this study could contribute

to an increased awareness of the manner in which these two areas, lean manufacturing

and sustainability, may converge, providing benefits to those organizations who use them

and ultimately allowing for increased organizational profitability. Lean initiatives support

companies by identifying areas of improvement, including (a) administrative functions,

(b) service, (c) sales, (d) production, (e) shipping, (f) quality, and (g) maintenance; such

improvements can work to not only increase profitability through the reduction of

expense but may also work to increase overall sustainability of resources.

The findings from this study may also provide business leaders with insights and

solutions as to the most effective means through which lean initiatives may be

implemented toward the maximization of business output, increasing profitability in that

regard as well. Additionally, data from this study might provide business leaders with an

understanding of the foundational knowledge necessary to implement and monitor lean

manufacturing initiatives toward the purpose of improving their application within the

field of surgical products and ultimately allowing for increased profitability within that

arena.

13

Implications for Social Change

Business leaders can become socially responsible through the application of lean

manufacturing techniques to monitor production performance (Sledge, 2015). Al-Asharf

and Rahani (2012) stated that the implications of social responsibility for positive social

change included the elimination of non-value added activities, an attribute of lean

manufacturing initiatives. The results from this study may contribute to positive social

change by increasing the knowledge of business leaders about lean manufacturing

initiatives as the initiatives relate to the various aspects of the manufacturing process

toward targeted specific applications within the manufacturing of surgical products,

contributing to success in this regard and ultimately leading to increased profitability.

Researchers have identified the unique role of lean manufacturing initiatives and

their ability to efficiently contribute to the achievement of sustainable development goals

(Konda, Starc, & Rodica, 2015). One aspect of this research is to enlighten business

leaders, manufacturing workers, and the community on sustainable growth as an

important phenomenon in today's real economy. Through the application of the

information gleaned as a result of this study, others within the surgical product field in

the manufacturing industry may be able to not only increase their overall levels of

profitability, but may also be able to work to decrease their overall carbon footprint,

minimize waste, and increase the overall platform of sustainability within their

organizations. Establishing the development of positive social change includes

minimizing waste, conserving resources, and implementing sustainable growth

14

initiatives, help to conserve communities, all of which can ultimately lead to increased

profitability for an organization (Viterna & Robertson, 2015).

A Review of the Professional and Academic Literature

The purpose of this proposed qualitative single subject case study is to explore the

strategies that some leaders of surgical product businesses in South Florida have used to

implement lean manufacturing initiatives within their organizations to increase their

overall profitability. The research question asked by this study is: “What strategies do

leaders of surgical product businesses in South Florida use to implement lean

manufacturing initiatives to increase profitability?” This research subject is important to

this researcher, as this researcher believes that the future of the economy relies on

sustainable solutions.

Lean Manufacturing Initiatives

Lean manufacturing is one initiative that many manufacturing plants have

attempted to adopt in order to remain competitive in an increasingly competitive global

market (Al-Ashraf & Rahani, 2012). The focus of lean manufacturing is on cost reduction

through the elimination of non-value added activities, allowing for the creation of a value

stream (Al-Ashraf & Rahani, 2012). The authors, Al-Ashraf and Rahani (2012), focus on

the identification and elimination of waste within the production chain with respect to

energy, time, motion and resources (Al-Ashraf & Rahani, 2012). The birth of the Toyota

Production System (TPS) spawned the creation of many other tools and techniques of

lean manufacturing including the just-in-time (JIT), total productive maintenance,

cellular manufacturing, single-minute exchange of dies, and production smoothing

15

methods (Al-Ashraf & Rahani, 2012). This research explored the application of the lean

manufacturing initiative referred to as the Toyota Production System (TPS), a systematic

approach to the identification and elimination of waste activities through continuous

improvement within an organization.

Lean manufacturing has to become a way of life in manufacturing (Brecht, 2012).

To highlight previous research on lean manufacturing, Sebastian Christoph Bernhard

Brecht (2012) structured his dissertation in accordance with lean manufacturing strides

relating to cost efficiency, high quality, and customized products. The use of renewable

energy resources and the demand for materials caused global production activities to

grow limitlessly (Brecht, 2012). Since entering the twenty first century, depletion of

natural resources, environmental degradation, and unequal proportions of wealth have

gained global consciousness. As oil shortages loom ever present, energy costs continue to

rise, the ozone layer becomes more depleted, and environmental disasters occur, the

paradigm of continuous growth fails (Brecht, 2012). Sustainable development has

become an important part of a company’s corporate policy as a result.

Meybodi (2013) examined the relationship between the alignment of strategic

benchmarking performance measures and lean manufacturing practices. A set of nine

hypotheses were used to examine the differences between conventional companies and

lean manufacturing companies in setting organizational goals and objectives, scanning

environmental factors, building core competencies, setting competitive priorities,

establishing manufacturing objectives, and aligning competitive capabilities with

competitive priorities (Meybodi, 2013). Statistical results indicated, as compared with

16

conventional companies, that lean manufacturing organizations were overall better in

setting long-term goals and objectives, recognizing external environmental factors,

building organizational core competencies, aligning competitive capabilities with

competitive priorities, and utilizing a broad range of balanced performance measures

(Meybodi, 2013).

Pope (2013) offered information about Lean Six Sigma programs. Lean Six

Sigma was implemented within several organizations associated with the clinical trial

industry for the purpose of addressing the negative effects of industry at the sponsor

level, the contract research organization (CRO) level and the institutional review board

(IRB) level (Pope, 2013). Pope (2013) determined that Lean Six Sigma combined the

best process improvement methodologies toward the improvement of productivity and

the delivery of sustainable and continuous improvement.

Grima, Marco-Almagro, Santiago, & Tort-Martorell (2014) conducted a study

that was able to conclusively show the manner in which Six Sigma has proven to be a

powerful system for improving quality and productivity within the organizational

context. However, the successful implementation of the methodology is not simple, and it

is therefore normal – especially in the early phases – to experience problems that may

impede taking full advantage of the methodology. We have grouped some of the most

frequent ones into four main areas: implementation and organizational aspects, adherence

to DMAIC methodology, tools and statistical techniques and implementation of

improvements and project closure. For each of them, the paper discusses some of the

difficulties and issues that should be taken into account.

17

All Six Sigma seminars, talks, manuals, etc. emphasize the importance of management,

leadership, and commitment (e.g. Hahn, 2005; Shanmugam, 2007). Dahlgaard and

Dahlgaard-Park (2006) took this a step further and argued that, in order to have success

with Six Sigma (and Lean) manufacturing, management has to apply leadership skills

within the organization in order to change the corporate culture to one that is receptive of

such processes while warning of the dangers that may arise in the application of the Six

Sigma roadmap without the right company culture. Unfortunately, the process as to how

that leadership is converted into concrete activities within the organization is not always

specified. This failure to define tasks, or the improper performance thereof, is a frequent

source of problems in Six Sigma programs and, in many cases, leads to failure and,

ultimately, to the abandonment of the program (Grima et al., 2014).

The objective Grima et al.’s (2014) study was to evaluate the effects of lean

manufacturing implementation within a Serbian production company over the course of

24 months, emphasizing observed benefits and constrains. The company employed within

the case study was a leading confectionery producer in Serbia with annual production of

more than 25,000 t (Grima et al., 2014). The approach to implementing lean

manufacturing practices within this organization was structured in five phases, as

follows: (i) training, (ii) analysis of lean wastes on one technological line, (iii) choice of

lean tools to be implemented in the factory, (iv) implementation of lean tools in

production and maintenance, and the (v) development of continual improvement sector

and further deployment of lean tools (Grima et al., 2014). Lean manufacturing tools

implemented in the production process were visual control and single minute exchange of

18

dies (SMED); maintenance process implemented 5S with total productive maintenance

(TPM) and problem solving sessions being the tools implemented in both processes

(Grima et al., 2014).

Organizational Leadership

There are several different types of organizational leadership that may be applied

within a given organization. Commonly referred to as either models or styles, the most

common of these include situational leadership, transactional leadership, participative

leadership, and transformational leadership (Miller, 2016). The leadership style that will

be the most effective for an organization will vary depending on the situation that the

organization is in, the life cycle stage of the organization, the field of industry in which

the organization operates, and even the department within that organization (Northouse,

2016). There is no one right type of leadership and the only form of leadership that can be

detrimental to an organization is an ineffective one (Northouse, 2016). Understanding the

different types of leadership styles is the first step to understanding what type of

leadership will be best suited for a given situation within a given organization and a given

department.

Situational leadership, thus, may seem the most effective leadership style to

employ, as this type of leadership requires the leader to adapt his or her leadership style

based on the needs of the given situation (Miller, 2016; Northouse, 2016). Transactional

leadership refers to a leader who operates on the system of punishments and rewards,

with punishments doled out based on errors and rewards granted to those who meet or

exceed the expectations or the needs of the given situation (Miller, 2016; Northouse,

19

2016). Transformational leadership is the process through which the leader motivates and

inspires his or her workers toward the improvement of the organization for the betterment

of all, while participative leadership simply requests, and takes into account, the

suggestions and commentary of individuals at all levels of the organization, regardless of

position (Miller, 2016; Northouse, 2016). While transformational leadership and

participative leadership may seem similar, the key difference is that transformational

leadership works all angles of a given situation to ensure that all parties and the

organization come out ahead, to the degree possible (Miller, 2016; Northouse, 2016).

Participative leadership, on the other hand, solicits suggestions and comments, but does

not act on all and if the business gains a competitive advantage or changes as a result of

those suggestions and comments, it is not active, but instead a passive process (Miller,

2016; Northouse, 2016). The style that best suits the organization will depend on all of

the aforementioned factors, but it will also depend on the type of person the leader is, as

some individuals are more effective in the application of certain leadership styles than

they are compared to the application of other leadership styles.

Increasing Profitability

One of the primary goals of lean manufacturing is to increase overall profitability

(Fullerton, Kennedy, & Widener, 2014; Hofer, Eroglu, & Hofer, 2012; Ward & Sobek,

2014). While some researchers indicate that this process occurs over time (Fullerton,

Kennedy, & Widener, 2014), other researchers indicate that the speed through which an

increase in profit margin occurs has more to do with the effectiveness of the applied

principles within the organization (Hofer, Eroglu, & Hofer, 2012; Ward & Sobek, 2014).

20

In spite of this, the one thing that all researchers are able to agree on when it comes to the

application of lean manufacturing and increasing the profitability of the organization is

that the application of lean manufacturing principles and practices does work to increase

the overall profitability of the organization (Fullerton, Kennedy, & Widener, 2014;

Hofer, Eroglu, & Hofer, 2012; Ward & Sobek, 2014).

By working to ensure that the lean manufacturing practices are appropriately

implemented, the first steps toward an increase in the profitability of the business have

been taken (Ferguson & Souza, 2010; Fullerton, Kennedy, & Widener, 2014; Hofer,

Eroglu, & Hofer, 2012; Ward & Sobek, 2014). Other factors that must be taken into

consideration are the size of the organization and the health of the industry (Dora, Van

Goubergen, Kumar, Molnar, & Gellynck, 2014). While this may at first appear as though

there are a great many variables in determining the success levels of the organization, and

there are, the primary purpose is not to look at the number of variables, but the manner in

which those variables interact with one another.

The structural design of the organization plays a large factor in its overall levels

of success (West & Dellana, 2016). An organization that has a sloppy supply chain, or

which does not have enough workers to effectively deliver on the promises of the

organization cannot gain a great deal from the implementation of lean manufacturing. In

such instances, the organization must resolve its structural issues first. By the same token,

the organization that does not have a great deal of warehouse space, and thus is already

primed for lean manufacturing principles, may not increase their profitability as quickly

as an organization that had a large warehouse, cleared the inventory out via sale, and

21

rented a smaller warehouse and started receiving smaller shipments of inventory. In this

situation, not only would the company be reducing their storage costs via the warehouse,

the organization would also be decreasing its expenditures, wherein less of a product was

ordered, and thus less of the capital of the organization would be tied up in merchandise,

instead being able to be diverted to other means of the organization and different areas of

the business. The overall point is that, regardless of the manner employed, barring issues

with the structural design of the organization, the organization will be able to increase its

profitability as a result of the implementation of such practices, though it will be unclear

until the time of implementation, the amount by which that increase will occur (Fullerton,

Kennedy, & Widener, 2014; Hofer, Eroglu, & Hofer, 2012; Ward & Sobek, 2014).

Pitfalls and Success in Lean Manufacturing Implementation

Chowdary and George (2012) explained the current good manufacturing practices

(cGMP) that are followed in the pharmaceutical sector to ensure that products are

produced and controlled consistently. Improvement experiences were shared due to the

implementation of lean principles in combination with cGMP in a pharmaceutical

company (Chowdary & George, 2012). Chowdary and George (2012) used the 5-whys

methodology for analysis of the problems existing within the selected production line. A

current state value stream map (VSM) and a future state VSM were developed

(Chowdary & George, 2012). Reductions in cycle times, lead times, and WIP inventory

were all evaluated (Chowdary & George, 2012). Lean strategies were shown to have

increased improvement in the areas of production efficiency and the effectiveness of

22

manufacturing operations. The driving principles of cGMP’s are the quality standards

built into a product (Chowdary & George, 2012).

Miina (2013) analyzed the critical success factors concerning the implementation

of lean rationality in manufacturing companies located in Estonia. The research resulted

in the development of a lean thinking implementation model that could be modified for

manufacturing companies ensuring the desired results of the lean implementation process

(Miina, 2013). According to the study, by managing supply chains, issues concerning low

efficiency and productivity should be solved (Miina, 2013).

Organizational issues that can enhance or hinder successful lean implementation

have also been examined. In order to do so, Sim and Chiang (2012) placed a specific

emphasis on exploring the situation within three manufacturing companies located in the

eastern part of the United States. Each company represented a different mode of

implementation, varying in the degree of resistance, success, and plateauing (Sim &

Chiang, 2012). Job satisfaction was found to be an important factor in connection with

successful implementation of lean production (Sim & Chiang, 2012). In addition, more

than half of the respondents felt that management had not and would not follow through

with the resolution of open issues and had not or would not address the aspects or issues

that needed to be resolved that originated as a result of the implementation of such

improvements. In one company, interview results from three randomly selected

employees indicated that management had been pushing harder and did not respect the

workers, leading to a decline in the quality of work life (Siam & Chiang, 2012). In lean

manufacturing, due to the fast-paced nature of work and/ or the claim that lean becomes

23

mean, resistance to the change is common, as is the failure of the implementation (Sim &

Chiang, 2012). As a result, additional nurturing from management has been shown to be

a useful tool to ease the pressures of overwork, a common syndrome often found in lean

enterprises. Finally, job security, which is at the heart of most employees' concerns,

remains an issue that should be carefully dealt with. Performance improvements are not

likely to be sustained over time if employees fear that by increasing productivity, they

will work themselves out of their jobs (Sim & Chiang, 2012).

Campos (2012), discussed how Lean Six Sigma principles improved workflow,

turnaround times (TATs) and patient outcomes at a microbiology lab at the Children's

National Medical Center (CNMC). It was stated that a Kaizen approach, an approach for

continual improvement and constant change designed to increase core values of any task,

was employed through the involvement of the entire staff of the lab. It involved an

observational audit of existing lab processes and provided the customer with a roadmap

that outlined the improvements being made to reduce waste and improve efficiency,

while simultaneously increasing the quality of results and reducing errors.

For clarity, the lean manufacturing process succeeds in some instances and fails in

others; as such, it is necessary to study the reasons for each in order to determine the

factors of organizational change and explore the manner in which they are able to

influence successful outcomes, all of which ultimately result in improved performance

for the organization (Bhasin, 2015). Lean processes have been evident for several

decades, and a number of implementation strategies and barriers have been identified

within the extant body of literature. Current research emphases the prominent obstacles

24

inhibiting organizations from embracing lean practices and or frustrating its wider

application. Whilst some of the aforementioned analysis has revealed definite barriers

indirectly, this section will explore in greater depth the issues that organizations, lean

practitioners, and executives need to consider in their efforts to implement lean

manufacturing processes within their organizations.

The barriers to lean manufacturing explored include their origins, interrelations,

and their relative importance. The ultimate aim of any organization should be to link its

lean initiatives to organizational financial improvements. A perfect example of where this

fails is found in a lack of senior management support, however, it is important to try to

determine why some managers are more supportive than others are and it is as yet unclear

as to how this may be empirically measured. In respect to the numbers of successful lean

initiatives, it is necessary to explore the reasons as to why so many companies have not

been able to achieve the benefits they had hoped for through the application of their lean

strategies, or, in some cases, why they abandoned their efforts altogether (Bhasin, 2015).

Organizational Sustainability

There has been a growing awareness of the adoption of lean principles within UK

construction organizations (Ogunbivi, 2014). The UK Government has recognized the

importance of the construction industry achieving the overall goals of sustainable

development. To this end, the Government has put several policies and strategies in place

in order to achieve increased sustainability within the construction industry (Ogunbivi,

2014). Assessment and performance improvements have been advocated by many

researchers, and there is a substantial interest in performance measurement by

25

construction organizations. Assessing the implementation efforts and benefits of lean

approach in sustainable construction has become more critical to organizations in pursuit

of continuous improvement (Ogunbivi, 2014). The inadequacy of many frameworks and

tools developed to address this advancement in the areas of lean manufacturing and

sustainability practices provided the motivation for this research. Therefore, the aim of

Ogunbivi’s (2014) research was to develop a conceptual framework for assessing the

implementation efforts and benefits of the lean approach in sustainable construction

within contracting organizations.

Djekic, Zivanovic, Dragojlovic, & Dragovic (2014) set forth to explore the

process of implementation of the lean approach throughout all the levels of construction

organizations, investigate the linkages between lean and sustainable construction, review

the concept of lean and its application to sustainable construction, analyze the barriers

and factors contributing to the success of such initiatives, and to identify the benefits of

lean in sustainable construction. An exploratory method of investigation and study

involving both quantitative and qualitative methodology was utilized in this research

(Djekic et al., 2014). An in-depth literature review was conducted, allowing for the

foundational information necessary to understand the topic being explored; following the

presentation of the same, results from a questionnaire survey conducted among UK-based

construction professionals on issues relating to sustainability and lean processes in order

to identify the barriers, success factors and linkages between sustainability and the lean

concept were presented (Djekic et al., 2014). The data collected were analyzed using

SPSS version 19.0 using the percentile method, factor analysis, Kruskal Wallis test,

26

Cronbach's Alpha reliability test, and the Severity Index Analysis (Djekic et al., 2014). A

case study was also provided which employed the use of content analysis in order to

allow for a better understanding of the implementation process and drivers of lean

manufacturing at the organizational level (Djekic et al., 2014). 

The success factors associated with the implementation of lean processes and

sustainability practices were subjected to factor analysis (Djekic et al., 2014). The factor

analysis of the data yielded two (2) critical success factors, which were labelled as

management and resource factors, and organizational culture factors. All the identified

benefits of implementing lean construction were classified into economic, social, and

environmental benefits. In addition, the drivers of implementing lean were discussed and

classified into internal and external drivers (Djekic et al., 2014).

The research further revealed that a reduction in waste was the most important

benefit of synchronizing lean processes with sustainability initiatives (Djekic et al.,

2014). The most significant barrier to the successful implementation of both was

identified as the resistance to change. The adoption of lean techniques have the potential

to significantly impact the realization of sustainable construction as there are linkages

between lean processes and sustainability initiatives (Djekic et al., 2014). The framework

developed by the researchers of a lean implementation process at the strategic level was

made up of three sections, namely: policy and strategy deployment, assessments criteria,

and the application and implementation phase, all with their own respective subsections

(Djekic et al., 2014). The framework highlighted the need to understand the

implementation issues within a contracting construction organization as well as the

27

implementation drivers of lean manufacturing. This study offered theoretical, practical,

and methodological significance in the study of successful lean implementation in

contracting construction organizations in the UK. 

Transition

Section 1 has offered up the foundation of the study, discussing the purpose and

history of the practice of lean manufacturing. It has identified the problem to be

addressed, namely that the study seeks to determine the manner in which lean

manufacturing can be applied within the realm of surgical tools in such a way as to allow

for the maintenance of such initiatives without a decrease in profit. The purpose of the

study was explored in greater detail, and the issues that the surgical tool field has faced,

combined with the reasons why such a practice has not yet been implemented in most

surgical instrument companies, has been discussed. The nature of the study was

presented, and the research questions, allowing for the ultimate answers to the problem

set forth, were presented. The study, seeking to interview those who have been able to

successfully implement the use of lean manufacturing within the surgical tool field, will

serve to provide insight to those who may otherwise be unable to accomplish this task

within the field, while at the same time seeking to determine the manner in which the

other companies may have gone wrong in order to provide the knowledge necessary

regarding how to best improve the situation.

28

Section 2: The Project

Section 1 provided an introduction to the problem of utilizing lean manufacturing

processes within the industry of surgical tools. The research questions were presented and

the problem, complete with background information, was provided. The research

question identified for resolution within the context of this study is: “What strategies do

leaders of surgical product businesses in South Florida use to implement lean

manufacturing initiatives to increase profitability?”

In order to explore this topic in great depth, it becomes necessary to not only

explore the relevant literature to the topic, as was presented, but also to look forward,

identifying the means and methods used in the completion of the study to ensure that

should another individual wish to do so, he or she could recreate the experiment and

obtain the same results. To this end, the research design, methodology, ethical concerns,

population, sampling, and data collection, organization, and analysis processes, among

other equally pertinent topics, are presented within section 2.

Purpose Statement

The purpose of this proposed qualitative single subject case study is to explore the

strategies that have been implemented by leaders of surgical product businesses in South

Florida toward the purpose of implementing lean manufacturing initiatives and increasing

profitability. The target population was leaders from within a surgical product

manufacturing organization located in south Florida. They were selected because they

have successfully implemented lean manufacturing strategies increasing profitability.

29

Data from this study may contribute to social change by sharing the strategies leaders of

surgical product businesses in South Florida use to increase profitability.

Role of the Researcher

In a qualitative case study, researchers gather data from multiple resources, such

as (a) interviews, (b) artifacts, (c) records, and (d) documentation (Yin, 2014). In this

sense, the researcher focuses on data organization, data collection, and data analysis

(Collins & Cooper, 2014) while instituting methodological rigor (Gray, 2013). As the

primary data collection instrument for this qualitative single case study, interviews, using

the previously described interview guide were conducted for the purpose of exploring

participants’ views and experiences.

The participants are business leaders from one medical supply product company

in South Florida (BIOMET, 2012). There is a need to provide additional data, however,

so that the reader can draw conclusions while also providing enough interpretation of that

data (Pettigrew, 2013). The researcher has a previous working relationship with the

organization, though no direct experience with the participants of the study; it was

through this relationship that the door was opened to gain access to the participants in the

completion of the study. While the company will receive a complimentary copy of the

completed study results, no remuneration was asked for nor given to the company or to

those participating, nor did the company have any control over the interview process or

results.

The researcher in keeping with an awareness of the need for ethical research

standards, the researcher reviewed the Belmont report’s ethical principles and guidelines

30

for the protection of human subjects of research. With this in mind, throughout the course

of the study, the researcher adhered to the three ethical principles identified therein; these

are (a) respect for persons, (b) beneficence, and (c) justice (The Belmont Report, 1979).

The role of the researcher in this research project was to ensure that participants

understood that participation was voluntarily after receiving sufficient information as to

the nature of the study, that the participants provided signed informed consent forms, as

well as ensuring that no harm came to the participants, and that each was treated equally

(The Belmont Report, 1979).

When completing any research study, it is important to avoid bias in interpreting

the data provided (Marshall & Rossman, 2016). In order to do so, it is beneficial for the

researcher to have personal experience, knowledge, and values from an interviewee

perspective; however, increased familiarity with a given subject can result in researcher

bias when analyzing research data (Torras & Surie, 2015). Bracketing was employed as a

means of mitigating bias, allowing the researcher to disregard beliefs, experiences, and

previous knowledge that relate to the topic under investigation (Chan et al., 2013).

Member checking is a quality control procedure designed to strengthen the validity,

accuracy, and credibility of the interview data (Harper & Cole, 2012). Member checking

is a way to minimize bias interpretation throughout the interview process (Harper & Cole,

2012).

Equally important to the validity of the study, an interview protocol was

employed. According to Jacob and Furgerson (2012), the use of an interview protocol

provides a guide for a fair and ethical interview process. An interview protocol contains

31

procedural prompts to follow during the meetings. Procedural prompts include (a) a

reminder to obtain informed consent (b) a brief introduction before the interview, and (c)

information on the data a researcher wants to collect (Jacob & Furgerson, 2012).

Participants

A researcher can conduct a qualitative case study with multiple participants from

a single organization within the same location (Yin, 2014). The eligibility criteria for

participants in this case study was that they be (a) 18 years old and above, (b) currently

employed at a surgical supply product company in South Florida, (c) work in a position

as a manager, administrator, quality assurance personnel, or supervisor within that

organization, and (d) that they had participated in the implementation of lean

manufacturing initiatives and sustainability efforts within that organization. To gain

access to participants, the researcher contacted the company’s leadership team by phone

to set an appointment to speak with them face-to-face and explained the proposed study

in more detail. The researcher then provided further information to the leadership team

regarding the study and explained to them the expectations for the participants. Once

written permission was received from the leadership team to conduct the study, the

researcher obtained the contact information of potential participants from the company’s

HR director, and set up a meet and greet forum to discuss the purpose and nature of the

study with prospective participants. Prospective participants received an invitation to

participate face-to-face and via e-mail. After participants signed an inform consent form

following the completion of that meeting, the participant pool was set and the forms were

collected in person at that time indicating their agreement to participate.

32

Embedded in qualitative research were the concepts of power and relationships

between participants and researchers (Swauger, 2011). To develop a working relationship

with participants, the researcher was clear about the values, intentions, and views

associated with the study when establishing a working relationship with the participants.

Furthermore, the researcher worked to ensure that the participants felt comfortable if they

decide to withdraw from the research study at any time during the research process, and

conscious efforts were made to ensure that the researcher did not use power to control

participants. In addition, the researcher employed an ethic-of-care approach; an approach

that involves connecting with participants through consistent communication while

maintaining the values of the researcher’s responsibility towards research participants

(Swauger, 2011). Additionally, the researcher used the process of reciprocation through

story sharing as a means of strengthening the researcher-participant relationship by

encouraging rapport and eliminating power inequities, improving the quality of data

collected, and conveying value for the experiences and stories of participants (Hayman,

Wilkes, Jackson, & Halcomb, 2012).

Research Method and Design

The research method and design are perhaps two of the most important parts in

the completion of research studies (Yin, 2014). To conduct a study, researchers can use

quantitative, qualitative, or mix-methods. A researcher can employ a quantitative,

qualitative, or mix-methods to conduct his or her study; however, it is crucial for

researchers to understand the need for the most appropriate choice of a research method

and design, both of which depend on the nature of the study and the research question or

33

questions being explored (Maxell, 2013). In this sense, whether the research is

qualitative, quantitative, or mix methods, it is important that researcher chooses the

method and design that best suits the purpose of the study (Cakiroglu, 2012).

Research Method

A qualitative research methodology depicts the perceptions and lived experiences

of the participants involved in the research (Fogle, 2012). This study employs the use of a

qualitative methodology, which enables an understanding of the data obtained from

secondary sources (Marshall & Rossman, 2011). The qualitative method is appropriate to

explore strategies surgical product business leaders in South Florida use to increase

profitability. Furthermore, qualitative research depends on specific forms of data,

including narratives, observations, images, and primary text (Namey & Trotter II, 2012).

In addition, qualitative research proposes processes and techniques designed to help

illuminate relevant issues through an examination of the given phenomena explored

within the context of the research study (Namey & Trotter II, 2012). In a qualitative

methodology, an analysis of open-ended explanations address issues in reference to the

research; as such, a qualitative approach is used to explore the strategies surgical product

business leaders use to increase profitability as opposed to a mixed method or the

quantitative method (Daniels, Park, Harmon, & Brayley, 2013). Unlike quantitative

research, a qualitative approach has a background targeted toward addressing or handling

issues (Weathers et al., 2011). The qualitative research method is appropriate for use in

researching the strategies that leaders of surgical supply companies use to increase

34

profitability as it allows the researcher to analyze primary and secondary data provided

by the participants.

When selecting a research method, in addition to the qualitative approach, the

researcher also has the option of selecting a quantitative approach. One aspect of a

quantitative approach is the generation of numeric measures for simple and effective

comparison, selection, and ranking (Thamhain, 2014). The process of measurement is

fundamental to quantitative research because measurements provide a connection

between the relationships among variables (Payne & Wansink, 2011). Often

times, quantitative methods do not always produce the most reliable inputs for decision-

making, nor are all methods equally suited for all circumstances (Thamhain, 2014). A

quantitative research method is not appropriate for this study, as quantitative research is

systematic while qualitative research is unstructured (Allwood, 2012). Quantitative

research provides concrete evidence of a research topic based on the numerical results,

but numerical results are not required for the sustainability research explored (Weathers,

Barg, Bowman, Briggs, Delmoor, Kumanyika, & Halbert, 2011).

The final method the researcher may consider is a mixed method approach, one

that allows for a combination of both quantitative and qualitative methods. Social science

has categorized mixed methods research as the uniting of qualitative and quantitative

research methodologies (Collins & Frydenlund, 2015). A mixed methods way of thinking

rests on assumptions that there are multiple legitimate approaches to social inquiry and

that any given approach to social inquiry is inevitably partial (Greene, 2008). The

obligation to be open to the use of mixed methods is based on the need to find the most

35

appropriate methodology to meet the purpose of any specific research project, and to

answer its questions (Bazeley, 2015). As this study will not support known data. the use

of the mixed method approach was not an appropriate choice of methodology either.

Implementing lean manufacturing initiatives can be an option to achieve long-term

sustainability of success and profitability. This study involves exploring the various

strategies surgical product business leaders use to increase profitability.

Research Design

A case study research design allows for the identification, investigation, and

interpretation of data to gain understanding as to the strategies employed by business

leaders for the implementation of lean initiatives to drive profitability. The case study

research design is suitable for studies where the researcher’s goal is to search in-depth by

collecting data from various sources (Yin, 2014). The aim of this study is to gain an

understanding of the participants’ viewpoints regarding the lean implementation process

and the strategies business leaders have implemented to sustain profits within the

organization. The goal is to seek greater understanding of the strategies business leaders

use to become successful at implementing lean manufacturing initiatives. This research

design allows the reseearcher to collect in-depth information that is valid while

identifying participants’ viewpoints of the problems encountered during lean

implementation and the strategies used to make it successful.

Ethnographic studies are culturally related and are concerned with presenting

shared experiences of language and behavior (Koning & Can-Seng, 2013). Ethnographic

designs are most appropriate for gathering observed data on cultures and human societies

36

(Koning, & Can-Seng, 2013). An ethnography includes organizational cultures, which in

turn using an ethnographic design, but the use of such a design would limit the researcher

to observations without participatory involvement. Narrative design involves the

researcher engaging individuals to learn about the stories that have influenced their lives

(Brooks, 2012). When the researcher finds details concerning emotions, feelings, and

processes it is the basis of a narrative design which moves the plot forward (Flory &

Iglesias, 2010).

A case study was used as it involved the observation and description of the

behavior of a subject without influencing the subject in any way (Jalil, 2013). A

descriptive research design broadens the data collection method to include interviews.

The descriptive research design allows participants to express their likes and dislikes as

pertaining to the process of implementing lean manufacturing processes within an

organizational setting (Manuel, & Delgado, 2011). The goal of the data collected was to

identify the strategies leaders of surgical supply products use to implement lean

manufacturing initiatives while identifying the variables to improve operation strategies

associated with lean manufacturing implementation.

Population and Sampling

There is a global increase in the number of manufacturing companies

implementing lean processes in recent years (Miina, 2013). Lean thinking increases the

sustainability of manufacturing companies by improving productivity and efficiency

(Miina, 2013). Using the criteria of manufacturing companies who have implemented

lean manufacturing within the past 10 years, the researcher chose to study manufacturing

37

companies within the surgical supply industry for the study because of their recent

experiences with lean manufacturing, access to information on sustainability, length of

existence, and the ease of access to the company’s information. One of the three top

surgical supply product manufacturers of interest is located in South Florida.

A population is a group of people regarded as a subset or class within a larger

group (Krieger, 2012). The population for the study consists of employees of a medical

device manufacturing company located in the South Florida. To narrow the qualitative

case study, a single company was selected.

According to Yin (2011), it is appropriate to a case study with multiple

participants if all those participants are from a single company within the same location.

The targeted subsidiary of the company is in the southeast region of the United States.

Manufacturing companies within the same industry adopted lean manufacturing as an

element to support their sustainability long-term. The company selected for the case

study was a representative of other companies in the same industry.

The researcher employed a purposive sampling method to select the sample size

for the qualitative case study. This case study consisted of participants both male and

female, with respondent selection based on purposeful sampling. Purposeful sampling

requires access to key informers in the arena who can identify important information

filled cases (Suri, 2011). In light of this and in light of what this study seeks to explore,

purposeful sampling is the appropriate sampling method for this qualitative case study.

Yin (2014) stated that the demands of case study research require the intellect,

ego, and emotions of the researcher, which are far greater than those of any other

38

research method are. Most studies reach theoretical saturation roughly in the same range

(Marshall, Cardon, Poddar, & Fontenot, 2013). A researcher usually conducts several

interviews past the point of theoretical saturation to justify data saturation (to indicate

that the dataset is becoming redundant) as the data collection procedures are not

routinized (Marshall, Cardon, Poddar, & Fontenot, 2013). Among the most difficult types

of qualitative research to classify are case studies (Marshall, Cardon, Poddar, & Fontenot,

2013). Yin (2014) recommends a minimum of six sources of evidence. Morse (2000)

recommends 20 to 30 interviewees with 2 to 3 interviews per person. Based on the

information obtained a purposeful sample of three participants was determined to be an

appropriate sample size for this qualitative case study.

Participants for the study ranged from shop floor employees to department

managers. Some participants had extensive lean manufacturing experience and some had

minimal experience. Each participate had initial involvement with lean activities or had

prior experience addressing the strategies that impeded or contributed to lean

manufacturing sustainability within the organization.

Ethical Research

Managing responsible research includes making sure conclusions are relevant,

valid, and supportable following ethical principles. There are five ethical principles that

are considered characteristics of responsible qualitative research: (a) protection of

vulnerable populations, (b) beneficence, (c) respect for participants, (d) autonomy, and

(e) justice (Choi, Sae, & Jai, 2010; Wester, 2011). According to the authors Drake,

39

Gerde, & Wasieleski (2011), ethical research should respect, inform, contribute to the

professional knowledge of, and minimize the risk of research participants.

Participation in the study was on a voluntary basis. Study participants received

information about the study and a consent form to read and sign, indicating that they

agreed with the study guidelines as stated. Study participants were verbally informed and

informed in writing that they could withdraw from participating in the study at any time.

Excluded from participating in the study were individuals under the age of 18 years old.

No incentives were provided.

A copy of the study’s findings and conclusions was made available to each

participant upon request. The identity of the participants remains confidential, but the

name of the targeted company will not, though data has been de-identified to maintain

anonymity. Participants received unique aliases in order to protect their identity. To

protect the identities of each of the three participants, the voice recordings and transcript

of each interview will remain in a lockbox for 5 years. The researcherwill retain sole

access to the lockbox and destroy the voice recordings after 5 years.

Data Collection Instruments (Qualitative Only)

For content guidance, consult the DBA Doctoral Study Rubric and Research

Handbook.

Data Collection Technique

For content guidance, consult the DBA Doctoral Study Rubric and Research

Handbook.

40

Data Organization Technique (Qualitative Only)

For content guidance, consult the DBA Doctoral Study Rubric and Research

Handbook.

Data Analysis (Quantitative Only)

Data analysis involves discussing the statistical test(s) you will use to answer each

research question and justifying its/their selection. Indicate the nature of the scale for

each variable (e.g., nominal, ordinal, interval, and ratio). Why is the selected statistical

test more appropriate than another? (Hint: The statistical test is usually selected due to the

nature of the question and scale of measurement of the variables you defined.) Describe

how you will deal with discrepant cases (e.g., missing data, data that cannot be

interpreted). Identify the software that will be used to analyze the data.

For additional content guidance on this section, consult the DBA Doctoral Study

Rubric and Research Handbook.

Data Analysis (Qualitative Only)

For content guidance, consult the DBA Doctoral Study Rubric and Research

Handbook.

Study Validity (Quantitative Only)

For information on the content of this subsection, consult the DBA Doctoral

Study Rubric and Research Handbook.

41

Reliability and Validity (Qualitative Only)

Reliability

For information on the content of this subsection, consult the DBA Doctoral

Study Rubric and Research Handbook.

Validity

For more information on the content of this subsection, consult the DBA Doctoral

Study Rubric and Research Handbook.

Transition and Summary

End with a transition that contains a summary of key points and provides an

overview of Section 3. Do not include any new information in the summary

This is the end of the proposal.

42

Section 3: Application to Professional Practice and Implications for Change

Introduction

Begin with the purpose of the study. Do not repeat the entire purpose statement;

typically the first sentence of the purpose statement will suffice. Provide a brief summary

of the findings, not to exceed one page.

Presentation of the Findings (Quantitative Only)

Describe the statistical test(s), the variables, and the purpose of the test(s) and

how they relate to the hypotheses. Present relevant descriptive statistics (i.e., mean,

standard deviation for scale variables; frequencies, and percentages for nominal

variables). Provide evaluation of statistical assumptions. Report inferential statistical

analyses results, organized by research question, in APA statistical notation/format.

Include alpha level chosen for the test, test value, p (significance) values, effect size,

degrees of freedom, confidence intervals (when appropriate), and so on. Include

appropriate tables and figures to illustrate results, as per the current edition of the

Publication Manual of the American Psychological Association. Consult the Instructions

for the DBA Template document for correct APA style for formatting and labeling tables

and figures. Summarize answers to research questions. Describe in what ways findings

confirm, disconfirm, or extend knowledge of the theoretical framework and

relationship(s) among variables by comparing the findings with other peer-reviewed

studies from the literature review. Includes studies addressed during the proposal stage

and studies added since writing the proposal. Tie findings or dispute findings to the

existing literature on effective business practice. Analyze and interpret the findings in the

43

context of the theoretical framework, as appropriate. Ensure interpretations do not exceed

the data, findings, and scope.

Presentation of the Findings (Qualitative Only)

List the overarching research question. Identifies each theme, and analyzes and

discuss findings in relation to the themes. Describe in what ways findings confirm,

disconfirm, or extend knowledge in the discipline by comparing the findings with other

peer-reviewed studies from the literature review; includes literature added since writing

the proposal. Tie findings to the conceptual framework, and tie findings or dispute

findings to the existing literature on effective business practice.

Applications to Professional Practice

Provide a detailed discussion on the applicability of the findings with respect to

the professional practice of business. This major subsection provides a rich academic

argument why and how the findings are relevant to improved business practice.

Implications for Social Change

The implications are expressed in terms of tangible improvements to individuals,

communities, organizations, institutions, cultures, or societies, as the finding could affect

social change/behavior.

Recommendations for Action

Recommendations (a) should flow logically from the conclusions and contain

steps to useful action, (b) state who needs to pay attention to the results, and (c) indicate

how the results might be disseminated via literature conferences, training, and so on.

44

Recommendations for Further Research

List recommendations for further study related to improved practice in business.

Identify how limitations identified in Section 1, Limitations, can be addressed in future

research.

Reflections

Include a reflection on your experience within the DBA Doctoral Study process,

in which you discuss possible personal biases or preconceived ideas and values, the

possible effects of those on the participants or the situation, and changes in your thinking

after completing the study.

Summary and Study Conclusions

The work closes with a strong concluding statement making the take-home

message clear to the reader.

45

References

3D Medical Manufacturing. (2016). LEAN Manufacturing. 3dmedicalmfg.com. Retrieved

18 June 2016, from http://www.3dmedicalmfg.com/capability/lean-

manufacturing/

Abro, M. M. Q., Khurshid, M. A., & Aamir, A. (2015). The use of mixed methods in

management research. Journal of Applied Finance and Banking, 5(2), 103-108.

Retrieved from http://www.proquest.com

Alam, M., & Kabir, M. (2013). Economic growth and environmental sustainability:

Empirical evidence from east and south-east Asia. International Journal of

Economics & Finance, 5(2), 86-97. doi:10.5539/ijef.v5n2p86

Al-Ashraf, M. and Rahani, A. (2012). Production flow analysis through value stream

mapping: A lean manufacturing process case study. Procedia Engineering, 41,

1727 – 1734. Retrieved from:

http://www.sciencedirect.com.ezp.waldenulibrary.org/science.

Araújo, U. P., Sanches, P. F., Júnior, & Gomes, A. F. (2015). Desafiando a

interdisciplinaridade na ciência administrativa: O caso da entropia/Challenging

interdisciplinarity in the administrative science: The case of entropy. Cadernos

EBAPE.BR, 13(4), 664-686. Retrieved from http://www.proquest.com

Asst, O. U., & Asst, Y. A. (2014). A research on perceptions of manufacturing firms

about marketing and financial problems with the method "qualitative

analysis": Adiyaman case.  International Journal of Business and Social

Science, 5(4) Retrieved from http://www.proquest.com

46

Bachmair, B., & Pachler, N. (2015). Sustainability for Innovative Education–The Case of

Mobile Learning. Journal of Interactive Media in Education,2015(1).

Bartkowiak, J. (2012). NLP in qualitative research. International Journal of Market

Research, 54, 451-453. doi:10.2501/IJMR-54-4-451-453

Bazeley, P. (2015). Mixed methods in management research: implications for the

field. Electronic Journal of Business Research Methods, 13(1), 27-35.

Bhasin, S. (2015). Lean management beyond manufacturing (1st ed). Springer

International Publishing: Switzerland. doi:10.1007/978-3-319-17410-5

Bhasin, S. (2012). An appropriate change strategy for lean success. Management

Decision, 50(3), 439 – 458. doi:10.1108/00251741211216223

Belvedere, V., & Stringhetti, L. (2014). Can lean systems engineering enhance the value

of astrophysical projects? Human Systems Management, 33(3), 99-111.

doi:10.3233/HSM-140815

BIOMET 3i. (2012). Biomet Corporation. Retrieved from

http://www.biomet.com/corporate/

environmentHealthSafetyStatement.cfmAmerica

Bishop, D., & Lexchin, J. (2013). Politics and its intersection with coverage with

evidence development: A qualitative analysis from expert interviews. BMC

Health Services Research, 13, 88–113. doi:10.1186/1472-6963-13-88

Blackmore, C., Bishop, R., Luker, S., & Williams, B. (2013). Applying Lean Methods to

Improve Quality and Safety in Surgical Sterile Instrument Processing. The Joint

Commission Journal on Quality and Patient Safety, 39(3), 99. Retrieved from

47

http://www.ingentaconnect.com/content/jcaho/jcjqs/2013/00000039/00000003/

art00001

Brecht, S. (2012). Modeling optimal tradeoffs for lean and sustainable manufacturing

(Doctoral dissertation). Available from Proquest Dissertations and Theses

database. (Accession No. 1095373339)

Bodaghi, N. B., Cheong, L. S., & Zainab, A. (2016). Librarians Empathy: Visually

Impaired Students' Experiences Towards Inclusion and Sense of

Belonging in an Academic Library. Journal of Academic Librarianship, 42(1),

87-96. doi:10.1016/j.acalib.2015.11.003

Brooks, P. (2012). Reading for the plot: design and intention in narrative. Knopf

Doubleday Publishing Group. Alfred A. Knog: New York

Campos, J. (2012). Lean lab in action. MLO: Medical Laboratory Observer, 44(3), 26

29.

Christensen, I., & Rymaszewska, A. (2016). Lean application to manufacturing ramp-up:

A conceptual approach. The Quality Management Journal, 23(1), 45-54, 5-6.

Retrieved from http:// proquest.com

Coghlan, D., & Brydon-Miller, M. (2014). Quantitative Methods. The Sage Encyclopedia

of Action Research,

Collins, A., & Frydenlund, E. (2015). Academic revenue management and quantitative

worship. Journal of Revenue and Pricing Management, 14(1), 50-56.

doi:http://dx.doi.org/10.1057/rpm.2014.34

Djekic, I., Zivanovic, D., Dragojlovic, S., & Dragovic, R. (2014). Lean manufacturing

48

effects in a Serbian confectionery company - Case study. Organizacija, 47(3),

143-152. doi:10.2478/orga-2014-0013

Dora, M., Van Goubergen, D., Kumar, M., Molnar, A., & Gellynck, X. (2013).

Application of lean practices in small and medium-sized food enterprises. British

Food Journal, 116(1), 125-141. http://dx.doi.org/10.1108/bfj-05-2012-0107

Down, S. (2012). A historiographical account of workplace and organizational

ethnography. Journal of Organizational Ethnography, 1, 72-82.

doi:10.1108/20466741211220679

Farrokhi, F., Gunther, M., Williams, B., & Blackmore, C. (2015). Application of Lean

Methodology for Improved Quality and Efficiency in Operating Room Instrument

Availability. Journal for Healthcare Quality, 37(5), 277-286.

http://dx.doi.org/10.1111/jhq.12053

Ferguson, M. & Souza, G. (2010). Closed-Loop Supply Chains: New Developments to

Improve the Sustainability of Business Practices. Boca Raton: CRC Press.

Fox, R. (2013). Resisting participation: Critiquing participatory research methodologies

with young people. Journal of Youth Studies, 16(8), 986–999.

http://doi.org/10.1080/13676261.2013.815698

Frels, R. K., & Onwuegbuzie, A. J. (2013). Administering quantitative instruments with

qualitative interviews: A mixed research approach. Journal of Counseling &

Development, 91, 184–194. doi:10.1002/j.1556-6676.2013.00085.x

Fullerton, R., Kennedy, F., & Widener, S. (2014). Lean manufacturing and firm

performance: The incremental contribution of lean management accounting

49

practices. Journal of Operations Management, 32(7-8), 414-428.

http://dx.doi.org/10.1016/j.jom.2014.09.002

Galea, S. (2012). Simplicity, complexity, and conceptual frameworks. Psychiatry:

Interpersonal & Biological Processes, 75, 223-226.

doi:10.1521/psyc.2012.75.3.223

Greene, J.C. (2008) ‘Is mixed methods social inquiry a distinctive methodology?’

Journal of Mixed Methods Research, 2(1), 7-22.

Grima, P., Marco-Almagro, L., Santiago, S., & Tort-Martorell, X. (2014). Six Sigma:

Hints from practice to overcome difficulties. Total Quality Management

& Business Excellence, 25(3/4), 198-208. doi:10.1080/14783363.2013.825101

Guiette, A., Matthyssens, P., & Vandenbempt, K. (2014). Organizing mindfully for

relevant process research on strategic change. The Journal of Business &

Industrial Marketing, 29(7), 610-618. Retrieved from http://www.proquest.com

Hadid, W., & Afshin Mansouri, S. (2014). The lean-performance relationship in services:

A theoretical model. International Journal of Operations & Production

Management, 34(6), 750. Retrieved from http://proquest.com

Hagg, H., Suskovich, F., Workman-Germann, J., Schitti, S., & Hudson, B. (2007).

Adaptation of Lean Methodologies for Healthcare Applications (pp. 1-9).

Regenstrief Center for Healthcare Engineering. Retrieved from

http://docs.lib.purdue.edu/cgi/viewcontent.cgi?article=1035&context=rche_rp

Hamersly, B., & Land, D. (2015). Building productivity in virtual project teams. Revista

De Gestão e Projetos, 6(1), 1. Retrieved from http://search.proquest.com

50

Harvey, L. (2015). Beyond member-checking: a dialogic approach to the research

interview. International Journal of Research & Method in Education, 38(1), 23–

38. http://doi.org/10.1080/1743727X.2014.914487

Hayman, B., Wilkes, L., Jackson, D., & Halcomb, E. (2012). Exchange and equality

during data collection: relationships through story sharing with lesbian

mothers. Nurse Researcher, 19(4), 6-10 5p.

Hofer, C., Eroglu, C., & Rossiter Hofer, A. (2012). The effect of lean production on

financial performance: The mediating role of inventory leanness. International

Journal of Production Economics, 138(2), 242-253.

http://dx.doi.org/10.1016/j.ijpe.2012.03.025

Hong, P., James, J. R., & Rawski, G. (2012). Benchmarking sustainability practices:

Evidence from manufacturing firms. Benchmarking, 19(4), 634-648.

doi:10.1108/14635771211258052

Irvine, A. (2011). Duration, dominance and depth in telephone and face-to-face

interviews: A comparative exploration. International Journal of Qualitative

Methods, 10(3), 202-220.

Judson, E. P., & Maller, C. (2014). Housing renovations and energy efficiency: insights

from homeowners’ practices. Building Research & Information, 0(0), 1–11.

http://doi.org/10.1080/09613218.2014.894808

Konda, I., Starc, J., & Rodica, B. (2015). Social challenges are opportunities for

sustainable development: tracing impacts of social entrepreneurship through

innovations and value creation. Economic Themes, 53(2), 215-233.

51

Kosuge, R. (2014). The integration of lean and socio-technical practices in Sweden.

Annals of Business Administrative Science, 13(5), 255-269. Retrieved from

http://www.proquest.com

Langstrand, J., & Elg, M. (2012). Non-human resistance in changes towards

lean. Journal of Organizational Change Management, 25(6), 853-866.

doi:10.1108/09534811211280609

Liska Belgrave, L. (2014). Grounded theory. In D. Coghlan, & M. Brydon-Miller

(Eds.), The SAGE encyclopedia of action research, 7, 388-390. London: SAGE

Publications Ltd. doi:10.4135/9781446294406.n136

Longoni, A. & Cagliano, R. (2015). Cross-functional executive involvement and worker

involvement in lean manufacturing and sustainability alignment. International

Journal of Operation & Production Management, 35(9), 1332-1358.

http://dx.doi.org/10.1108/ijopm-02-2015-0113

Malinowski, B. (2014). The group and the individual in functional analysis. Anthropology

in theory, 90.

Matos, A., Alves, A., & Tereso, A. (2016). Lean Principles in an Operating Room

Environment: An Action Research Study. Journal of Health Management, online

before print. http://dx.doi.org/10.1177/0972063416637716

McLean, R., & Antony, J. (2014). Why continuous improvement initiatives fail in

manufacturing environments? A systematic review of the evidence. International

Journal of Productivity and Performance Management, 63(3), 370-376. Retrieved

from http://www.proquest.com

52

Meybodi, M. Z. (2013). Alignment of strategic benchmarking performance measures: A

lean manufacturing perspective. Advances in Competitiveness Research, 21(1/2),

14-28.

Miina, A. (2013). Critical success factors of lean thinking implementation in Estonian

manufacturing companies. Baltic Journal of Economics, 13(1), 113-114.

Miller, B. (2016). What Are the Different Types of Organizational Leadership?.

wiseGEEK. Retrieved 25 June 2016, from http://www.wisegeek.com/what-are-

the-different-types-of-organizational-leadership.htm

Mukhopadhyay, S., & Gupta, R. K. (2014). Survey of qualitative research methodology

in strategy research and implication for Indian researchers. Vision (09722629),

18(2), 109-123. doi:10.1177/0972262914528437

Northouse, P. (2016). Leadership (7th ed.). Thousand Oaks, Calif.: Sage.

Padgett, D. K. (2012). Mixed methods in Qualitative and mixed methods in public health,

47-65. Thousand Oaks, CA: SAGE Publications, Inc.

doi.:10.4135/9781483384511.n3

Pettigrew, A. (2013). The conduct of qualitative research in organizational settings.

Corporate Governance: An International Review, 21, 123-126.

doi:10.1111/j.1467-8683.2012.00925.x

Ogunbiyi, O. E. (2014). Implementation of the lean approach in sustainable

construction: A conceptual framework (Order No. U620948). Available from

ProQuest Dissertations & Theses Global. (1654745530). Retrieved from

http://www.proquest.com

53

Prowse, M., & Camfield, L. (2013). Improving the quality of development assistance:

What role for qualitative methods in randomized experiments? Progress in

Development Studies, 13(1), 51–61. http://doi.org/10.1177/146499341201300104

Rajashekharaiah, J. (2015). Responsible operations through materials' conservation - an

overview of techniques and trends. International Journal of Information,

Business and Management, 7(2), 85-96. Retrieved from http:// proquest.com

Sadgrove, M. K. (2015). The complete guide to business risk management. Ashgate

Publishing, Ltd.

Shepperd, M. (2015). How Do I Know Whether to Trust a Research Result? IEEE

Software, 32(1), 106-109. doi:10.1109/MS.2015.8

Sim, K. L., & Chiang, B. (2012). Lean production systems: Resistance, success and

plateauing. Review of Business, 33(1), 97-110.

Simboli, A., Taddeo, R., & Morgante, A. (2014). Value and wastes in manufacturing: An

overview and a new perspective based on eco-efficiency. Administrative Sciences

(2076-3387), 4(3), 173-191. doi:10.3390/admsci4030173

Simon, M. K. (2011). Dissertation and scholarly research: A practical guide to start and

complete your dissertation, thesis, or formal research project (3rd ed.).

Sisson, J. & Elshennawy, A. (2015). Achieving success with lean: An analysis of key

factors in lean transformation at Toyota and beyond. International Journal of

Lean Six Sigma, 6(3), 263 – 280. doi:10.1108/IJLSS-07-2014-0024

Sledge, S. (2015). An examination of corporate social responsibility practices and firm

performance in U.S. corporations. Academy of Strategic Management Journal,

54

14(2), 171-184. Retrieved from http://proquest.com

Stoudt, B. (2014). Quantitative methods in D. Coghlan, & M. Brydon-Miller (Eds.). The

SAGE encyclopedia of action research, 17, 670-674. London: SAGE Publications

Ltd. doi:10.4135/9781446294406.n252

Swauger, M. (2011). Afterword: The ethics of risk, power, and representation.

Qualitative Sociology, 34, 497-502. doi:10.1007/s11133-011-9201-5

Thamhain, H. J. (2014). Assessing the effectiveness of quantitative and qualitative

methods for R&D project proposal evaluations. Engineering Management

Journal, 26(3), 3-12. Retrieved from http://ezp.waldenulibrary.org/login?

url=http://search.proquest.com/docview/1561957577?accountid=14872

Torras, M., & Surie, G. (2015). On the Quantity Bias in Economics. Journal of Economic

Issues (M.E. Sharpe Inc.), 49(4), 1028-1044.

doi:10.1080/00213624.2015.1105033

Toro, J., Patel, A., Lytle, N., Sweeney, J., Medbery, R., & Scott Davis, S. et al. (2015).

Detecting performance variance in complex surgical procedures: analysis of a

step-wise technique for laparoscopic right hepatectomy. The American Journal of

Surgery, 209(2), 418-423. http://dx.doi.org/10.1016/j.amjsurg.2014.03.014

Vienazindiene, M., & Ciarniene, R. (2013). Lean manufacturing implementation and

progress measurement. Economics & Management, 18(2), 366-373.

doi:10.5755/j01.em.18.2.4732

Viterna, J., & Robertson, C. (2015). New directions for the sociology of development.

Annual Review of Sociology, 41(1), 243-269. doi:10.1146/annurev-soc-071913-

55

043426

von Bertalanffy, L. (1972). The history and status of general systems theory. Academy of

Management Journal, 15, 407-426. doi:10.2307/255139

Ward, A., Shook, J., & Sobek, D. (2014). Lean Product and Process Development (2nd

ed.). Cambridge, MA, USA: Lean Enterprise Institute.

West, D. & Dellana, S. (2016). Linking service structural design to service profitability: a

U.S. airline industry study. Operations Management Research, 9(1-2), 22-34.

http://dx.doi.org/10.1007/s12063-016-0109-9

Woolard, N. (2015). Academic capitalism and the impact on state spending for higher

education: Perceptions from members of the Oklahoma state

legislature. Academy of Educational Leadership Journal, 19(3), 319-335.

Retrieved from http://proquest.com

Yin, R. K. (2014). Case study research: Design and methods (5th ed.). Thousand Oaks,

CA: Sage publications.

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Appendix A: Title of Appendix

Insert appendix here. Appendices are ordered with letters rather than numbers. If

there is but one appendix, it has no letter designation.

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dissertation. Photocopied or previously printed material may have to be shifted on the

page or reduced in size to fit within the area bounded by the margins.

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appendix; no label is needed for the table itself. If you have text in addition to a table or

tables in an appendix, label the table with the letter of the appendix (e.g., Table A1, Table

A2, Table B1, and so on). These tables would be listed in the List of Tables at the end of

the Table of Contents.

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domain, you must also include permission to do so.

Template updated 2/18/15.