The Revolution Lean Six Sigma 4.0

G. Arcidiacono, A. Pieroni


Industry 4.0 makes a factory smart by applying advanced information systems and future-oriented technologies. Today, thanks to the application of the most innovative digital technologies offered by the new Industry 4.0 paradigm, in this Fourth Industrial Revolution, there is a significant “evolution†of many methodologies of Continuous Improvement, such as, e.g., Lean Six Sigma (LSS). Most of the tools of Lean Six Sigma relies on data to know in depth problems: data is necessary to drive any process improvement. The key issue is based on data integrity and on real time data. The aim of this paper consists of proving the efficiency of the so called “Lean Six Sigma 4.0â€. This paper deals with engineering approaches, here applied in HealthCare environment, in order to optimise the services supply process and to reduce the waste of resources (human and/or material), while improving the Quality of Experience (QoE) of the patients. Indeed, it has been proved that the huge growth in the HealthCare costs is due to inefficient use of available resources and not-optimised service processes. Applying Lean Six Sigma 4.0 it is possible to reduce HealthCare costs, improving at the same time the QoE perceived by the patient.


industry 4.0; IoT; information engineering; additive manufacturing; performance evaluation; DMAIC; healthcare.

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Schwab K., Davis N. (2018) “Shaping the Fourth Industrial Revolutionâ€, Book ISBN–978-1-944835-14-9.

Pieroni A., Scarpato N., Brilli M. (2018). Performance Study in Autonomous and Connected Vehicles, an Industry 4.0 Issue. Journal of Theoretical and Applied Information Technology January 2018 Vol. 96 No.2 E-ISSN 1817-3195 / ISSN1992-8645.

Pieroni A., Scarpato N., Brilli M. (2018). Industry 4.0 Revolution in Autonomous and Connected Vehicle A non-conventional approach to manage Big Data. Journal of Theoretical and Applied Information Technology January 2018 Vol. 96 No.1 E-ISSN 1817-3195 / ISSN1992-8645.

F. Guadagni et al., (2017). RISK: A Random Optimization Interactive System Based on Kernel Learning for Predicting Breast Cancer Disease Progression. In Bioinformatics and Biomedical Engineering: 5th International Work-Conference, IWBBIO 2017, Granada, Spain, April 26--28, 2017, Proceedings. Part I, I. Rojas and F. Ortuño, Eds. Cham: Springer International Publishing, 2017, pp.189–196.

A. R. D. Accardi and S. Chiarenza. (2016). Musei digitali dell’architettura immaginata: un approccio integrato per la definizione di percorsi di conoscenza del patrimonio culturale Digital museums of the imagined architecture: an integrated approach. DISEGNARECON, vol. 9.

M. Pennacchiotti and F. M. Zanzotto. (2008). Natural Language Processing Across Time: An Empirical Investigation on Italian,†Springer, Berlin, Heidelberg, pp. 371–382.

R. Beccaceci, F. Fallucchi, C. F. Giannone, F. Spagnoulo, and F. M. Zanzotto. (2009). Education with ‘living artworks’ in museums,†in CSEDU 2009 – Proceedings of the 1st International Conference on Computer Supported Education, 2009, vol.1.

Arcidiacono, G., De Luca, E.W., Fallucchi, F., Pieroni, A. (2016). “The use of lean six sigma methodology in digital curationâ€, CEUR Workshop Proceedings.

M. T. Pazienza, N. Scarpato, and A. Stellato. (2009). STIA*: Experience of semantic annotation in Jurisprudence domain. In Frontiers in Artificial Intelligence and Applications, 2009, vol. 205, pp. 156–161.

M. Bianchi, M. Draoli, G. Gambosi, M. T. Pazienza, N. Scarpato, and A. Stellato. (2009). ICT tools for the discovery of semantic relations in legal documents. In CEUR Workshop Proceedings, 2009, vol. 582.

G. Boella, L. Di Caro, L. Humphreys, L. Robaldo, P. Rossi, and L. van der Torre. (2016). “Eunomos, a legal document and knowledge management system for the Web to provide relevant, reliable and up-todate information on the law. Artif. Intell. Law, vol. 24, no. 3, pp. 245–283, Sep.2016.

V. Morabito (2015). Big Data and Analytics for Government Innovation. Big Data Anal. Strateg. Organ. Impacts, pp. 23–45, 2015.

Zanella Andrea, et al. (2014). Internet of things for smart cities. IEEE Internet Things J. 1.1, p. 22–32.

F. Fallucchi, E. Alfonsi, A. Ligi, and M. Tarquini. (2014). Ontology-driven public administration web hosting monitoring system, vol. 8842.

M. Bianchi, M. Draoli, F. Fallucchi, and A. Ligi. (2014). Service level agreement constraints into processes for document classification. In ICEIS 2014 - Proceedings of the 16th International Conference on Enterprise Information Systems, 2014, vol. 1

D. Zhang, L. Zhou, and J. F. Nunamaker Jr. (2002) A Knowledge Management Framework for the Support of Decision Making in Humanitarian Assistance/Disaster Relief. Knowl. Inf. Syst., vol. 4, no. 3, pp. 370–385, Jul. 2002.

F. Fallucchi, M. Tarquini, and E. W. De Luca. (2016). Knowledge management for the support of logistics during Humanitarian Assistance and Disaster Relief (HADR), vol. 265.

A. D’Ambrogio et al. (2017). Use of integrated technologies for fire monitoring and first alert,†in Application of Information and Communication Technologies, AICT 2016 -Conference Proceedings, 2017, pp. 1–5.

Scarpato N., Pieroni A., Di Nunzio L., Fallucchi F, 2017, “E-health-IoT Universe: A Reviewâ€, International Journal on Advanced Science, Engineering and Information Technology, Vol. 7 (2017) No. 6, pages: 2328-2336, DOI:10.18517/ijaseit.7.6.4467.

Iazeolla, G., Pieroni, A., D'Ambrogio, A., Gianni, D. (2010). A distributed approach to wireless system simulation. 6th Advanced International Conference on Telecommunications, AICT 2010, art. no. 5489830, pp. 252-262.

D'Ambrogio, A., Gianni, D., Iazeolla, G., Pieroni, A. Distributed simulation of complex systems by use of an HLA-transparent simulation language. (2008). Asia Simulation Conference - 7th International Conference on System Simulation and Scientific Computing, ICSC 2008, art. no. 4675405, pp. 460-467.

Iazeolla, G., Pieroni, A., D'Ambrogio, A., Gianni, D. (2010). A distributed approach to the simulation of inherently distributed systems. Spring Simulation Multiconference 2010, SpringSim'10, art. no. 132.

Bocciarelli, P., Pieroni, A., Gianni, D., D'Ambrogio, A. (2012). A model-driven method for building distributed simulation systems from business process models (2012) Proceedings - Winter Simulation Conference, art. no. 6465106.

D'Ambrogio, A., Gianni, D., Risco-Martín, J.L., Pieroni, A. (2010). A MDA-based approach for the development of DEVS/SOA simulations. Spring Simulation Multiconference 2010, SpringSim'10, art. no. 142.

Gianni, D., D'Ambrogio, A., Iazeolla, G., Pieroni, A. (2008) Producing simulation sequences by use of a java-based generalized framework. Proceedings - EMS 2008, European Modelling Symposium, 2nd UKSim European Symposium on Computer Modelling and Simulation, art. no. 4625266, pp. 171-176.

D'Ambrogio, A., Iazeolla, G., Pieroni, A., Gianni, D. (2011). A model transformation approach for the development of HLA-based distributed simulation systems. SIMULTECH 2011 - Proceedings of 1st International Conference on Simulation and Modeling Methodologies, Technologies and Applications, pp. 155-160.

Iazeolla, G., Pieroni, A. (2014). Energy saving in data processing and communication systems. Scientific World Journal, art. no. 452863.

Cardarilli, G.C., Di Nunzio, L., Fazzolari, R., Pontarelli, S., Re, M., Salsano, A. (2011), “Implementation of the AES algorithm using a Reconfigurable Functional Unitâ€, ISSCS 2011 - International Symposium on Signals, Circuits and Systems, Proceedings, art. no. 5978668, pp. 97-100.

Cardarilli, G.C., Di Nunzio, L., Fazzolari, R., Re, M., Lee, R.B. Integration of butterfly and inverse butterfly nets in embedded processors: Effects on power saving (2012) Conference Record - Asilomar Conference on Signals, Systems and Computers, art. no. 6489268, pp. 1457-1459.

Sanders A, Elangeswaran C, Wulfsberg J, (2016). “Industry 4.0 implies Lean Manufacturing: research activities in Industry 4.0 function as enablers for Lean Manufacturinâ€, Journal of Industrial Engineering and Management, - 9(3): 811-833.

Fogarty D, (2015). “Lean Six Sigma and Big Data: continuing to innovative and optimize business processâ€, Journal of Management and Innovation, Fall 2015 1(2).

Arcidiacono G, Costantino N, Yang, K, 2016, "The AMSE Lean Six Sigma Governance Model", International Journal of Lean Six Sigma, Vol. 7, Issue 3; pp. 233-266, doi: 10.1108/ IJLSS-06-2015-0026

Gijo, E.V., Antony, J., Reducing patient waiting time in outpatient department using lean six sigma methodology (2014) Quality and Reliability Engineering International, 30 (8), pp. 1481-1491.

Hicks, C., McGovern, T., Prior, G., Smith, I., Applying lean principles to the design of healthcare facilities (2015) International Journal of Production Economics, 170, pp. 677-686.

Moraros, J., Lemstra, M., Nwankwo, C., Lean interventions in healthcare: Do they actually work? A systematic literature review (2016) International Journal for Quality in Health Care, 28 (2), pp. 150-165.

Walshe, K. Pseudoinnovation: The development and spread of healthcare quality improvement methodologies (2009) International Journal for Quality in Health Care, 21 (3), pp. 153-159.

Van Der Meulen, F., Vermaat, T., Willems, P., Case study: An application of logistic regression in a six sigma project in health care (2011) Quality Engineering, 23 (2), pp. 113-124.

W. Gao et al. (2015). ““The status, challenges, and future of additive manufacturing in engineeringâ€. Computer-Aided Design 69, pag. 65–89.

Arcidiacono G, Wang J, Yang, K, 2015, "Operating room adjusted utilization study", International Journal of Lean Six Sigma, Vol. 6, Issue 2; pp.111 – 137, doi: 10.1108/ IJLSS-02-2014-0005

Arcidiacono G, Calabrese C, Yang K, 2012, “Leading processes to lead companies: Lean Six Sigmaâ€, Springer, ISBN 978-88-470-2492-2

Womack J, Jones D. (2003). “Lean Thinkingâ€. New York, NY: Simon & Schuster.

Arcidiacono G, Matt DT, Rauch E, 2017, “Axiomatic Design of a Framework for the Comprehensive Optimization of Patient Flows in Hospitalsâ€, Journal of HealthCare Engineering, Vol. 2017, Article ID 2309265, 9 pp. doi: 10.1155/2017/2309265

Walshe, K. Pseudoinnovation: the development and spread of healthcare quality improvement methodologies. Int J Qual Health Care 2009; 21: 153-159.

Brandao de Souza, L., (2009). “Trends and approaches in Lean healthcareâ€. Leadership in Health Services 2009; 22: 121–139.

Arcidiacono G, Berni R, Cantone L, Placidoli P, 2017, “Kriging models for payload-distribution optimization of freight trainsâ€, International Journal of Production Research, Vol. 55, No. 17, 4878-4890, doi: 10.1080/00207543.2016.1268275

Ohno T, (1988). “Toyota Production System: beyond large-scale productionâ€, Cambridge, Mass: Productivity Press.

Spath D, Ganschar O, Gerlach S, Hämmerle M, Krause M, Schlund S., (2013). “Produktionsarbeit der Zukunftâ€. Stuggart: Fraunhofer Verlag.

Wan J, Cai H, Zhou K, (2015). “Industrie 4.0 Enabling technologiesâ€, International Conferences on Intelligent Computing and Internet of Things (ICIT), IEEE 2015, Harbin, China, 135-140.

Giorgetti A, Cavallini C, Ciappi A, Arcidiacono G, Citti P, (2017). “A holistic model for the proactive reduction of non-conformities within new industrial technologiesâ€, International Journal of Mechanical Engineering and Robotics Research, vol. 6(4), pp. 313-317.



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