Purpose -This article aims to contribute towards a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations.Design/methodology/approach -The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data was collected by methods including interviews, observations, and document studies. Findings -The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers.Practical implications -Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance.Originality/value -In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

The aim of this paper is to contribute to a better understanding of managerial practices and leadership in Lean organisations. The results presented here are based on five case studies. The manager's role changed radically with the implementation of Lean production. The focus in managerial tasks changed from managing processes to developing and coaching people. Supporting structures were developed to empower employees and give them more responsibility for daily management activities. These supporting structures included visual control, goal deployment, short daily meetings, two-way communication flow, and a system of continuous improvement. Many leadership behaviours exhibited by Lean managers can be classified as transformational leadership behaviours. However, the need for transformational leadership behaviours was smaller, if the supporting management structure was strong

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