Contextual factors: assessing their influence on flow or resource efficiency orientations in healthcare lean projects

Abstract

The outcomes of lean projects have been mixed, with some being successful while many others have not. An explanation for this is a paradox that can develop depending on the focus of the project. Ironically, in projects where the focus is on maximizing the efficiency of a resource ("resource efficiency"), this focus might lead to worsening of the resource"s efficiency, thereby generating an "efficiency paradox". This paradox does not usually arise in projects where the focus is on the subject of interest being processed through the system in the most efficient manner ("flow efficiency"). The aim of this paper is to investigate the factors that give rise to either form of efficiency. We conducted a detailed study of eight lean projects in two large hospitals. In doing so, we advance the theory of lean service operations by identifying four key contextual factors that drive the orientation of a project to resource or flow efficiency. These are: service variety, interdependency, capital resource intensity, and service uniqueness. We propose a conceptual framework and four propositions that integrate the contextual factors to determine the dominant focus in lean projects. Through this, recommendations are made as to how the efficiency paradox can be avoided.

Adapting Lean for process redesign in senior day care services

“…Further, studies on the adaptation of Lean in community care settings seems to be scarce and limited in practice. Researchers noted that there seems to be limited knowledge and understanding on the operations and work processes in community care contexts and attention on process improvement are also relatively nascent (14,18,(28)(29)(30). Therefore, this article aims to extend understanding in the adaptation of lean in the community care contexts by conducting an in-depth case-based research in two elder day care centres in Singapore.…”

“…During the Lean adaptations at the 2 SDCs, key insights that emerged from the field was the importance of stakeholder buy-in, where leadership from the management, cooperation and involvement of the functional units are pivotal for effecting the desired outcome. From the case observations and focused group discussion, key themes that emerged were also the presence of strong leadership and management support from the organisation, which facilitated the adaptation of Lean for possible improvements to the process redesign (28,30,(40)(41)(42).…”

Padronização de kits de material cirúrgico para tratamentos de coluna utilizando a abordagem Lean Healthcare approach

“…Improta, Cesarelli, Montuori, Santillo, & Triassi (2017) To adopt the Lean Six Sigma to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. Tay, Singh, Bhakoo, & Al-Balushi (2017) To investigate the factors that give rise to either form of efficiency ('resource efficiency' or 'flow efficiency'). Lindskog, Hemphälä, & Eriksson (2017) To expand upon lean tools and innovation enabling job resources.…”

“…The latter had a reduction in the number of patients colonized by sentinel bacteria after the improvement phase Tay (2016). andTay et al (2017) conducted detailed studies of lean projects in two large hospitals. They found the redundancy between resource efficiencies and flow efficiencies, and identified key contextual factors that drove the project orientation to each of them Tay et al (2017).…”

A New Methodology for Supply Chain Management: Discourse Analysis and its Potential for Theoretical Advancement

“…We problematize the meaning embedded in this mature, dominant discourse that serves to render employees invisible. In doing so, we address two criticisms often levelled at lean: that it can be oppressive as far as employees are concerned (Samuel et al, ), and that lean initiative is often unsuccessful (e.g., Bhamu & Sangwan, ; Carter et al, ; Radnor, Holweg & Waring, ; Radnor & Osborne, ; Tay et al, ). We argue that these two issues are interwoven—that the exclusion of employees is one reason why lean initiatives fail.…”