Exploring the barriers to lean health care implementation

Souza, Luciano Brandão de; Pidd, Michael

doi:10.1080/09540962.2011.545548

Cited by 175 publications

(175 citation statements)

References 16 publications

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“…However, this thesis shows that the primarily customer in the public sector is the direct user of the service, whether it is a client, patient, or user. This is in line with the de Souza and Pidd's (2011) suggestion that the value flow should be seen from the user's perspective.…”

Section: Define Customer Valuesupporting

confidence: 52%

“…The current way of using Lean in the public sector has also been criticized due to the lack of system perspective, meaning that Lean is only used in limited parts of organizations (Radnor et al, 2012).There is a need to see the value flow from the user's perspective, which in most cases crosses functional and professional borders (de Souza and Pidd, 2011). All in all, despite the number of papers and studies regarding Lean in the public sector, there are some gaps that must be filled.…”

Section: Lean In Public Sectormentioning

confidence: 99%

“…Other writers agree that Lean often has the wrong focus when it is implemented in healthcare, but suggest that this depends on the interpretation of the concept rather than the concept itself (Modig and Åhlström, 2013). Several researchers stress that most of the barriers toward Lean implementation in public sector are related to resistance from people, leadership failures, identity of improvement team members, weak links between improvement programs and strategy, lack of resources, poor communication, and functional and professional silos (de Souza and Pidd, 2011;Radnor et al, 2006). Considering the lack of knowledge about the relevance of Lean in the public sector, there is a need for a deeper investigation on how Lean is used in the public sector and how it fits in that context.…”

Section: Sammanfattningmentioning

confidence: 99%

See 2 more Smart Citations

Lean in the Public Sector : Possibilities and Limitations

Drotz¹

2014

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Section: Define Customer Valuesupporting

confidence: 52%

Section: Lean In Public Sectormentioning

confidence: 99%

Section: Sammanfattningmentioning

confidence: 99%

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Lean in the Public Sector : Possibilities and Limitations

Drotz¹

2014

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“…[6,7,22,28] During change it is of great importance to achieve alignment across the HCO -that is, to achieve shared understanding and orientation, common values and priorities within the HCO [12,21] -and to attain clarity concerning roles, responsibilities and the possibility of adapting the strategy to the local context. [22,29] In our study, CAs with powers formally granted by a sponsor, i.e.…”

Section: Supporting Alignmentmentioning

confidence: 99%

“…the existence of competing logics of managerialism and professionalism and resistance from strong groups of health care professionals towards change based on management concepts. [5][6][7] A wide range of terminology is used to describe key functions or roles during change. [8] In the change management literature, a key role for change is that of the "champion".…”

Section: Introductionmentioning

confidence: 99%

Organization of change agents during care process redesign in Swedish health care

Williamsson

Eriksson

Dellve

2016

JHA

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Background: Swedish health care organizations (HCOs) are changing using management concepts such as Lean, in attempts of improving efficiency, quality of care and work environment. Since there are pre-conditional challenges for operative managers to engage in change, HCOs tend to assign supportive functions such as change agents (CAs) to facilitate change. Research on the use of CAs in HCOs is sparse, thus the aim of this study explores role assignments and conditions of formally appointed CAs contributing to care process redesign. Methods: A purposive sample of three Swedish hospitals initiating Lean-inspired care process redesign during 2010-2011 was done. In-depth interviews were held with fifty-one key functions during change. Focus group interviews were conducted with thirty-eight health care professionals. Data were analysed by content analysis. Results: Top managers' goal was to have operative management responsible for change during care process redesign, with support from assigned CAs. Organizing of CAs varied concerning, e.g. their hierarchical positions, job descriptions and practices, and conditions to act as driving forces towards change. Being granted formal power, having earned legitimacy and credibility, clarity regarding roles and responsibilities in change; a good sense of timing and ability to build relationships and trust, were identified as beneficial for CAs to support change. Conclusions: Role assignment and organizing of CAs varies. A position closer to the operative levels, formalized and clarified responsibilities, earned legitimacy and timing support adaptation and alignment of planned change, such as Lean-inspired care process redesign.

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Application of Lean Manufacturing in Hospitals—the Need to Consider Maturity, Complexity, and the Value Concept

Hasle

Nielsen

Edwards

2016

Hum Ftrs & Erg Mfg Svc

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Lean is widely applied in hospitals but the impact tend to be limited. This paper investigates three possible explanations: maturity, complexity and the value concept and analyses the bearing of these in a case study of lean application in a large Danish university hospital. The results indicate that lean tends to be applied in secondary and support functions with a logistic character, and therefore has had a limited impact on the overall healthcare performance. The case study show that there are constraints related to low lean maturity, the complexity of processes and operations as well as differences in value perceptions among the different professions within the hospital. The conclusion is that lean is useful for hospitals, but the lean concept as well as its implementation methods need to be fitted to the organisational complexity and diverging values in hospitals in order to bring about a larger impact. It is therefore necessary to develop new models for the lean concept as well as the implementation of lean adapted to the particular context of hospitals with a stronger focus on patient experiences and on coordination of social relations.

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Exploring the barriers to lean health care implementation

Cited by 175 publications

References 16 publications

Lean in the Public Sector : Possibilities and Limitations

Lean in the Public Sector : Possibilities and Limitations

Organization of change agents during care process redesign in Swedish health care

Application of Lean Manufacturing in Hospitals—the Need to Consider Maturity, Complexity, and the Value Concept

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