Readiness factors for lean implementation in healthcare settings – a literature review

Al-Balushi, Shahid; Sohal, Amrik S.; Singh, Prakash J.; Hajri, Abdullah Al; Farsi, Y.M. Al; Al-Abri, Rashid

doi:10.1108/jhom-04-2013-0083

Cited by 206 publications

(319 citation statements)

References 59 publications

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“…75% indicate that Lean contributes to an improvement culture but only 51% to problems being solved to a higher degree. Creating a continuous improvement culture is necessary to receive an effective Lean application in healthcare as authors such as Al-Balushi et al [20] state and problems need to be handled and solved in a structured way [9]. 74% are also assured that Lean is a general support in improvement work which might signify that the concept provides a structure for how to drive change in practice.…”

Section: Results and Analysismentioning

confidence: 99%

“…Several authors have argued that Lean only makes a lasting contribution if it enhances the problem-solving abilities of healthcare professionals, teams and ultimately entire institutions, and that leadership is essential [14,18,19]. Instead of having this quick win, tool-based approach researchers emphasize the importance of developing people and creating a continuous improvement culture as well as the leadership competence to introduce an effective Lean application in healthcare [18,20,21].…”

Section: What Are You Assured About? What Is It That Makes You Confidmentioning

confidence: 99%

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Lean from the First-line Managers’ Perspective – Assuredness about the Effects of Lean as a Driving Force for Sustainable Change

Kahm

Ingelsson

2017

Management and Production Engineering Review

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The purpose of this article is to present the results from a survey concerning first-line managers' assuredness about the effects of Lean after two years of Lean application in a Swedish healthcare organization. The purpose is also to reflect about assuredness as a driving force for sustainable change. Questionnaires were sent to all first-line managers in a healthcare organization in order to investigate how these managers consider their role, ability and conditions to create change according to Lean. One of the questions included 17 statements about how assured these managers were about the effects of Lean. The results from this question will be presented in this paper. The study showed that the majority of the first-line managers in this particular healthcare organization were assured that developmental work supported by Lean contributes to a higher patient focus, supports first-line managers with useful tools and methods, contributes to the development of an improvement culture and that the Lean concept in general is a support in improvement work. The question can either be used separately or as a part of an entire questionnaire in healthcare organizations. Asking first-line managers about their assuredness about the effects of Lean on a regular basis is one way to follow the Lean process from their perspective. The survey question might encourage discussions about the process of Lean and hopefully contribute to a greater understanding about the importance of assuredness and about the desired effects when applying Lean.

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Section: Results and Analysismentioning

confidence: 99%

Section: What Are You Assured About? What Is It That Makes You Confidmentioning

confidence: 99%

Lean from the First-line Managers’ Perspective – Assuredness about the Effects of Lean as a Driving Force for Sustainable Change

Kahm

Ingelsson

2017

Management and Production Engineering Review

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“…Some healthcare managers implement Lean, guided by eliminating waste based on what is defined as being valuable, rather than as a total system governing the whole organization. When Lean is implemented solely as an approach to providing process standards, creating flow, reducing interruptions and potential errors without being part of a comprehensive management system and adapted to the organization's decision making context, improvements will be made, but these may not be sustainable (Al-Balushi et al, 2014;Dixon-Woods et al, 2014;Kaplan et al, 2014;McIntosh et al, 2014). Even though Lean seems promising, no final conclusions can be drawn on its positive effects in healthcare or on implementation challenges (D'Andreamatteo et al, 2015;Mazzocato et al, 2010;Brandao de Souza, 2009;Waring and Bishop, 2010).…”

Section: Introductionmentioning

confidence: 99%

Has Lean improved organizational decision making?

Simons

Benders

Bergs

et al. 2016

International Journal of Health Care Quality Assurance

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Purpose - Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization's decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization's decision-making context, making it more amenable for QI initiatives. Design/methodology/approach - In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings - Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications - Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value - Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI's sustainability.

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“…Especialmente a partir dos anos 2000, diversas organizações de saúde vêm buscando adaptar os conceitos do Lean à realidade de suas operações, o que na literatura ficou conhecido como Lean healthcare. As recentes publicações de Andreamatteo et al (2015); Holden et al (2015); Al-Balushi et al (2014);Drotz;Poksinska (2014) ;De Carvalho et al (2014);Teich;Faddoul (2013); Rinehart (2013); Burgess; Radnor (2013); Radnor et al (2012) demonstram este fato. O Lean Healthcare é tido como uma abordagem promissora para a solução de problemas que, há muito tempo, o setor vem tentando superar, especialmente em setores de alta complexidade como cirurgia e emergência (CASTALDI et al, 2016).…”

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Uma análise das barreiras e dificuldades em lean healthcare

Soliman

Saurin

2017

Revista PO: R. Eletr. de Eng. de Produção e Correlatas

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Resumo: O Lean Healthcare tem se tornado uma tendência de investigação devido ao potencial de resultados que pode trazer para o contexto hospitalar. No entanto, a transposição dos conceitos Lean da manufatura para a saúde ainda encontra barreiras e dificuldades que não estão totalmente esclarecidas neste novo ambiente. Assim, esta pesquisa buscou responder ao seguinte questionamento: quais as barreiras e dificuldades enfrentadas por acadêmicos e praticantes do Lean Healthcare durante tentativas de melhoria de processos hospitalares? Entrevistas semiestruturadas foram realizadas com três acadêmicos e dois praticantes do assunto, juntamente com seis rodadas de observações participantes em dois hospitais de grande porte para a coleta de dados. Os resultados obtidos foram comparados com a literatura, mostrando diferentes níveis de similaridade e contrapontos, que podem estar atrelados a fatores de contexto e aos avanços na disseminação do Lean Healthcare. Foram revelados também outros três fatores que impactam na implementação do Lean na área da saúde, e que devem ser considerados: (i) Dificuldade de experimentação; (ii) Desequilíbrio na entrega de valor; e (iii) Abordagem inadequada. Através dos exemplos mostrados, espera-se contribuir com acadêmicos e praticantes do tema, evidenciando como diferentes fatores impactam nas tentativas de melhorias de processos hospitalares e como essas barreiras podem ser contornadas.Palavras-chave: Lean Healthcare. Barreiras. Dificuldades. Hospitais. Lean. Abstract:Lean Healthcare has become a research trend due to the potential results that it can bring to the hospital setting. However, the tuning of Lean concepts from manufacturing to healthcare still encounter barriers and difficulties that is not entirely clear in this new environment. Thus, this research sought to answer the following question: what are the barriers and difficulties faced by researchers and practitioners of Lean Healthcare during attempts for improving hospital processes? Semistructured interviews were conducted with three researchers and two practitioners of the subject, along with six rounds of participant observation in two large hospitals to collect data. The results were compared with literature, showing different levels of similarity and counterpoints, which may be linked to context factors and advances in the spread of Lean Healthcare. It was also revealed at least three other factors that impact the implementation of Lean in healthcare, and should be considered: (i) Difficulty of experimentation; (ii) Imbalance in the delivery of value; and (iii) Inadequate approach. Through the examples shown, we expect to contribute with researchers and practitioners, showing how different factors impact on attempts to hospital process improvements and how these barriers can be circumvented. BARREIRAS E DIFICULDADES EM LEAN HEALTHCARETornar processos enxutos é um desafio em qualquer ambiente. Embora muito já se saiba sobre as dificuldades de se aplicar Lean na manufatura (EMILIANI, 2000;ACHANGA et al., 2006;SIM;ROGER...

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Readiness factors for lean implementation in healthcare settings – a literature review

Abstract: To the best of the knowledge, this is the first paper that provides a consolidated list of key lean readiness factors that can guide practice, as well as future theory and empirical research.

Cited by 206 publications

References 59 publications

Lean from the First-line Managers’ Perspective – Assuredness about the Effects of Lean as a Driving Force for Sustainable Change

Lean from the First-line Managers’ Perspective – Assuredness about the Effects of Lean as a Driving Force for Sustainable Change

Has Lean improved organizational decision making?

Uma análise das barreiras e dificuldades em lean healthcare

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