Relationship-centered health care as a Lean intervention

Dunsford, Jennifer; Reimer, Laura E

doi:10.1093/intqhc/mzx156

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…The fourth contribution of our research is that while many studies so far have argued for the inclusion of HR practices in an LM&SS systems approach (MacDuffie, 1995; Shah and Ward, 2003), our results argue for the application of a separate HRM systems approach. Dunsford and Reimer (2017) argue that research must acknowledge the fundamental dichotomy between the impersonal tasks required to provide health services, and human factors. In that sense, separating LM&SS and HRM could be an opportunity for health-care organizations.…”

Section: Discussionmentioning

confidence: 99%

Examining of the effect of HRM in mitigating negative effects of LM&SS on employee well-being in health care

Koeijer

Paauwe

Huijsman

et al. 2021

IJLSS

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Purpose This study aims to examine the effect of human resource management (HRM) in mitigating negative effects of Lean management and Six Sigma (LM&SS) on employee well-being in health care. The authors subdivide well-being into three components: happiness, trust and health. Design/methodology/approach This is a cross-sectional, multisite survey study in internal service units of hospitals. Data analyzed using multivariate regression come from a sample of 1,886 survey respondents (42 units, N = 218 supervisors, N = 1,668 employees) in eight Dutch academic hospitals that have implemented LM&SS. Findings The present study findings show no or weak effects of LM&SS on the happiness and health component of employee well-being. In addition, the authors found a significant but weak direct positive effect (ß = 0.07) of the LM&SS bundle on the trusting relationships component of well-being. Therefore, moderating effects of HRM practices on the relationship between LM&SS and employee well-being seem less relevant because an existing relationship between LM&SS and employee well-being is a prerequisite for moderation (Hayes, 2009). There were unexpected side effects. Inspired by research that discusses direct effects of HRM on employee well-being, the authors tested this relationship and found that HRM has a direct positive effect on trust and happiness of employees in health care. For the health component of well-being, the present results show a weak negative effect of HRM. Practical implications This study results in a cautiously optimistic view about LM&SS in health care, provided that it is applied in a targeted manner (to improve the performance of their processes) and that HRM is strategically aligned with the goals of LM&SS to improve employees’ happiness and trusting relationships. Originality/value Unique features of the study are the focus on the consequences for employees’ well-being related to LM&SS in health care, the role of HRM in regard to this relationship and the participation of all eight Dutch academic hospitals in this research.

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Section: Discussionmentioning

confidence: 99%

Examining of the effect of HRM in mitigating negative effects of LM&SS on employee well-being in health care

Koeijer

Paauwe

Huijsman

et al. 2021

IJLSS

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“…It is vital for healthcare executives to acknowledge the fundamental dichotomy between the process-oriented tasks required to provide health services and human factors [71]. Where most literature on LSS so far has argued for the inclusion of HR practices in an LSS systems approach, this chapter enlightens that LSS and HRM should be viewed as two different things.…”

Section: Managerial and Practical Implicationsmentioning

confidence: 96%

Perspective Chapter: A Renewed Perspective on Lean Six Sigma in Healthcare – People and Performance

Koeijer¹,

Paauwe²,

Strating³

et al. 2024

Six Sigma and Quality Management

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The Lean Six Sigma (LSS) approach has taken a central role in healthcare quality management, and many studies report positive effects of the method on performance of healthcare organizations. However, LSS in healthcare is also unbalanced because the human side of the method is undervalued. A more balanced application of LSS in healthcare includes an interrelated approach of both “soft” and “hard” LSS practices, broad perspective on employee well-being, “soft” HR approach related to LSS, and “soft” climate for LSS. This leads to a renewed perspective on LSS in healthcare that considers both people and performance and where the interplay between “hard” and “soft” factors is addressed.

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“…Despite the increase in the volume of literature on Lean Six Sigma in healthcare between 2000 and 2018, very few studies have examined its contribution alongside person-centred approaches and the impact on person-centred care and person-centred cultures. In total, 22 publications referred to person-centredness when discussing Lean Six Sigma use, however only 4 publications (Veech, 2004;Kelly, 2013;Colldén et al 2017;Dunsford and Reimer, 2017) specifically discuss Lean Six Sigma and person-centredness and only 1 of these articles focused on nursing.…”

Section: Inclusion Of Work Relating To Person-centred Carementioning

confidence: 99%

A Discussion of the Synergy and Divergence between Lean Six Sigma and Person-Centred Improvement Sciences

Teeling

Dewing

Baldie

2020

International Journal of Research in Nursing

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Background: This paper discusses if and how the improvement sciences of Lean Six Sigma and person-centred approaches can be melded or blended in the health care context. The discussion highlights the relationship between each approach to improvement science in terms of their respective purposes, intentions and probable outcomes; positioning these as either synergies or divergences. Comparison of the key theoretical and methodological principles underpinning each approach to improvement is also considered and implications for future practice, policy and research are drawn out. The discussion is informed by part of the findings of a realist review of relevant literature. Conclusions: Lean Six Sigma as a process improvement methodology appeals to a wide range of stakeholders in healthcare internationally. Four key synergies and three key divergences between Lean Six Sigma and person-centred approaches were found. The discussion here highlights the need for further research into Lean Six Sigma implementation and its possible contribution to developing person-centred cultures. Impact: Adoption of Lean Six Sigma in health care by stakeholder groups, external to nursing, has been taking place. At the same time there has been a loss of Lean's original intention of respect for people in favour of a technical efficiency focus on reducing waste and variation. Our findings of four key synergies and three key divergences between both approaches indicate where synergies can be maximised and divergence narrowed to improve implementation and enhance methodological coherence. Researchers, policy makers and practitioners should be aware that use of Lean Six Sigma alone may have a limited impact on developing personcentred care and culture. Use of Lean combined with person-centred approaches may appeal to a wider range of stakeholders. Yet, their combined use and effectiveness has not as yet been evaluated.

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Relationship-centered health care as a Lean intervention

Cited by 10 publications

References 9 publications

Examining of the effect of HRM in mitigating negative effects of LM&SS on employee well-being in health care

Examining of the effect of HRM in mitigating negative effects of LM&SS on employee well-being in health care

Perspective Chapter: A Renewed Perspective on Lean Six Sigma in Healthcare – People and Performance

A Discussion of the Synergy and Divergence between Lean Six Sigma and Person-Centred Improvement Sciences

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