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Measuring Lean Initiatives in Health Care Services: Issues and Findings
Linköping University, Department of Management and Engineering. Linköping University, The Institute of Technology.
Linköping University, Department of Management and Engineering, Quality Technology and Management . Linköping University, The Institute of Technology.
Linköping University, Department of Management and Engineering, Logistics . Linköping University, The Institute of Technology.ORCID iD: 0000-0003-3986-9160
2007 (English)In: International Journal of Productivity and Performance Management, ISSN 1741-0401, E-ISSN 1758-6658, Vol. 56, no 1, 7-24 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: To discuss how a performance measurement system called 'the flow model' is designed to measure changes towards lean thinking in health care services.

Design/methodology/approach: Integrates literature from the health care sector and the lean production movement in order to understand whether lean thinking is applicable in healthcare and thereby identify key performance indicators that measure changes towards lean thinking in health care. The flow model is discussed in relation to this measurement framework.

Findings: Finds that lean thinking is applicable in health care settings, and that the flow model is a suitable tool for following up these initiatives. However, it is argued that the flow model needs to be balanced with other measurements in order to receive a complete picture of lean performance.

Research limitations/implications: Shows that the framework of measurements may be used in empirical research of assessing changes towards lean thinking in health care settings.

Practical implications: Shows that health care practitioners may use the findings to develop measurements of the outcome of lean initiatives on existing care processes.

Originality/value: Shows analysis and discussion of the application of an industrial concept - Lean Production - in health care services.

Place, publisher, year, edition, pages
2007. Vol. 56, no 1, 7-24 p.
Keyword [en]
Health services, Lean production, Sweden
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-14568DOI: 10.1108/17410400710717064OAI: oai:DiVA.org:liu-14568DiVA: diva2:23847
Available from: 2007-06-18 Created: 2007-06-18 Last updated: 2017-12-13
In thesis
1. Performance Measurement Systems in Swedish Health Care Services
Open this publication in new window or tab >>Performance Measurement Systems in Swedish Health Care Services
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the quality management literature, measurements are attributed great importance in improving products and processes. Systems for performance measurement assessing financial and non-financial measurements were developed in the late 1980s and early 1990s. The research on performance measurement systems has mainly been focused on the design of different performance measurement systems. Many authors are occupied with the study of the constructs of measures and developing prescriptive models of performance measurement systems. There is a need in the research to shift focus from studying the construct of measurements to how they are used in real face-to-face situations in specific contexts.

The purpose of this thesis is to analyse the development, i.e. the design, implementation and use, of performance measurement systems in Swedish health care services. The study aims to increase the understanding of the role of performance measurement system in Swedish health care and thereby support health care improvements in general. Three research questions have been derived from the purpose. (1) How and why are performance measurement systems being developed in Swedish health care services? (2) What problems can be identified in the development? (3) What enabling factors can be identified in the development? A qualitative research strategy was selected for the research. The research is based on a multiple case study design conducted within two research projects. Information has been gathered through interviews, documents and observations.

The idea of performance measurement systems develops through several tracks when implemented in health care and the development follows a purposeful process of activities. The development was initiated when major changes occurred in the organisation or its environment. Performance measurement systems are primarily used to support a dialogue between management and employees regarding organisational improvement. Problems experienced are related to struggles to reach national consensus for measures, involving management, and the clarification of various end-users’ needs. Enabling factors are the frequent interaction with people developing the system, management’s involvement, the use of multi-skilled teams, and visual displays.

The research contributes to several insights to the research area of performance measurement system and health care practitioners. The research shows that the development process is far from straight forward and is formed by the influence of factors in the organisational context, which cannot always be predicted. By seeing the development as an innovation process, the focus is broadened from being technological towards the organisation as whole, which contribute to the existing research on performance measurement systems.

Place, publisher, year, edition, pages
Institutionen för ekonomisk och industriell utveckling, 2007. 98 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1092Dissertations from the International Graduate School of Management and Industrial Engineering, ISSN 1402-0793 ; 108
Keyword
Quality management, Health care, Performance measurement, Innovation management, Qualitative research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-9302 (URN)978-91-85715-19-0 (ISBN)
Public defence
2007-05-11, A2, Hus A, Campus Valla, Linköpings universitet, Linköping, 13:15 (English)
Opponent
Supervisors
Available from: 2007-06-18 Created: 2007-06-18 Last updated: 2013-08-29

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Kollberg, BeataDahlgaard, Jens JörnBrehmer, Per-Olof

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