Several studies may be found on how Lean production is implemented in healthcare. Most articles include single case studies and are often published in medical journals. There is however a different tradition on how research is performed in medical and management sciences. The medical studies describe the state before and after an intervention or improvement program, but rarely pay attention to the implementation process and consider such important issues such as leadership, management processes and employee's role. There is a need for more management studies on Lean healthcare that focus not only on outcomes, but also on the context and factors that influence outcomes.
The purpose of the article is to contribute to the knowledge on how Lean production influences the daily work and routines of healthcare staff.
- What does it mean to employees to work in a Lean healthcare unit?
- How does a Lean implementation affect the role and responsibilities of the employees?
The data described in this paper comes from three case studies performed in healthcare organizations: two district care centres and one hospital unit. The data was collected through interviews, both with managers and employees, observations and document studies. The case organizations were described as successful Lean organizations and had worked with Lean for at least three years.
The implementation of Lean production often implies increased responsibility of employees for management of daily activities and increased participation in the improvement work. The influence of Lean on the daily work is however to great extent a matter of how the implementation is managed. In one case, Lean had been implemented by discrete projects, mainly conducted by the manager group with little effort on empowering the employees, increasing two-way communication and involvement in improvement work. Therefore, the role of the employees did not change much in conjunction with the Lean implementation. On the contrary, at another case the managers put a lot effort on coaching, developing and empowering the employees, and the improvement work had become an important working task for all employees. This led to a substantial improvement in the social climate, since the former barriers between different professions were weakened and the teamwork had increased.
The conclusion is that there are great potential benefits with a Lean implementation for the employees, but this can only be realized if the implementation is managed with a focus on the development of employees and a more open social structure. An important method to facilitate this is improvement groups with employees from different professions and functions within the organization that has an explicit ownership of the improvements, from idea to realization.
Originality/Value of paper:
Lean Healthcare is relatively a new phenomenon and more research work is needed to determine the full range of implications of the concept. The paper increases the understanding of what Lean production actually means to the healthcare staff. This knowledge is vital for the success and sustainability of Lean improvement programs in healthcare. The paper is also an inspiring source for both researchers and healthcare professional who are interested in the application of lean production in healthcare.
15th QMOD conference on Quality and Service Sciences ICQSS 2012, 5-7 September, Poznan, Poland