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Lean in primary care - a critical appraisal from the service perspective
Wroclaw University of Technology, Wroclaw, Poland. (Quality Management)
Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology. (Quality Technology & Management)ORCID iD: 0000-0003-4040-8302
2014 (English)In: Proceedings of the 17th QMOD conference on Quality and Service Sciences ICQSS, Prague, Czech Republic, 2014Conference paper (Refereed)
Abstract [en]

Purpose –The paper aims to investigate how Lean is applied in the primary care settings and to discuss what implications can be drawn for improving quality of primary care.

Methodology/approach – The paper presents results from a survey on the Lean application in primary care units from the perspective of managers. Data for this study was collected using a web based questionnaire, which measures the application of Lean in five aspects: improvement work, daily control, process orientation, patient focus and Lean tools. Additional part of the survey covers information about outcomes of Lean. The data has been analysed by applying a service perspective, with focus on technical and functional determinants of service quality.

Findings –The study shows that the application of Lean in the primary care focuses on employee involvement in improvement work, increased responsibility for the coordination of daily work, teamwork, process orientation, patient focus and problem solving activities. Hard practices of Lean (e.g. Just-in-time) are not practiced and have a limited relevance for the primary care organizations. The study shows also that Lean has the highest impact on accessibility and time dimension of quality of care but marginal impact on the patient involvement in decisions about care and treatment. Thus Lean, which was originally designed to ensure the technical quality of manufacturing, has a limited influence on the functional quality of primary care.

Practical implications – Practitioners who consider to implement Lean into primary care organizations should consider how important for them is to apply an improvement concept called ‘Lean’, when the actual application of Lean in primary care context is limited to basic Quality Management principles and tools. When Lean is already applied, it should be remembered that manufacturing significantly differs from services and some aspects important in the health care service context such as for example patient experience need to be enhanced by additional improvement activities.

Originality/value – There are many case studies presenting the Lean application in hospital units, but there are few studies from primary care organizations. More than that, there is a lack of quantitative studies on Lean in primary care, which this paper provides. This paper makes also contribution by discussing the relevance and consequences of applying Lean to improve services in primary care settings.

Place, publisher, year, edition, pages
Prague, Czech Republic, 2014.
Keyword [en]
Lean production, health care, primary care, quality dimensions, quality of service
National Category
Mechanical Engineering
URN: urn:nbn:se:liu:diva-113706OAI: diva2:784339
The 17th QMOD conference on Quality and Service Sciences ICQSS
Available from: 2015-01-29 Created: 2015-01-29 Last updated: 2015-02-05

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