Assessing the readiness to implement lean in healthcare institutions – A case study

Abstract

We develop a lean readiness framework and an assessment methodology to quantify the readiness of healthcare institutions for implementing lean. We use stakeholder theory and work with a lean implementation team responsible for process improvement in a healthcare group to develop the framework. The framework uses fuzzy based input derived from the stakeholders of the healthcare institution to generate an overall ranking through ideal solution technique. The assessment method derives input from the readiness scores shared by various stakeholders. The ranking suggests future improvement areas to prepare the healthcare institution for a lean implementation project. We provide an alternative perspective of assessing the lean readiness of healthcare institutions before beginning a lean implementation project for both researchers and practitioners. Our research is the first to develop a lean readiness framework for healthcare institutions and demonstrate it using an assessment technique.

Lean readiness within emergency departments: a conceptual framework

“…Thelen (2016) lack of knowledge about lean concepts, a lack of a proper system to solve employee issues, and a lack of training (Narayanamurthy et al 2018). Bhasin (2012) declares that LSs require distinct organisational cultures and that despite the benefits they might bring to organisations, they will not work well if the organisational cultures are not supportive.…”

“…Bhasin (2012) declares that LSs require distinct organisational cultures and that despite the benefits they might bring to organisations, they will not work well if the organisational cultures are not supportive. Narayanamurthy et al (2018) identifies three factors that contribute to LS adoption failures: the absence of adaptation, a lack of readiness, and a lack of a systemic approach.…”

“…Furthermore, Radnor and Bucci (2007) explain that service industries might face a tough task in implementing LSs, as the processes of identifying customer value and improving process flow might be unclear or complex. Narayanamurthy et al (2018) declare that a lack of LS implementation within the healthcare context increases the chance of business failure in the sector.…”

“…To measure ED readiness in this category, several questions were developed that aimed to identify the level of top management commitment in terms of being present in the working area, locating the right people in the right places, providing job security, investing in consultancy and expert advice, and investing in training. Without top management and leadership commitment, LS implementation will not succeed (Alnajem et al, 2012(Alnajem et al, , 2013Shazali et al, 2013;Narayanamurthy et al, 2018). Table 5 summarises the key areas covered in this category.…”

“…Bucci et al (2016) note that there have been few studies on lean within healthcare, particular regarding emergency departments (EDs). Similarly, Narayanamurthy et al (2018) highlight the lack of lean studies within healthcare and emphasise that there is a need for a robust lean readiness assessment framework that suits healthcare to reduce the LS failure rate in the sector. Moreover, Sangwa and Sangwan (2018) explain that there are few lean assessment models and that most studies in the literature have used qualitative assessment models, which might not be helpful in other hospitals.…”