Can lean save lives?

Fillingham, David

doi:10.1108/17511870710829346

Cited by 255 publications

(217 citation statements)

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“…Up until that time, the implementation of lean and similar tools and methods in the NHS had involved relatively small-scale interventions confined to particular hospital departments and support services. 15 However, NHS NE was committed to addressing more complex system-wide issues, including addressing transformational change, culture and the relationship between clinicians and managers. Many aspects of the NETS were aligned with Darzi's NHS next stage review conclusions about how best to ensure service redesign.…”

Section: The North East Transformation System: Key Features Researchmentioning

confidence: 99%

A mixed-methods evaluation of transformational change in NHS North East

Hunter

Erskine

Hicks

et al. 2014

Health Services and Delivery Research

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BackgroundThe North East Transformation System (NETS) was conceived as an experiment in adopting large-scale transformational change across a NHS region in England. Although the NHS in the North East performs well, the health of the population ranks among the poorest in the country. The NETS was viewed as a means of addressing this conundrum. It comprised three components: Vision, Compact and Method.ObjectivesThe evaluation study comprised six elements: a literature review; an evaluation of the evolution and impact of the NETS; an identification of the factors facilitating, and/or acting as barriers to, successful change; an assessment of the role of the NETS project team; establishing how far the changes introduced through the NETS became embedded and sustained; and an evaluation of the impact of the NETS on end users.DesignThe research comprised a longitudinal mixed-methods study conducted over 3.5 years. Research methods included 68 semistructured interviews, observation, two focus groups, documentary analysis and interrupted time series (ITS) analysis. The ITS component comprised analysis of five rapid process improvement workshops in two of the sites.SettingThe research setting was the NHS North East region until its abolition in April 2013 following the UK government’s NHS changes. Fourteen sites were selected for the study, comprising primary care trusts as commissioners, and provider trusts including mental health, community, acute care and ambulance services.ParticipantsThe study respondents were members of staff in the 14 sites drawn from different levels of their organisations.InterventionsThe NETS comprised a complex set of interventions aimed at improving the efficiency and effectiveness of care pathways for staff and patients.Main outcome measuresThe ‘receptive contexts for change’ framework was used to evaluate the transformational change process and its outcomes.Data sourcesQualitative parts of the study drew on semistructured interviews, focus groups, observation and documents. Quantitative parts of the study used routinely collected NHS data.ResultsTransformational change in a complex system takes time and demands consistency, constancy of purpose and organisational stability. The NETS was seriously disrupted by the NHS changes announced in July 2010. Progress was sustained at four of the study sites, but slowed or ceased at the other sites. Leadership style was found to be critical to the success of transformational change.ConclusionsThe NETS was a bold and ambitious initiative which succeeded in bringing about real and lasting change in some parts of the North East. However, it was unable to fully realise its vision and purpose partly because of the widespread reorganisation of the NHS by the new coalition government.Future workThere is a need to develop new methods to understand how change occurs, or fails, in complex settings like the NHS. There is a need for more in-depth studies in those sites that were able to implement and sustain change. This would inform future policy and practice. The results of the quantitative analyses were less conclusive than those obtained by qualitative methods. Further development of mixed-methods approaches would provide additional support for evidence-based decision-making.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: The North East Transformation System: Key Features Researchmentioning

confidence: 99%

A mixed-methods evaluation of transformational change in NHS North East

Hunter

Erskine

Hicks

et al. 2014

Health Services and Delivery Research

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“…Cuatrecasas, 2004;Alsmadi et al, 2012;Suarez-Barraza et al, 2012) and healthcare (see e.g. Miller, 2005;Lummus et al, 2006;Fillingham, 2007). The concept is often described as an integrated socio-technical system whose main objective is to eliminate waste and reduce operational costs (Ohno, 1988;Shah and Ward, 2007).…”

Section: Introductionmentioning

confidence: 99%

The daily work of Lean leaders – lessons from manufacturing and healthcare

Poksińska

Swartling

Drotz

2013

Total Quality Management & Business Excellence

133

203

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The aim of this paper is to contribute to a better understanding of managerial practices and leadership in Lean organisations. The results presented here are based on five case studies. The manager's role changed radically with the implementation of Lean production. The focus in managerial tasks changed from managing processes to developing and coaching people. Supporting structures were developed to empower employees and give them more responsibility for daily management activities. These supporting structures included visual control, goal deployment, short daily meetings, two-way communication flow, and a system of continuous improvement. Many leadership behaviours exhibited by Lean managers can be classified as transformational leadership behaviours. However, the need for transformational leadership behaviours was smaller, if the supporting management structure was strong

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“…Otro caso exitoso registrado en la literatura es la aplicación de Lean como una estrategia operativa en la organización Virginia Centro Mason Medical (VMMC) en Seattle [38], donde reconocen la mejora en los niveles de inventario y de la productividad, y la reducción del tiempo de espera y de movimientos. Por otra parte en el Reino Unido el caso del Bolton NHS Trust, expone los principales resultados obtenidos en más de dos años de práctica tales como: mejora en el servicio, en el rendimiento y en la calidad y la seguridad [39]. Adicionalmente diferentes organismos internacionales se dedican a elaborar guías y mostrar los resultados de aplicación de Lean Healthcare tal como NHS-Institute for Innovation and Improvement, el IHI-Institute for Healthcare Improvement y el Lean Enterprise Institute.…”

Section: Figura 4 Principales Autoresunclassified

“…Asimismo Lean ha sido identificado como una alternativa a los enfoques tradicionales que buscan la solución de los problemas de calidad en un hospital o clínica ( [4]; [42]. Por lo tanto el propósito de Lean Healthcare es crear valor para el paciente y el valor es creado cuando se eliminan los desperdicios del proceso, con el propósito de darle un adecuado diagnóstico y tratamiento ( [24], [39], [43]; [44]). Muchos de los impactos y resultados de la aplicación de Lean Healthcare son: mejor cuidado de los pacientes, mejor calidad en los procesos de atención, mejor diseño de los procesos, mayor rendimiento financiero, mayor valor para el paciente, aumento de la productividad y oportuna prestación de servicios, mediante la reducción de los tiempos de espera, reducción de errores, incidentes y procedimientos inadecuados, y la disminución de costos ( [11], [22], [24], [45]; [46]; [47]; [48]; [49]; [50]; [51]; [52]; [53]; [54]; [55].…”

Section: Figura 4 Principales Autoresunclassified

Lean Healthcare: Una Revisión Bibliográfica Y Futuras Líneas De Investigación

Orjuela

Pimiento

2015

Sci. tech

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Resumen-La filosofía Lean a través del tiempo ha evolucionado y ha sido implementada en varios tipos de empresas tanto en el sector manufacturero como en el de los servicios, lo cual se evidencia en el gran número de estudios que investigan sobre la implementación de lean en dichos sectores. El propósito de este estudio es analizar las tendencias de las publicaciones, identificar los autores más influyentes y describir las futuras investigaciones en la aplicación de Lean en el sector salud. En esta investigación se presentan los resultados de un análisis bibliométrico realizadas a las publicaciones científicas acerca de la filosofía Lean Healthcare durante el periodo 1990-2015, en la base de datos: Isi Web of Knowladge, Scopus y PubMed. Los resultados de esta investigación contribuyen a identificar tópicos emergentes y ser un marco de referencia para futuras investigaciones en este tema de investigación.Palabras clave-análisis bibliómetrico, lean healthcare, servicios en salud, tendencias.Abstract-The lean philosophy through time, it has evolved and has been implemented in several types of companies both in the manufacturing sector and services, which is evident in the large number of studies that investigate on the implementation of lean in those sectors. The purpose of this study is to analyze the trends of the publications, identify the most influential authors and describe the future research in the application of Lean in the health sector. In this research presents the results of a bibliometric analysis carried out to the scientific publications about the philosophy of Lean Healthcare during the period 1990-2015, in the database: ISI Web of Knowladge, Scopus and PubMed. The results of this research will help to identify emerging topics and be a framework of reference for future research in this research topic.Key Word -bibliometric analysis, lean healtcare, health services, trends. , todas las definiciones que se plantean en las referencias anteriores son comunes ya que describen a Lean como una filosofía centrada en cumplir satisfactoriamente las necesidades del cliente, utilizando todos los recursos de producción disponibles con un mínimo de desperdicios, con la mayor calidad y al menor costo. Se puede concluir entonces con [8] que el propósito de Lean es minimizar las actividades que no agregan valor o desperdicios, y mejorar las actividades que si lo hacen; por lo tanto, se trata de la entrega del máximo valor a los clientes, mientras se utiliza la menor cantidad de recursos. I. INTRODUCCIÓN El término Lean¿Qué hizo que el concepto de Lean Manufacturing desarrollado en las últimas décadas por la empresa Toyota sea tan atractivo tanto para los académicos como para los empresarios? En primer lugar fue en Toyota donde se definió el propósito fundamental de la filosofía lean en los procesos productivos: eliminar desperdicios y agregar valor, lo cual permitió a los académicos y empresarios incorporar esta filosofía lean progresivamente a otros tipos de procesos de cualquier tipo de organización, por lo tanto...

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Can lean save lives?

Cited by 255 publications

References 1 publication

A mixed-methods evaluation of transformational change in NHS North East

A mixed-methods evaluation of transformational change in NHS North East

The daily work of Lean leaders – lessons from manufacturing and healthcare

Lean Healthcare: Una Revisión Bibliográfica Y Futuras Líneas De Investigación

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