Has Lean improved organizational decision making?

Abstract

Purpose - Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization's decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization's decision-making context, making it more amenable for QI initiatives. Design/methodology/approach - In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings - Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications - Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value - Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI's sustainability.

Lean healthcare: scale, scope and sustainability

“…Positive outcomes associated with Lean healthcare have been documented (Cheng et al , 2015; Costa et al , 2015; Grove et al , 2010; Simons et al , 2016; Sanders and Karr, 2015). Different studies show that Lean is being applied to improve patient care and clinical processes, improve safety, eliminate delays and reduce hospital stay, all while reducing costs (Al-Hyari et al , 2016; Costa and Godinho Filho, 2016; D’Andreamatteo et al , 2015; White et al , 2013).…”

The impact of restricted decision‐making autonomy on health care managers’ health and work performance

“…Lean is a concept based on processes for efficiency with the main focus to reduce waste, maximize customer value and improve flow in production (Womack & Jones, ). One idea with Lean is that decision‐making is set by those who perform the work, it should be transparent and lead to improvements (Simons, Benders, Bergs, Marneffe, & Vandijck, ) that lead to standardized procedures (Womack & Jones, ). The research literature has little to say about the work environment as perceived by operational managers employed in health care organisations conforming to the Lean concept.…”

The Toyota Way to Effective Strategy Deployment: How Organizations Can Focus Energy on Key Priorities Through Hoshin Kanri to Achieve the Business Goals

“…However, medicinal service specialists have not generally welcomed and appreciated information and encounters from the other sectors with great enthusiasm (Hellström et al, 2015). Healthcare is characterized by a bureaucratic style of management, and it is hard to get medicinal service professionals to change their daily practice (Simons et al, 2016). More research should be done on how lean initiative and lean training can be incorporated into the frameworks in medical clinics and healthcare institutions.…”