Illusion or delusion – Lean management in the health sector

Abstract

Structured AbstractPurpose: There has been considerable interest in implementing practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach attracting particular interest is Lean management, which is explored in this article. Design/methodology/approach: The exploratory research focuses on Lean management in the health sector. It is based on extensive secondary data and it is a practical in implication. Data provided both background and context. Findings: Despite widespread enthusiasm about Lean management's potential, evidence about its contribution to higher performance is inconsistent. Research limitations/implications: Major Lean operations management and human resource management concepts, including just-in-time (JIT), total quality management (TQM) and total productive maintenance (TPM) are explored. Practical implications: This article contributes to the healthcare organizational management literature by showing that although Lean management seems to have the potential to improve organizational performance; it is far from a panacea for underperforming hospitals. The article informs policy-making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than adopting practices from any particular managerial approach. Originality/value: A critical evaluation on Lean's impact on informing healthcare policy is presented, which contributes to healthcare organisational management literature by showing that even though Lean management in healthcare appears to have the potential to improve performance; there remain problems with its application.

Exploring “patient-centered” hospitals: a systematic review to understand change

“…This approach however is rare and there are no lean implementations across an entire hospital [67]. Therefore it is suggested to interpret evidence with extreme caution [68]. …”

Throughput efficiency and service quality after process redesign at a cancer day care unit: Two sides of the coin?

“…Despite the growing recognition and acceptance of the need to embrace patient-centred care approaches (Masselink et al, 2012), healthcare studies have paid limited attention to the patient perspective in process redesign initiatives (Moraros, Lemstra, & Nwankwo, 2016). Most studies have focused merely on the collection of operational metrics, such as patient throughput time and the number of operational failures (McIntosh, Sheppy, & Cohen, 2014), but have neglected "the patient's perspective" as a measure. This study instead aims to integrate the patient perspective into the operational analysis and design of hospital processes in cancer care.…”

Has Lean improved organizational decision making?

“…Some healthcare managers implement Lean, guided by eliminating waste based on what is defined as being valuable, rather than as a total system governing the whole organization. When Lean is implemented solely as an approach to providing process standards, creating flow, reducing interruptions and potential errors without being part of a comprehensive management system and adapted to the organization's decision making context, improvements will be made, but these may not be sustainable (Al-Balushi et al, 2014;Dixon-Woods et al, 2014;Kaplan et al, 2014;McIntosh et al, 2014). Even though Lean seems promising, no final conclusions can be drawn on its positive effects in healthcare or on implementation challenges (D'Andreamatteo et al, 2015;Mazzocato et al, 2010;Brandao de Souza, 2009;Waring and Bishop, 2010).…”