Major barriers in Lean health care: an exploratory study in Uruguay

Abstract

Purpose This paper aims to outline the barriers in introducing Lean in health care and to asses which of these have a greater impact in the Uruguayan health-care sector. Design/methodology/approach To uncover the barriers hindering Lean health-care implementation, a literature review was undertaken. Once identified, first-hand information was obtained from managers and professionals involved in managerial activities who evaluated each of the difficulties using a Likert scale. Findings In total, 17 barriers to the implementation of Lean health care were identified. Survey results show that the highest scores correspond to “controllable” barriers, those which can be overcome, almost exclusively, by the organization willing to implement the program. Practical implications Managers need to understand and ascertain the existing barriers before implementing Lean if they want to develop strategies to mitigate them. Although the exploratory study was conducted in the Uruguayan health-care sector, it could be replicated elsewhere. Originality/value An exhaustive list of barriers was synthesized and was later assessed by managers in the Uruguayan context. This is an important first step that could help foresee obstacles and develop strategies prior future implementation.

An SEM Approach for the Barrier Analysis in Lean Implementation in Manufacturing Industries

“…Escuder et al [21] Outline 17 barriers in implementing lean in health care, which are; terminology (B0); lack of resources (B1); leader to guide the process (B2); lack of training (B3); lacking key performance indicators (KPI) (B4), commitment and support from top managers (B5), resistance to change (B6), lack of an improvement culture (B7); the existence of conflicting requirements (B8); the existence of functional silos (B9); hierarchical structure (B10); lack of motivation (B11); poor communication (B12); health-care regulations (B13); union conflicts (B14); lack of time devoted to the improvement program (B15); poor managerial skills (B16).…”

Analysis of the relationship between barriers and practices in the lean supply chain management

“…Regarding the lack of "commitment of senior management" (B 2 ), the leadership support is commonly mentioned as fundamental to sustain the lean transformation (Adamides et al, 2008;Jadhav et al, 2014;Adebanjo et al, 2016;Abu et al, 2019). This barrier is one of the most commonly mentioned factors and it has been categorized as a major inhibitor (Escuder et al, 2018). The commitment refers to aspects such as consistent financial support, team Sources: Frequency of citation of LSCM practices motivation, active involvement and supervision of the implementation of the lean practices (Vlachos, 2015;Dora et al, 2016;Abu et al, 2019).…”

Meaningful inhibitors of the lean journey: a systematic review and categorisation of over 20 years of literature

“…Thus, supportive organisational strategies and alignments are essential to implement successful lean initiatives, as they help to build confidence, ease cultural changes and become aligned with the new improvement system (Bhasin, 2013bAchanga et al, 2006Rise and Haddud, 2016;Escuder et al, 2018). This leads us to our second proposition towards organisational conduct and strategy:…”

“…All the studies mentioned have contributed significantly, bringing new knowledge to academics and practitioners. However, after decades, the outcome of these research studies is merely a reporting of large lists of lean barriers (Poksinska, 2010;De Souza and Pidd, 2011;Hilton and Sohal, 2012;Aij et al, 2013a;Mostafa et al, 2013;Escuder et al, 2018). These lists present some degree of saturation with similar barriers, many of which have considerable overlaps, and barely represent new barriers.…”