The social benefits of kaizen initiatives in healthcare: an empirical study

Abstract

Purpose The purpose of this paper is to identify the most influential determinants of healthcare employees’ problem-solving capabilities and attitudes towards kaizen initiatives, and clarify how these determinants are related to social outcomes. Design/methodology/approach Drawing on the input-process-outcome framework, applied to kaizen initiatives, the determinants of the input and process factors are embodied in hypotheses concerning the direct effects of input and process factors on social outcomes and the indirect effects of input factors on social outcomes resulting from process factors. The hypotheses are tested through multiple regressions using data from 105 kaizen initiatives drawn from two hospitals. Findings Of the 14 determinants investigated, goal clarity, team autonomy, management support, goal difficulty and affective commitment to change (ACC) are the most influential determinants of kaizen capabilities and/or employees’ attitude. Goal clarity, goal difficulty, team autonomy and management support are also found to influence social outcomes directly and/or indirectly through ACC, internal processes and/or an action orientation. Practical implications The results support healthcare practitioners to understand how to establish “focused kaizen” actions to leverage specific determinants that positively influence social outcomes. Originality/value This study provides an original contribution to the literature concerning effective kaizen initiatives in healthcare operations by empirically testing a comprehensive model of the relationship between kaizen initiative determinants and social outcomes. Unlike previous studies, which are mostly anecdotal or focused on one or few determinants, this research adopts a holistic view, and investigates a pluralist set of determinants on social outcomes through a systematic and quantitative approach.

Operationalising lean in healthcare: the impact of professionalism

“…Limited evidence of research on Lean sustainability in healthcare requires researchers to investigate the reasons for the slow adoption and lack of progress of Lean in healthcare settings (Costa and Godinho Filho, 2016). The statement below from Bortolotti et al (2018) justifies the two objectives of our research proposed below.…”

“…Twenty three years since healthcare was described by Womack and Jones (1996: 289) as "a world of queues and disjointed processes", Lean application in healthcare has been much debated, yet it has failed to have the same impact as in manufacturing. The reasons for this are uncertain as authors relate to complexity (Mazzocato, et al, 2014) and more recently, the potential impact of professional dynamics (Bortolotti et al, 2018). This paper responds to ongoing calls made in literature, to determine the impact of medical professionals on Lean implementations, through the lens of professionalism.…”

“…This paper responds to ongoing calls made in literature, to determine the impact of medical professionals on Lean implementations, through the lens of professionalism. This continued uncertainty over the progress of Lean in healthcare has resulted in a transition of the research focus from the operational aspects of the work environment (Holden, 2011;Costa and Godinho Filho, 2016) to softer practices including development of employees' capabilities through employee empowerment and engagement (Drotz and Poksinska, 2014;Matthias and Brown, 2016;Poksinska et al, 2017;Bortolotti et al, 2018).…”

“…Research has proven the moderating/ mediating effects of soft Lean practices on hard practices and organisational outcomes to sustain benefits from continuous improvement (CI) programs including Lean (Hirzel et al, 2017;Bortolotti et al, 2015Bortolotti et al, , 2018Mansouri, 2014, 2016). Nonetheless, literature to date has had a limited focus on two key aspects of Lean implementationsustainability of Lean (Costa and Godinho Filho, 2016) and the impact of professionals on the sustainability of Lean.…”

“…This silo and small project approach observed to date has overly focused on Lean as a tool kit methodology for problem solving rather than considering Lean as a philosophy (Matthias and Buckle, 2016). This exploration of the technical or operational aspects of Lean has neglected to unpick Lean in healthcare fully through a balanced sociotechnical lens (Matthias and Brown, 2016;Bortolotti et al, 2018).…”