Measures of Success: The Role of Human Factors in Lean Implementation in Healthcare

Desired improvements in the delivery of quality healthcare drive healthcare managers toward lean technologies. Sustaining efficiencies gained from lean-associated process reengineering requires managers to address human factors in lean implementation. Drawing from the existing research literature, the authors identified three human factors essential to successful lean implementation: communication, leadership, and workload. Using case-study and qualitative methods, the authors identified relevant key concepts from each construct. To account for variation among organizations' behavior and explain the interaction between the sociotechnical factors, they used concepts from complexity theory, other case studies, and semi-structured interviews with two healthcare managers responsible for process improvement. They found that elements of communication, leadership, and workload are interactive, interrelated, and dynamic. Managers of successful lean implementations have well-developed shared vision and implementation plans that are adaptive to workforce stress arising from management's drive toward the efficient delivery of healthcare. Leaders using timely two-way communication through organizational hierarchy and across departments find successful implementations of their initiatives. The consolidation of literature and interpretation of interactions between communication, leadership, and workload through triangulation and cross-case evaluation has potential to provide realistic and relevant information to managers working toward a successful lean implementation in their healthcare facility.

[1]  Dana L Nelson-Peterson,et al.  Creating an Environment for Caring Using Lean Principles of the Virginia Mason Production System , 2007, Journal of Nursing Administration.

[2]  James R. Bradley,et al.  Cornell Students Participate in Lord Corporation's Kaizen Projects , 2004, Interfaces.

[3]  Federico Garriga Garzón,et al.  Detection of the necessary characteristics in a Lean leader to achieve the success in the implantation of the Lean methodology. , 2009 .

[4]  Monica W. Tracey,et al.  How Human Resource Departments Can Help Lean Transformation , 2006 .

[5]  Jiju Antony,et al.  Reducing employees' turnover in transactional services: a Lean Six Sigma case study , 2010 .

[6]  A. Wall,et al.  Book ReviewTo Err is Human: building a safer health system Kohn L T Corrigan J M Donaldson M S Washington DC USA: Institute of Medicine/National Academy Press ISBN 0 309 06837 1 $34.95 , 2000 .

[7]  William J. Kolarik,et al.  The Assessment of the Impacts of Improvement Projects in the Interrelated Processes: A Cross-Case Study , 2012 .

[8]  Sharan B. Merriam,et al.  Qualitative Research: A Guide to Design and Implementation , 2009 .

[9]  Jeroen De Mast,et al.  Generic Lean Six Sigma Project Definitions in Financial Services , 2008 .

[10]  Heather C Kaplan,et al.  The influence of context on quality improvement success in health care: a systematic review of the literature. , 2010, The Milbank quarterly.

[11]  Nick Rich,et al.  Companies’ perceptions of inhibitors and enablers for process improvement activities , 2003 .

[12]  S. Murray,et al.  Knowledge Type and Communication Media Choice in the Knowledge Transfer Process , 2007 .

[13]  R. Natarajan Transferring best practices to healthcare: opportunities and challenges , 2006 .

[14]  Charles R. Gowen,et al.  Contrasting continuous quality improvement, Six Sigma, and lean management for enhanced outcomes in US hospitals , 2012 .

[15]  Krisztina Demeter,et al.  Factors influencing employee perceptions in lean transformations , 2011 .

[16]  Peter Hasle,et al.  Lean Production—An Evaluation of the Possibilities for an Employee Supportive Lean Practice , 2014 .

[17]  K. Eisenhardt Building theories from case study research , 1989, STUDI ORGANIZZATIVI.

[18]  Pius Achanga,et al.  Critical success factors for lean implementation within SMEs , 2006 .

[19]  Richard Janssen,et al.  Application of lean thinking to health care: issues and observations , 2009, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[20]  P Hibbert,et al.  Human factors in the management of the critically ill patient. , 2010, British journal of anaesthesia.

[21]  Toni L. Doolen,et al.  Critical success factors for human resource outcomes in Kaizen events: An empirical study , 2009 .

[22]  C. Marano,et al.  To err is human. Building a safer health system , 2005 .

[23]  Simon Bishop,et al.  Lean healthcare: rhetoric, ritual and resistance. , 2010, Social science & medicine.

[24]  Senthilkumar Muthusamy,et al.  Applying the Toyota Production System to a Healthcare Organization: A Case Study on a Rural Community Healthcare Provider , 2007 .

[25]  Satya S. Chakravorty,et al.  Prioritizing Improvement Projects: Benefit & Effort (B&E) Analysis , 2012 .

[26]  A. Ojha,et al.  Organisational Learning, Transformational Leadership and Implementation of Continuous Quality Improvement in Canadian Hospitals , 2002 .

[27]  Griffiths,et al.  Complexity And Healthcare: an Introduction , 2002 .

[28]  Cary L. Cooper,et al.  The effects of lean production on worker job stress , 2006 .

[29]  M. Esposito,et al.  IMPROVING CHANGE MANAGEMENT: HOW COMMUNICATION NATURE INFLUENCES RESISTANCE TO CHANGE , 2014 .

[30]  E. Dickson,et al.  Use of lean in the emergency department: a case series of 4 hospitals. , 2009, Annals of emergency medicine.