Lean in healthcare: the unfilled promise?
By Zoe J. Radnor, Matthias Holweg, Justin Waring. Social Science & Medicine (1967), 2012
738 citations recorded by the source corpus.
In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level.
Subfields: Economics and Econometrics, Health Information Management, Management Information Systems
View Paper: https://www.semanticscholar.org/paper/d2d05afae0152e3981450194a409284bc3ba0410
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Citations in the corpus
- How to study improvement interventions: a brief overview of possible study types (2015, background): “39 A rich social science literature is now beginning to emerge that offers important critiques of modes of improvement, including their ideological foundations 40 41 and social, ethical, professional and organisational implications, 42 but this work is not the primary focus of this review.”
- Process mining in healthcare: A literature review (2016, methodology): “In the past, different strategies have been used to analyze hospital processes, including Business Process Redesign [3], Evidence Based Medicine [4], and Lean [5], among others.”