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Lean, a Tool Set or a Mind Set? A Healthcare Case Study

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Book cover Modelling Value

Part of the book series: Contributions to Management Science ((MANAGEMENT SC.))

Abstract

Applying “Lean” (Womack and Jones 1996 [2003]; Hines et al. 2004) in healthcare services has been the most visible and recent trend in services industry (Brandao de Souza 2009; Holm and Ahlström 2010; Jones 2006). However, is “Lean” in healthcare just a buzzword, a set of tools (Hines and Rich 1997) for quick-wins or a sustainable enterprise process improvement system? Lean thinking has a sustainability issue that needs to be addressed. In order to assess how embedded are Lean principles and tools in healthcare and how organizations sustain the gains, a case study was conducted in a healthcare organization with 21 diagnosis units running Kaizen events. This study aims to bring some answers regarding the regression causes in Lean practices and healthcare organizations priorities in matching customer needs to value streams provided. Conclusions about: (1) translation of Lean models and practices from other settings (manufacturing) to healthcare (services), (2) how elimination of waste in healthcare is made by eliminating non-value-added activities and how customers perceived the value creation, and (3) how is (internal and external) communication of value, are presented, as well as some thoughts concerning the future of Lean in healthcare. In spite of being supported by a single case study, the followed approach and the research design enables any other researcher to replicate it in other units of analysis with similar inclusion criteria.

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References

  • Achanga, P., Shehab, E., Roy, R., & Nelder, G. (2006). Critical success factors for Lean implementation within SMEs. Journal of Manufacturing Technology Management, 17(4), 460–471.

    Article  Google Scholar 

  • Ahlström, P. (2004). Lean service operations: Translating Lean production principles to service operations. International Journal of Services, Technology and Management, 5(5/6), 545–564.

    Article  Google Scholar 

  • Allway, M. A., & Corbett, S. (2002). Shifting to Lean service: Stealing from manufactures’playbooks. Journal of Organizational Excellence, 21(2), 45–54.

    Article  Google Scholar 

  • Bale, M., & Regnier, A. (2007). Lean as a learning system in a hospital ward. Leadership in Health Services, 20(1), 33–41.

    Article  Google Scholar 

  • Barraza, M. F., Smith, T., & Dahlgaard-Park, S. M. (2009). Lean-kaizen public service: An empirical approach in Spanish local governments. The TQM Journal, 21(2), 143–167.

    Article  Google Scholar 

  • Bateman, N. (2005). Sustainability: The elusive element of process improvement. International Journal of Operations and Production Management, 25(3), 261–276.

    Article  Google Scholar 

  • Bateman, N., & Rich, N. (2003). Companies’ perceptions of inhibitors and enablers for process improvement activities. International Journal of Operations & Production Management, 23(2), 185–199.

    Article  Google Scholar 

  • Black, J., & Miller, D. (2008). The Toyota way to healthcare excellence; Increase efficiency and improve quality with Lean. Chicago: Health Administration Press-American College of Healthcare Executives.

    Google Scholar 

  • Bowen, D. E., & Youngdahl, W. E. (1998). Lean service: In defense of a production-line approach. International Journal of Service Industry Management, 9(3), 207.

    Article  Google Scholar 

  • Brandao de Souza, L. (2009). Trends and approaches in Lean healthcare. Leadership in Health Services, 22(2), 121–139.

    Article  Google Scholar 

  • Browning, T. R., & Heath, R. D. (2009). Reconceptualising the effects of Lean on production costs with evidence from the F-22 program. Journal of Operations Management, 27, 23–44.

    Article  Google Scholar 

  • Buesa, R. J. (2009). Adapting Lean to histology laboratories. Annals of Diagnostic Pathology, 13, 322–333.

    Article  Google Scholar 

  • Caldwell, C. (2006). Lean-six sigma tools for rapid cycle cost reduction. Healthcare Financial Management, 60(10), 96.

    Google Scholar 

  • Dal Pont, G. (2010). Contextual variables of Lean adoptions in services: An exploratory study. Proceedings of 17th international annual European operations management association (EurOMA) conference – managing operations in services economies, Porto.

    Google Scholar 

  • Eaton, M., & Phillips, S. (2008). Sustaining lean healthcare programmes – a practical survival guide. Cornwall: Ecademy Press.

    Google Scholar 

  • Eisenhardt, K. M. (1989). Agency theory: an assessment and review. Academy of Management Review, 14(1), 57–74.

    Google Scholar 

  • Ellram, L. M. (1996). The use of case study method in logistics research, Journal of Business Logistics, 17(2), 93–138.

    Google Scholar 

  • Esain, A., Williams, S., & Massey, L. (2008). Combining planned and emergent change in a healthcare Lean transformation. Public Money and Management, 28(1), 21–27.

    Google Scholar 

  • Fillingham, D. (2007). Can Lean save lives? Leadership in Health Services, 20(4), 231–241.

    Article  Google Scholar 

  • Flyvbjerg, B. (2006). Five misunderstandings about case study research, Qualitative Inquiry, 12 (2), 219–245.

    Article  Google Scholar 

  • Forrester, R. (1995). Implications of Lean manufacturing for human resource strategy. Work Study, 44(3), 20–24.

    Article  Google Scholar 

  • Goodman, K. J., Kasper, S. A., & Leek, K. (2007). When project termination is the beginning. ASQ Six Sigma Forum Magazine, 7(1), 20–26.

    Google Scholar 

  • Grunden, N. (2009). Lean at the front line: All hands on deck. Frontiers of Health Services Management, 26(1), 33–37.

    Google Scholar 

  • Hines, P. (2010). How to create and sustain a Lean culture, June 2010. www.trainingjournal.com, pp. 28–32.

  • Hines, P., Found, P., & Harrison, R. (2008). Staying Lean: Thriving, not just surviving. Cardiff: Lean Enterprise Research Centre, Cardiff University. 0902810111.

    Google Scholar 

  • Hines, P., & Lethbridge, S. (2008). New development: Creating a Lean university. Public Money & Management, 28(1), 53–56.

    Google Scholar 

  • Hines, P., Mathias, H., & Rich, N. (2004). Learning to evolve – A review of contemporary Lean thinking. International Journal of Operations & Production Management, 24(10), 994–1011.

    Article  Google Scholar 

  • Hines, P., & Rich, N. (1997). The seven value stream mapping tools. International Journal of Operations & Production Management, 17(1), 46–64.

    Article  Google Scholar 

  • Holm, M., & Ahlström, P. (2010). Lean service – a literature review. Proceedings of 17th international annual European operations management association (EurOMA) Conference – Managing Operations in Services Economies, Porto.

    Google Scholar 

  • Jackson, T. L. (2009). 5S for healthcare. New York: Productivity Press.

    Google Scholar 

  • Jones, D. T. (2006). Leaning healthcare. Management Services, 50(2), 16–17.

    Google Scholar 

  • Kollberg, B., Dahlgaard, J. J., & Brehmer, P. O. (2007). Measuring Lean initiatives in health care service: Issues and findings. International Journal of Productivity and Performance Management, 56(1), 2–24.

    Article  Google Scholar 

  • Kosuge, R., Modig, N., & Ahlström, P. (2010). Standardization in Lean service: Exploring the contradiction. Proceedings of 17th international annual European operations management association (EurOMA) conference – managing operations in services economies, Porto.

    Google Scholar 

  • Levitt, T. (1972). Production-line approach to service. Harvard Business Review, 50(5), 20–31.

    Google Scholar 

  • Levitt, T. (1976). The industrialisation of service. Harvard Business Review, 54(5), 32–43.

    Google Scholar 

  • Lodge, A., & Bamford, D. (2008). New development: Using Lean techniques to reduce radiology waiting times. Public Money & Management, 28(1), 49–52.

    Google Scholar 

  • Lucey, J., Bateman, N., & Hines, P. (2005). Why major Lean transitions have not been sustained. Management Services, 49(2), 9–13.

    Google Scholar 

  • Manos, A. (2007). The benefits of Kaizen and Kaizen events. Quality Progress, 40(2), 47–48.

    Google Scholar 

  • Manos, A., Mark, S., & George, A. (2006). Make healthcare Lean. Quality Progress, 39(7), 24–30.

    Google Scholar 

  • McQuade, D. (2008). New development: Leading Lean action to transform housing services. Public Money & Management, 28(1), 57–60.

    Google Scholar 

  • Piercy, N., & Rich, N. (2009a). High quality and low cost: The Lean service centre. European Journal of Marketing, 43(11/12), 1477–1497.

    Article  Google Scholar 

  • Piercy, N., & Rich, N. (2009b). Lean transformation in the pure service environment: The case of the call service centre. International Journal of Operations & Production Management, 29(1), 54–76.

    Article  Google Scholar 

  • Proudlove, N., Moxham, C., & Boaden, R. (2008). Lessons for Lean in healthcare from using six sigma in the NHS. Public Money and Management, 28(1), 27–34.

    Google Scholar 

  • Radnor, Z. J., & Holweg, M. (2010). From tools to systems: A critical appraisal of Lean Healthcare implementations. Proceedings of the 17th international annual European operations management association (EurOMA) conference – managing operations in service economies (pp.1–10), Porto.

    Google Scholar 

  • Radnor, Z. J., & Walley, P. (2006). Lean on me…, Public Finance (28 July–3 August), pp. 16–19.

    Google Scholar 

  • Radnor, Z. J., & Walley, P. (2008). Learning to walk before we try to run: Adapting Lean for the public sector. Public Money & Management, 28(1), 13–20.

    Google Scholar 

  • Renner, C., & Palmer, E. (1999). Outsourcing to increase service capacity in a New Zealand hospital. Journal of Management in Medicine, 13(5), 325–338.

    Article  Google Scholar 

  • Scorsone, E. A. (2008). New development: What are the challenges in transferring Lean thinking to government? Public Money & Management, 28(1), 61–64.

    Google Scholar 

  • Silva, C., Tantardini, M., Staudacher, A. P., & Salviano, K. (2010). Lean production implementation: A survey in Portugal and a comparison of results with Italian, UK and USA companies. Proceedings of 17th international annual European operations management association (EurOMA) conference – managing operations in services economies, Porto.

    Google Scholar 

  • Silvestro, R., Fitzgerald, L., Johnston, R., & Voss, C. (1992). Towards a classification of service processes. International Journal of Service Industry Management, 3(3), 62–75.

    Article  Google Scholar 

  • Spear, S. J. (2004). Learning to lead at Toyota. Harvard Business Review, 82(5), 78–86.

    Google Scholar 

  • Voss, C. N., Tsikriktsis & Frohlich M. (2002). Case research in operations management, International Journal of Operations & Production Management, 22(2), 195–219.

    Google Scholar 

  • Weber, D. O. (2006). Toyota-style management drives Virginia Mason. Physician Executive, 32(1), 12–17.

    Google Scholar 

  • Wennecke, G. (2008). Kaizen - Lean in a week: How to implement improvements in healthcare settings within a week, Lab Management, Medical Laboratory Observer, August 2008. Available at www.mlo-online.com

  • Womack, J. P. (2007). The Problem of sustainability. White Paper of 31 May, Lean Enterprise Institute. www.Leanuk.org. Accessed on September 2010.

  • Womack, J. P., & Jones, D. T. (1996 [2003]). Lean thinking, banish waste and create wealth in your corporation. London: Simon & Schuster.

    Google Scholar 

  • Womack, J. P., & Jones, D. T. (1996b). Beyond Toyota: How to root out waste and pursue perfection. Harvard Business Review, 74(5), 140–158.

    Google Scholar 

  • Womack, J. P., Jones, D. T., & Ross, D. (1990). The machine that changed the world. New York: Rawson Associates.

    Google Scholar 

  • Yin, R. K. (2009). Case study research: Design and methods (4th ed.). London: Sage Publications.

    Google Scholar 

  • Young, T. P., & McClean, S. I. (2008). A critical look at Lean thinking in healthcare. Quality and Safety in Healthcare, 17(5), 382–386.

    Article  Google Scholar 

  • Young, T., & McClean, S. (2009). Some challenges facing Lean thinking in healthcare. International Journal For Quality in Health Care, 21(5), 309–310.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Marketing, Operations and General Management, Lisbon University Institute, Lisbon, Portugal

    Cristina Machado Guimarães & José Crespo de Carvalho

Authors
  1. Cristina Machado Guimarães
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  2. José Crespo de Carvalho
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Correspondence to Cristina Machado Guimarães .

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Editors and Affiliations

  1. FH Oberösterreich, Wehrgrabengasse 1-3, Steyr, 4400, Austria

    Herbert Jodlbauer

  2. , Department of Management, Linköping University, Linköping, 58183, Sweden

    Jan Olhager

  3. Schonberger & Associates, 107th Avenue N.E. #2101 177, Bellevue, 98004, Washington, USA

    Richard J. Schonberger

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Guimarães, C.M., de Carvalho, J.C. (2012). Lean, a Tool Set or a Mind Set? A Healthcare Case Study. In: Jodlbauer, H., Olhager, J., Schonberger, R. (eds) Modelling Value. Contributions to Management Science. Physica-Verlag HD. https://doi.org/10.1007/978-3-7908-2747-7_16

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