Lean in Healthcare: What is Required to Support a Successful Hospital Lean Improvement Programme?

Purdue, Marie (2019) Lean in Healthcare: What is Required to Support a Successful Hospital Lean Improvement Programme? [Dissertation (University of Nottingham only)]

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The NHS has committed to reduce variation in practice, increase productivity and expand integration of services in healthcare, (NHS England, 2019). To achieve these outcomes adequate improvement capacity and capability is required. A systematic lean approach to improvement appears to be delivering sustained success in healthcare organisations in Canada and the United States (Toussaint & Berry, 2013; Kaplan et al, 2014) and now in the UK (KPMG, 2018; BBC News, 2019) and the NHS is therefore investing in this type of programme, (Health Service Journal (HSJ), 2015).

This study seeks to understand what constitutes a systemic approach to lean improvement, how this is integrated into the wider work of healthcare and what the barriers and enablers are in an acute hospital setting. A case study methodology was used with semi-structured interviews and the main findings were

• Systematic features that impacted on improvement in everyday work included knowledge and implementation of the improvement vision, lean leadership and in particular empowerment of teams to own and sustain change.

• Barriers and enablers were identified, with varying views on the presence of resistance as a barrier or whether this was a feature of conflicting priorities and time commitment rather than a lack of motivation.

• Other barriers included maintaining momentum for change, and hospital internal support functions that did not always support improvement. The participants identified the central QI team as being essential to momentum and support but believed this should diminish as local improvement capability and capacity increased.

This study has generated learning around the nature of systemic lean improvements, including the importance of understanding reasons for resistance and impact of leadership, training and engagement. This contributes to the existing literature on lean improvement and the learning can be applied to develop the improvement programme in the case study hospital and similar organisations.

Item Type: Dissertation (University of Nottingham only)
Depositing User: Purdue, Marie
Date Deposited: 30 Nov 2022 13:52
Last Modified: 30 Nov 2022 13:52
URI: https://eprints.nottingham.ac.uk/id/eprint/57589

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