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The influence of policy makers over Lean implementations in healthcare

Christian Gadolin (University of Skövde, Skövde, Sweden)

International Journal of Health Governance

ISSN: 2059-4631

Article publication date: 23 July 2019

Issue publication date: 1 August 2019




It is often argued that Lean enables the challenges of contemporary healthcare delivery to be tackled in relation to consistently high-quality care, while utilizing the full potential of available resources. Nevertheless, system-wide implementations of Lean are notoriously difficult and the desired results are often not achieved. Policy makers play a pivotal role in enabling healthcare organizations to enact more precise strategies and frameworks through steering professionals toward both adopting guidelines and becoming more comfortable with Lean as an improvement technique. However, the difficulties in achieving system-wide implementations of Lean indicate their shortcomings in this respect. The purpose of this paper is to outline how these shortcomings may be manifested empirically.


A qualitative content analysis of Swedish counties’ annual reports with regard to how the implementation of Lean is presented and promoted.


The study shows that policy makers have vague and divergent perceptions of what Lean is, and that they often reduce Lean to a means of achieving cost reductions and savings, while relying on the education of managers as the primary factor to ensure implementation.


In order for policy makers to facilitate system-wide implementations of Lean, this study indicates that they need to rectify their simplistic perception of Lean while elaborating on why and how Lean should be implemented in healthcare.



Gadolin, C. (2019), "The influence of policy makers over Lean implementations in healthcare", International Journal of Health Governance, Vol. 24 No. 3, pp. 222-229.



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