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Sustainable Lean in psychiatry? Assessment through socio-technical principles

Pernilla Lindskog (Department of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden AND HELIX Vinn Excellence Centre, Linköping University, Linköping, Sweden)
Annika Vänje (Department of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden)
Åsa Törnkvist (Psychiatry Division, Uppsala University Hospital, Uppsala, Sweden)
Jörgen Eklund (Department of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden AND HELIX Vinn Excellence Centre, Linköping University, Linköping, Sweden)

International Journal of Quality and Service Sciences

ISSN: 1756-669X

Article publication date: 21 March 2016

440

Abstract

Purpose

This paper aims to identify conditions affecting sustainability of Lean implementations in Swedish psychiatric healthcare, from a socio-technical perspective.

Design/methodology/approach

Longitudinal focus group interviews were conducted with 24 first-line managers within Swedish psychiatric healthcare. The analysis was made using Cherns’ ten socio-technical principles and a framework for sustainable development work in healthcare.

Findings

The most critical socio-technical principles for a sustainable Lean implementation were boundary location; power and authority; and compatibility. At hospital level, socio-technical principles were inhibited by the weak ownership of the Lean implementation. However, strong ownership at division level meant the same principles were supported. Unclear goals made follow-ups difficult which had negative effects on the learning processes in the Lean implementation. The role and responsibility of first-line managers were unclear in that they perceived they lacked power and authority resulting in negative effects on the participation – an important sustainability concept.

Originality/value

Empirically based papers assessing Lean implementations in psychiatry are rare. This study is a contribution to the research area of sustainable Lean implementations in healthcare. The practical implication of this study is that decision makers, senior managers, first-line managers and psychiatrists can be supported in reaching sustainable implementations of Lean.

Keywords

Acknowledgements

The authors would like to acknowledge PhD student Mikael Brännmark who died tragically during the work of this project. He participated in the collection of empirical data and inputted into the first drafts. We also want to acknowledge Associate Professor Paul Yeow’s input and discussion of later manuscript versions.

This project was funded by AFA Insurance, grant no. 100013, which is gratefully acknowledged.

Citation

Lindskog, P., Vänje, A., Törnkvist, Å. and Eklund, J. (2016), "Sustainable Lean in psychiatry? Assessment through socio-technical principles", International Journal of Quality and Service Sciences, Vol. 8 No. 1, pp. 53-71. https://doi.org/10.1108/IJQSS-07-2015-0056

Publisher

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Emerald Group Publishing Limited

Copyright © 2016, Emerald Group Publishing Limited

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