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Can lean contribute to work intensification in healthcare?

Gareth H. Rees (Centre for Health Systems, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand)
Robin Gauld (Centre for Health Systems, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 15 May 2017

Abstract

Purpose

The purpose of this paper is to review and discuss the effects of the introduction of lean into healthcare workplaces, phenomena that have not been widely investigated.

Design/methodology/approach

The paper draws on discussions and findings from the literature. It seeks to bring the few geographically dispersed experiences and case studies together to draw some conclusions regarding lean’s negative effects.

Findings

Two recurring themes emerge. The first is there is little evidence of Lean’s impact on work and the people who perform it. The literature therefore suggests that we understand very little about how work conditions are changed and how Lean’s negative effects arise and may be managed in healthcare workplaces. A second observation is that Lean’s effects are ambiguous. For some Lean seems to intensify work, while for others it leads to improved job satisfaction and productivity. Given this variety, the paper suggests a research emphasis on Lean’s socio-cultural side and to derive more data on how work and its processes change, particularly in the context of healthcare team-working.

Originality/value

The paper concludes that without improved understanding of social contexts of Lean interventions its value for healthcare improvement may be limited. Future research should also include a focus on how the work is changed and whether high-performance work system practices may be used to offset Lean’s negative effects.

Keywords

Citation

Rees, G.H. and Gauld, R. (2017), "Can lean contribute to work intensification in healthcare?", Journal of Health Organization and Management, Vol. 31 No. 3, pp. 369-384. https://doi.org/10.1108/JHOM-11-2016-0219

Publisher

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Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited