Engineering Medicine: The Deployment of Lean Production in Healthcare

Abstract

Originally developed by the Japanese firm Toyota in the 1950s, the core innovation of lean production is to reorient all organizational activity around continuous improvement and the elimination of waste. We use the case of lean production in two healthcare organizations to explore the process of translating management models into new environments (Czarniawska & Sevón, 1996; Mohr, 1998). We draw on insights from organizational sociology and social movement theory to understand the strategies of actors as they attempt to overcome opposition to model transfer (Battilana, Leca, & Boxenbaum, 2009; Friedland & Alford, 1991; Snow, Rochford, Worden, & Benford, 1986). We examine two attempts to export lean production to healthcare organizations: Riverside Hospital, a research and teaching institution, and Lakeview Associations, a managed health provider. We use these cases to illustrate two ways that management models can get lost in the process of institutional translation: model attenuation, and model decoupling.

Citation

Attwood-Charles, W. and Babb, S. (2017), "Engineering Medicine: The Deployment of Lean Production in Healthcare", Emerging Conceptions of Work, Management and the Labor Market (Research in the Sociology of Work, Vol. 30), Emerald Publishing Limited, Leeds, pp. 87-115. https://doi.org/10.1108/S0277-283320170000030005