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Managing a variable acute patient flow – categorising the strategies

Olle Olsson (Department of Management and Engineering, Linköping University, Linköping, Sweden)
Håkan Aronsson (Department of Management and Engineering, Linköping University, Linköping, Sweden)

Supply Chain Management

ISSN: 1359-8546

Article publication date: 9 March 2015




This paper aims to explore if actions used at a hospital to manage a variable acute patient flow can be categorised using the concepts of lean, agile and leagile.


Empirical evidence from a university hospital was gathered by interviews, internal documents, shadowing and participation in meetings. Identified actions used at both hospital level and departmental level are categorised as lean or agile, while combinations of actions are compared with different leagile approaches.


Actions from every lean and agile category derived from literature are used at the hospital, however in varying extent. Many agile actions are reactive, indicating a lack of proactive measures. Actions that directly manage external variation are also few in numbers. Leagile approaches of all three combinations derived from literature are also used at the hospital.

Research limitations/implications

As a single-case study is used, empirical generalisation to other hospitals cannot be deduced. Future research assessing the appropriateness of different actions for managing a variable acute patient flow is encouraged.

Practical implications

The use of actions within both lean and agile categories indicate the possibility of combining these process strategies in hospitals, and not only focusing on implementing lean. By cleverly combining lean and agile actions, leagile approaches can be formed.


The use of lean in health care has been a topic of research, while the use of agile has been sparsely researched, as well as the combination of the two.



The authors would like to thank all interviewees at the University Hospital in Linköping. Special thanks to Division Chief Stefan Franzén, Chief Medical Officer Christer Andersson and Healthcare Director Tommy Skau for their assistance and insightful comments throughout the research process. Associate Professor Erik Sandberg at Linköping University is also thanked for comments on an earlier version of the paper.


Olsson, O. and Aronsson, H. (2015), "Managing a variable acute patient flow – categorising the strategies", Supply Chain Management, Vol. 20 No. 2, pp. 113-127.



Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited

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