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Ward rounds in hospitals are crucial for decision-making in the context of patient treatment processes. However, these tasks are not systematically managed and are often extended due to missing information or equipment or staff unavailability. This research aims to assess whether ward rounds can be structured more efficiently and effectively from the perspective of patients and staff.

This mixed-method approach examines the ward rounds conducted in three units within a haematology department of a major Danish hospital. Baseline measures were collected to capture the value of the ward round described by patients and staff. The information on patient and equipment flows associated with a typical ward round was mapped with recommendations for improvement.

Staff aspired to deliver a good-quality ward round, but what this meant was never articulated and there were no established standards. The duration of the ward round was unpredictable and could take 6 hours to complete. Improvements identified by the team allow the ward rounds to be completed by mid-day with much more certainty.

This research provides an insight as to how ward rounds are conducted within a Danish haematology department.

The research has implications for those involved in ward rounds to reduce the time taken whilst maintaining quality and safety of patient care.

This research has implications for patients and their families who wish to spend time with consultants.

Previous research has focused on the interactions between doctors and nurses. This research focuses on the operational process of the ward round and presents a structured approach to support multi-disciplinary teams with a focus on value from the patient’s perspective.

The purpose of this paper is to analyse through ethnographic fieldwork the social and cultural context and (unintended) consequences of introducing a management concept from the private sector (LEAN) into the public sector.

Ethnographic fieldwork combined with reading of reports and material.

The major findings are: first, Lean is seen in a cultural context, it is argued that the persuasiveness of Lean depends on building a metaphorical connection between organizational aims and individual experiences and bodily ideals; second, Lean purports to be a win-win game and road to eliminating “waste” through worker participation, empowerment and enthusiasm. The research points to the contrary. Lean was met with scepticism and was seen by the social workers as a waste of time.

As demonstrated in the paper, the vast majority of research published about Lean is hortatory in nature. It is recipe books trying to convince readers of the benefits of introducing Lean. This paper, on the contrary, attempts an open ethnographic exploration of the Lean process and its social and cultural ramifications.