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Article
Publication date: 9 October 2007

David Fillingham

The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota…

7723

Abstract

Purpose

The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare.

Design/methodology/approach

This paper is a viewpoint.

Findings

One's early experience is that lean really can save lives. The Toyota Production System is an amazingly successful way of manufacturing cars. It cannot be simply translated unthinkingly into a hospital but lessons can be learned from it and the method can be adapted and developed so that it becomes owned by healthcare staff and focused towards the goal of improved patient care.

Originality/value

Working in healthcare is a stressful and difficult thing. Everyone needs a touch of inspiration and encouragement. Applying lean to healthcare in Bolton seems to be achieving just that for those who work there.

Details

Leadership in Health Services, vol. 20 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 15 March 2013

Nicola Burgess and Zoe Radnor

The purpose of this paper is to present findings relating to how Lean is implemented in English hospitals.

12723

Abstract

Purpose

The purpose of this paper is to present findings relating to how Lean is implemented in English hospitals.

Design/methodology/approach

Lean implementation snapshots in English hospitals were conducted by content analysing all annual reports and web sites over two time periods, giving a thorough analysis of Lean's status in English healthcare.

Findings

The article identifies divergent approaches to Lean implementation in English hospitals. These approaches are classified into a typology to facilitate an evaluation of how Lean is implemented. The findings suggest that implementation tends to be isolated rather than system‐wide. A second dataset conveys Lean implementation trajectory across the time period. These data signal Lean's increasing use by English hospitals and shows progression towards an increasingly systemic approach.

Practical implications

Data were collected using content analysis methods, which relies on how “Lean” methods were articulated within the annual report and/or on the organisation's web site, which indicates approaches taken by hospital staff implementing Lean.

Originality/value

This research is the first to examine more closely “how” Lean is implemented in English hospitals. The emergent typology could prove relevant to other public sector organizations and service organisations more generally. The research also presents a first step to understanding Lean thinking in the English NHS. This article empirically analyses Lean implementation in English hospitals. It identifies divergent approaches that allow inferences about how far Lean is implemented in an organisation. Data represent a baseline for further analysis so that Lean implementation can be tracked.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 3
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 19 August 2009

Hári Sewell

The national policy Delivering Race Equality in Mental Health (Department of Health, 2005) is in its fifth and final year. Evidence suggests that the changes that were hoped for…

Abstract

The national policy Delivering Race Equality in Mental Health (Department of Health, 2005) is in its fifth and final year. Evidence suggests that the changes that were hoped for have not been achieved. This has raised the question as to whether the objectives were unattainable or whether the implementation is yet to see the leadership that is required to bring change in a field fraught with emotion and soured optimism. Drawing on engaging leadership theories and the concept of organisational incompetence this paper highlights key requirements for change, including giving a focus on what has gone well, for example through using appreciative inquiry, and on pursuing possibilities beyond those prescribed through performance management.

Details

International Journal of Leadership in Public Services, vol. 5 no. 2
Type: Research Article
ISSN: 1747-9886

Keywords

Content available
Article
Publication date: 9 October 2007

Jennifer Bowerman

261

Abstract

Details

Leadership in Health Services, vol. 20 no. 4
Type: Research Article
ISSN: 1751-1879

Article
Publication date: 1 May 2009

Luciano Brandao de Souza

The aim of this paper is to provide a review of the existing literature on lean healthcare. It seeks to describe how this concept has being applied and to assess how trends and…

24532

Abstract

Purpose

The aim of this paper is to provide a review of the existing literature on lean healthcare. It seeks to describe how this concept has being applied and to assess how trends and methods of approach in lean healthcare have evolved over the years.

Design/methodology/approach

The paper surveys the applications of lean healthcare in the current literature and classifies over 90 works according to a taxonomy suggested.

Findings

Though there seems to exist an agreement about the potential of lean healthcare, it remains a challenge for academics and practitioners to evaluate lean healthcare under a more critical perspective.

Practical implications

This work is helpful not only for healthcare practitioners and for researchers in private and public organisations, but also for journal editors and reviewers because it offers ready access to an up to date comprehensive review.

Originality/value

Since lean started being applied in healthcare, no effort to provide a complete resource surveying the existing literature has been done.

Details

Leadership in Health Services, vol. 22 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Content available
Article
Publication date: 1 October 2006

2140

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 19 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 2 March 2015

Siu Yee Cheng, David Bamford, Marina Papalexi and Benjamin Dehe

Healthcare organisations face significant productivity pressures and are undergoing major service transformation. The purpose of this paper is to disseminate findings from a Lean…

2420

Abstract

Purpose

Healthcare organisations face significant productivity pressures and are undergoing major service transformation. The purpose of this paper is to disseminate findings from a Lean healthcare project using a National Health Service Single Point of Access environment as the case study. It demonstrates the relevance and extent that Lean can be applied to this type of healthcare service setting.

Design/methodology/approach

Action research was applied and Lean tools used to establish current state processes, identify wastes and develop service improvement opportunities based upon defined customer values.

Findings

The quality of referral information was found to be the root cause of a number of process wastes and causes of failure for the service. Recognising the relationship and the nature of interaction with the service’s customer/supplier lead to more effective and sustainable service improvement opportunities and the co-creation of value. It was also recognised that not all the Lean principles could be applied to this type of healthcare setting.

Practical implications

The study is useful to organisations using Lean to undertake service improvement activities. The paper outlines how extending the value stream beyond the organisation to include suppliers can lead to improved co-production and generation of service value.

Originality/value

The study contributes to service productivity research by demonstrating the relevance and limitations of Lean application in a new healthcare service setting. The case study demonstrates the practical challenges of implementing Lean in reciprocal service design models and adds validity to existing contextual models.

Details

International Journal of Public Sector Management, vol. 28 no. 2
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 20 July 2010

A.L. Grove, J.O. Meredith, M. MacIntyre, J. Angelis and K. Neailey

The purpose of this paper is to present the challenges identified during a lean implementation in a health visiting service within a large primary care trust in NHS UK.

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Abstract

Purpose

The purpose of this paper is to present the challenges identified during a lean implementation in a health visiting service within a large primary care trust in NHS UK.

Design/methodology/approach

Following a series of lean workshops a triangulated approach to data collection was adopted in order to determine the root cause of the challenges that were faced during this lean implementation. The three methods that were selected for qualitative analysis included semi‐structured interviews, document analysis and researcher participant observation.

Findings

Six key challenges were identified from the data analysis. These were: high process variability; a lack of understanding of lean; poor communication and leadership; target focused; problems defining waste; and difficulty in determining who is the customer and what do they value?

Practical implications

Although this particular lean implantation had limited success, the research has highlighted a number of challenges which would have to be addressed prior to future lean exercises. This will assist other clinical and managerial staff to prepare for the challenges that may be faced during a lean implementation, and adapt their approach to future quality improvement.

Originality/value

The barriers to lean implementation could be overcome with upfront planning, transformational leadership, excellent communication, identification and sharing of best practice and, above all, a shared vision. There is no quick and easy solution to productivity improvement, community services, as in this paper, cannot expect to select lean tools and techniques and emulate the success seen elsewhere. If they wish to deliver world‐class healthcare in the face of constrained resources and greater demand, they need to adopt a long‐term vision.

Details

Leadership in Health Services, vol. 23 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Book part
Publication date: 22 October 2020

Randal Joy Thompson

Abstract

Details

Proleptic Leadership on the Commons: Ushering in a New Global Order
Type: Book
ISBN: 978-1-83867-799-2

Content available
358

Abstract

Details

Nutrition & Food Science, vol. 36 no. 2
Type: Research Article
ISSN: 0034-6659

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