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Article
Publication date: 5 January 2022

Najla Alemsan, Guilherme Tortorella, Carlos Manuel Taboada Rodriguez, Hadi Balouei Jamkhaneh and Rui M. Lima

The importance of a lean health-care supply chain is increasingly discussed. However, it is still not very clear how lean practices relate to resilience capabilities, as…

Abstract

Purpose

The importance of a lean health-care supply chain is increasingly discussed. However, it is still not very clear how lean practices relate to resilience capabilities, as there are synergies and divergences between them. This study aims at identifying the relationship between lean practices and resilience capabilities in the health-care supply chain.

Design/methodology/approach

This study conducted a scoping review based on five databases, which allowed the content analysis of 44 articles. Such analysis allowed the verification of trends and volume of studies on this topic. Further, the descriptive numerical and thematic analyses enabled the proposition of a conceptual framework, relating the adoption of lean practices to the development of resilience capabilities according to the tiers of the health-care supply chain in different value streams.

Findings

Three research directions were derived from this scoping review: empirical validation of the contribution of lean practices to resilience capabilities in the health-care supply chain; systemic implementation of lean practices across tier levels of the health-care supply chain; and complementary approaches to lean implementation toward a more resilient health-care supply chain.

Practical implications

The understanding of these relationships provides health-care managers arguments to prioritize the application of lean practices to improve desired resilience capabilities in the entire health-care supply chain.

Originality/value

To the best of the authors’ knowledge, there is no similar study in the literature.

Details

International Journal of Lean Six Sigma, vol. 13 no. 5
Type: Research Article
ISSN: 2040-4166

Keywords

Article
Publication date: 12 June 2019

Ayman Bahjat Abdallah and Rasha Zuhair Alkhaldi

The purpose of this paper is to review original research on lean management (LM) in health care to identify potential research gaps and present recommendations for future…

Abstract

Purpose

The purpose of this paper is to review original research on lean management (LM) in health care to identify potential research gaps and present recommendations for future research. The paper also discusses the current state of implementing LM practices in health care. In addition, it presents and highlights “lean bundles” imported from manufacturing, namely, total quality management (TQM), human resource management, just-in-time and total productive maintenance, as a potential implementation strategy of LM in hospitals to optimize overall health care performance.

Design/methodology/approach

The scoping review was conducted based on the guidelines specified by Arksey and O’Malley (2005). Relevant included studies were retrieved by searching various electronic databases. The PRISMA guidelines were applied to identify and select eligible studies.

Findings

The majority of previous studies used selected practices to measure LM in health care. In most cases, these practices reflected a narrow and biased view of LM. Lean bundles which comprehensively view LM and reflect all its aspects have rarely been discussed in the health care literature. Evidence about the contribution of lean bundles to hospital performance needs to be addressed in future studies.

Practical implications

This paper demonstrates the implementation of the four lean bundles in hospitals. It argues that, instead of adopting one dimension or selected practices of LM, hospitals viewing LM as a comprehensive multi-dimensional approach through the adoption of the four lean bundles are expected to maximize their performances.

Originality/value

This is one of the first works to comprehensively review and discuss lean bundles in the context of health care. It argues that the adoption of the four lean bundles by hospitals will enable them to yield the maximum LM performance benefits. In addition, a proposed survey questionnaire based on the literature review is provided to assist researchers in conducting future empirical studies.

Details

Journal of Health Organization and Management, vol. 33 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 9 October 2017

Kjeld Harald Aij and Maurits Teunissen

Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean

14608

Abstract

Purpose

Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care. The purpose of this paper is to provide insight into applicable attributes for lean leaders in health care.

Design/methodology/approach

The authors systematically reviewed the literature on principles of leadership and, using Dombrowski and Mielke’s (2013) conceptual model of lean leadership, developed a parallel theoretical model for lean leadership in health care.

Findings

This work contributes to the development of a new framework for describing leadership attributes within lean management of health care.

Originality/value

The summary of attributes can provide a model for health-care leaders to apply lean in their organizations.

Details

Journal of Health Organization and Management, vol. 31 no. 7/8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 27 July 2012

Rajeev Chadha, Amita Singh and Jay Kalra

Patient satisfaction and quality care are important indicators for the success of any health care enterprise. The critical nature of health care operations entails that…

4240

Abstract

Purpose

Patient satisfaction and quality care are important indicators for the success of any health care enterprise. The critical nature of health care operations entails that some excess capacity is stored in the system to provide the necessary flexibility of response. To prepare health care organizations to deliver high quality services at lower costs, this paper aims to report a lean health care (LEAN‐HC) transformation model that integrates queuing theory and lean methodology to improve the dynamic performance of the health care system.

Design/methodology/approach

This paper reviews and evaluates an emergency department health care system that adopts a system dynamic model, redesigned the process using value stream mapping to eliminate non‐value‐added activities to achieve just‐in‐time (JIT) services. This study was conducted at SD Mission Hospital, India. The LEAN‐HC model includes three steps. First, the patient arrival flow is assessed and adjusted, using physicians at the front of the queue to separate patients at triage into major, medium, and minor injury classes. Second, a cross‐functional team consisting of process, information and clinical experts maps the hospital's current state to identify and eliminate wasteful non‐value‐added activities. Third, the process is continually de‐bottlenecked using a variety of lean techniques, such as 5S visual management, one‐piece‐flow to reduce service lead time, and adoption of standard operating procedures.

Findings

The authors' results reveal that a lean integration to queuing methodology frees up capacity in the health care system, providing necessary flexibility of response. The implementation of the LEAN‐HC model resulted in the following improvement. First, an improved process flow and increased capacity. Second, emergency department length of stay for all patient classes decreased. Third, value stream mapping was found to be useful in detecting opportunities to decrease patient turnaround. Fourth, the service bottleneck could be identified and shifted to where it could be most easily controlled, adhering to the principle of one piece flow. No changes in resource availability and safety or quality issues occurred during the implementation of lean methodology.

Originality/value

This study demonstrates how to apply lean methodology in conjunction with the queuing modeling in the health care industry, particularly with regards to the patient wait time and reduction in medical errors. The LEAN‐HC model delivers more efficient service by increasing hospital capacity while reducing non‐value‐added times and overhead costs.

Details

Clinical Governance: An International Journal, vol. 17 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 2 September 2019

Abdulaziz Marzouq Almutairi, Konstantinos Salonitis and Ahmed Al-Ashaab

The main purpose of this paper is to present lean implementation in hospital supply chain management (HSCM) and propose a new conceptual framework tailored specifically to…

1053

Abstract

Purpose

The main purpose of this paper is to present lean implementation in hospital supply chain management (HSCM) and propose a new conceptual framework tailored specifically to the needs of Saudi health-care organizations.

Design/methodology/approach

This paper starts with an in-depth review of existing frameworks or models for lean implementation in health care in general and in HSCM specifically. Based on the literature studies and taking experts’ opinions into account, a new framework for lean implementation in the Saudi HSCM is presented.

Findings

A new lean implementation framework is offered to decision-makers in the health-care organization for implementing a lean approach in HSCM practices.

Research limitations/implications

This study focused on health-care organizations, which were selected from hospitals operated by the Ministry of Health and only those hospitals that are accredited by both the Saudi Central Board for Accreditation of Healthcare Institutions and the Joint Commission International. The framework is limited to Saudi health care.

Practical implications

The lean supply chain management (LSCM) framework is easy to understand and use without much complexity. This simplicity makes the LSCM applicable in health-care settings. Further, LSCM was validated in three different hospitals, and it helped them to identify and improve their non-added activities, thereby readying them for lean deployment in HSCM.

Originality/value

Little attention has been paid to implementing a lean approach by health-care providers in developing countries. This study presents a new framework that is considered the first of its kind for implementing lean in HSCM in Saudi. This framework could help HSCMs’ decision-makers to implement lean successfully in HSCM practices.

Details

International Journal of Lean Six Sigma, vol. 11 no. 3
Type: Research Article
ISSN: 2040-4166

Keywords

Article
Publication date: 20 November 2017

Susanna Hihnala, Lilja Kettunen, Marjo Suhonen and Hanna Tiirinki

The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of…

1698

Abstract

Purpose

The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers’ work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments.

Design/methodology/approach

These data were collected through a number of thematic interviews. The participants were nurse managers (n = 7) and medical managers (n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis.

Findings

A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills.

Practical implications

Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care.

Originality/value

The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers’ experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.

Details

Leadership in Health Services, vol. 31 no. 1
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 25 October 2018

Abdulaziz Marzouq Almutairi, Konstantinos Salonitis and Ahmed Al-Ashaab

Numerous and diverse organizations have implemented lean principles and practices, which concentrate on improving the efficiency of business processes by reducing cost…

Abstract

Purpose

Numerous and diverse organizations have implemented lean principles and practices, which concentrate on improving the efficiency of business processes by reducing cost, waste, consumptions and effort. However, previous assessments have not focused on the leanness of the supply chain in a health-care setting. This paper aims to introduce a method for assessing the successful implementation of lean principles and tools in a supply chain. Furthermore, this paper validates the method in a health-care organization.

Design/methodology/approach

This paper starts with an extensive literature review on assessing leanness and using multi-grade fuzzy logic. Then, a conceptual model was developed to measure leanness. The conceptual model was validated by discussing the initial version with select academic experts, especially those who deal with leanness in health-care organizations. After responding to the experts’ valuable comments, the health-care organization that is the focus of this case study was chosen based on two criteria. The first criterion was the organization’s ability to participate in the study, and the second was the organization’s commitment to implementing lean principles. These criteria were important to ensure the organization had the necessary foundation for implementing change initiatives such as lean process improvements. Next, a multi-grade (multi-attributes) fuzzy logic was used for leanness measurement. A leanness index was calculated, and the results were validated using experts from the case study organization. Finally, the weaker areas of the organization’s processes were identified to point the way for further improvements.

Findings

The assessment indicated that the case study organization is not lean. The organization’s weaker attributes were identified, and improvements have been suggested.

Research limitations/implications

This study focused on a single health-care organization, which was selected from a limited pool of potential organizations, namely, organizations which are accredited by both the Saudi Central Board for Accreditation of Healthcare Institutions and the Joint Commission International. The scope of future research should be extended to multi-case studies to enhance the findings presented in this paper. This paper’s findings can be used to help decision-makers at health-care providers to implement lean thinking in supply chain processes.

Practical implications

This research may be interest to practicing supply chain managers, as it proposes what enablers, factors and attributes should be emphasized in lean implementation. The proposed model can work as an assessment tool to identify the gap between the present level of leanness and the desired leanness state so the health-care organization can identify what can be improved. This model enables decision-makers in hospital supply chain to take suitable actions for improving lean implementation level.

Originality/value

This study makes an original contribution to the body of research concerning lean principles; the study developed a conceptual model for leanness assessment that can be applied to the supply chain of health-care organizations. Indeed, the conceptual model is likely to be useful for assessing leanness outside of the health-care field, which suggests avenues for future research.

Details

International Journal of Lean Six Sigma, vol. 10 no. 1
Type: Research Article
ISSN: 2040-4166

Keywords

Article
Publication date: 3 May 2011

Håkan Aronsson, Mats Abrahamsson and Karen Spens

The objective of this exploratory paper is to find out what is important to consider when developing a supply chain in health care, what is required in order to establish…

11887

Abstract

Purpose

The objective of this exploratory paper is to find out what is important to consider when developing a supply chain in health care, what is required in order to establish a supply chain orientation and how lean and agile can be used as process strategies in order to improve supply chain performance.

Design/methodology/approach

In order to build an empirical framework for using both lean and agile strategies in health care supply chain management illustrative examples are provided from a Swedish health care setting describing the patient flow and planning processes.

Findings

Supply chain management has potential to work well as a philosophy for patient flow in the health care sector. However, it should not only be about the use of the concept of lean in health care, as in fact is the case in practice today. It is rather about organizing for quick response and flexibility in a hybrid strategy through combining lean and agile process strategies. This can only be done if a systems approach is applied together with a strategic orientation, where cooperative efforts by the supply chain members should synchronize and converge operational as well as strategic capabilities into a unified whole.

Practical implications

The analysis in the paper underlines the importance of focusing on both agility and leanness combined. Hospitals or health care systems that introduce such an approach, as opposed to only relying on lean strategies, could gain both competitive advantages and improved performance.

Originality/value

In health care, even more so than in the manufacturing industry, containment of costs without sacrificing quality is important. This paper applies SCM techniques, tools and concepts that have not been used previously for patient flow in a health care setting, combining lean and agile in one and the same analysis.

Details

Supply Chain Management: An International Journal, vol. 16 no. 3
Type: Research Article
ISSN: 1359-8546

Keywords

Article
Publication date: 1 January 2007

Beata Kollberg, Jens J. Dahlgaard and Per‐Olaf Brehmer

The purpose of this paper is to discuss how a performance measurement system called “the flow model” is designed to measure changes towards lean thinking in health care services.

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Abstract

Purpose

The purpose of this paper is to discuss how a performance measurement system called “the flow model” is designed to measure changes towards lean thinking in health care services.

Design/methodology/approach

The paper integrates literature from the health care sector and the lean production movement in order to understand whether lean thinking is applicable in healthcare and thereby identify key performance indicators that measure changes towards lean thinking in health care. The flow model is discussed in relation to this measurement framework.

Findings

The paper finds that lean thinking is applicable in health care settings, and that the flow model is a suitable tool for following up these initiatives. However, it is argued that the flow model needs to be balanced with other measurements in order to receive a complete picture of lean performance.

Research limitations/implications

The paper shows that the framework of measurements may be used in empirical research of assessing changes towards lean thinking in health care settings.

Practical implications

The paper shows that health care practitioners may use the findings to develop measurements of the outcome of lean initiatives on existing care processes.

Originality/value

The paper shows analysis and discussion of the application of an industrial concept – Lean Production – in health care services.

Details

International Journal of Productivity and Performance Management, vol. 56 no. 1
Type: Research Article
ISSN: 1741-0401

Keywords

Article
Publication date: 9 February 2021

Marta Marsilio and Martina Pisarra

The aims of the implementation of lean management in health care are to improve quality of care, to eliminate waste and to increase efficiency. The purpose of this study…

Abstract

Purpose

The aims of the implementation of lean management in health care are to improve quality of care, to eliminate waste and to increase efficiency. The purpose of this study is to contribute to the advancement of knowledge by investigating which main socio-technical factors are considered to be effective for the implementation and management of lean initiatives.

Design/methodology/approach

A systematic review of literature reviews on lean management in health care was conducted. The components of the socio-technical system are identified by moving from the socio-technical drivers that support organization-wide quality improvement practices and the lean implementation process in health care. The impacts of lean management are classified using the internal processes, patient, learning and financial dimensions.

Findings

The 28 reviews retrieved confirm the current and increasing interest in lean management. While more than 60% of them call for a system-wide approach, system-wide implementations have rarely been observed, and, instead, adoption in isolated units or departments, or the use of single techniques and tools, prevails. The most commonly investigated socio-technical components are organizational structure, techniques and tools and organizational culture and strategic management. Significant impacts are reported for all the four dimensions. Nonetheless, the review reveals that there is still a lack of evidence on the sustainability of lean results and a need for a standardized impact measurement system.

Originality/value

This work stands out as the first review of reviews of how the socio-technical components of the lean management approach obtain positive impacts within the patient, internal processes, learning and financial dimensions.

Details

Journal of Health Organization and Management, vol. 35 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

1 – 10 of over 7000