Implementing lean management in hospitals: a survey on social and technical outcomes of kaizen initiatives

Abstract

Kaizen initiatives are core organisational mechanisms in lean healthcare projects. Although they show specific peculiarities (e.g. a narrow goal and an accelerated timeframe), they can vary in the way they are planned and executed. This study investigates what types of configurations of kaizen initiatives (profiled as gestalts of specific characteristics) can exist in healthcare, if they differ for social and technical outcomes, and for their application context (here considered in terms of work area routineness and team composition). The study is based on data from 362 participants to 105 kaizen initiatives implemented in two public hospitals in Italy. It identifies three clusters (i.e. ‘hard practices-oriented’, ‘soft practices-oriented’ and ‘full-lean adherent’ kaizen initiatives) characterised by different social and technical outcomes. The original contribution to the lean healthcare literature is twofold: first, the simultaneous focus on performance improvement (technical outcome) and modification of operators’ mindset (social outcome); second, the adoption of a configurational approach to understand how gestalts of many variables explain the dynamics that lead to social and technical outcomes. No significant differences were found among clusters in terms of work area routineness and team composition, which also opens interesting directions for future research.

KEYWORDS:

• Lean
• kaizen
• continuous improvement
• team management
• social outcomes
• hospital

KEYWORD:

• SDG: ‘SDG 3: Good health and well-being’

Disclosure statements

The authors report there are no competing interests to declare.

Additional information

Notes on contributors

Pamela Danese

Pamela Danese is Full Professor of Operations & Supply Chain Management at University of Padova, Italy. From 2019 to 2023 she has been coordinator of the EDEN Doctoral Seminar on Research Methodology in Operations Management. She is Associate Editor of International Journal of Operations and Production Management, and a member of the Editorial Review Board of Journal of Operations Management. She was a member of the European Operations Management Association (EurOMA) board and chair of EurOMA communication team. She is Director of the Master in Lean Management of Fondazione CUOA, Italy. Her research interests focus on lean management and supply chain management. She has published in several prestigious journals.

Pietro Romano

Pietro Romano is Full Professor of Supply Chain Management and New Product Development at the University of Udine (Italy). He is coordinator of the bachelor and master degrees in management engineering at the University of Udine. He is director of the Master in Coffee Science and Economics at Illy Academy and of the Executive Master in Operations and Supply Chain Management at CUOA Business School where he is also Director of the Digital Supply Chain Lab. He is involved in several research projects on lean – and supply chain management – related topics and is author of more than 120 publications.

Hebert Alonso Medina Suni

Hebert Alonso Medina Suni is Senior Process Engineer at Alpitronic GmbH. He graduated in Management Engineering and completed his PhD in Industrial and Informatics Engineering at the University of Udine. With over 4 years of kaizen management experience, he has a proven track record of successful improvement and operational excellence initiatives in service and manufacturing companies.