A complexity theory perspective of kaizen: a study in healthcare

Abstract

Kaizen projects (KPs) change the interactions between the elements of socio-technical systems, and therefore their impacts cannot be fully controlled. By using complexity theory as a lens for making sense of interactions, this study proposes a nine-step framework for assessing and influencing KPs planned, under way, and completed. The most innovative part of the framework is the assessment of the interactions within and between KPs. A study of five KPs carried out in the process of preparation and administration of medications in a surgical ward illustrates the use of the framework. Based on this study and extant theory, seven design propositions that support the framework application were devised. Also, the use of the framework produces descriptive data that sheds light on nuances and unintended consequences of kaizen.

Keywords:

• Kaizen
• complexity
• lean production
• healthcare

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The authors are thankful to the agencies Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS) [17/2551-0001190-2] and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) [88887.153859/2017-00] for partially funding this research.

Notes on contributors

Dayane Maximiano Carvalho Ferreira

Dayane M. C. Ferreira has received her BS in Industrial Engineering from the Universidade Federal de Juiz de Fora (Brazil), and her MS from the Universidade Federal do Rio Grande do Sul (Brazil). Her areas of interest are lean production, production planning and control, and healthcare management. She has given executive training courses and consulting to healthcare and manufacturing companies.

Tarcisio Abreu Saurin

Tarcisio A. Saurin is an Associate Professor at the Industrial Engineering Department of the Universidade Federal do Rio Grande do Sul (Brazil). He has a BS in Civil Engineering, MS in Construction Management, and PhD in Industrial Engineering. He was a visiting scholar at the University of Salford (UK) and at Macquaire University, at the Australian Institute of Health Innovation. His main research interests are related to the modelling and management of complex socio-technical systems, resilience engineering, safety management, lean production, process improvement, and performance measurement. He has carried out research and consulting projects on these topics in healthcare, construction, electricity distribution, and manufacturing.