Operationalising lean in healthcare: the impact of professionalism

Abstract

Lean is endorsed as policy in practice in the UK but the challenges and complexities affecting Lean in healthcare are still to be adequately assessed. Through a qualitative single case study of an NHS organisation implementing Lean, 43 interviews with multi-disciplinary team members involved in Lean were conducted. The progress of Lean is found to be inhibited as medical professionals have failed to engage or provide clinical leadership in supporting the trajectory of Lean. This resulted in limited outcomes, sustainability implications, and failed projects. Lean is challenged by complexity and this is evident in conflicts between professional identity, corresponding status and clinical/managerial relationships. Medical professionals as a group have received a limited focus in papers assessing the progress of Lean in Healthcare from an operational perspective. Going forward, strategies for mitigating the negative impact of this can be developed to support operational managers in the healthcare domain.

Keywords:

• Lean
• healthcare
• professionalism
• sustainability

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Claire F. Lindsay

Dr Claire F. Lindsay is an Associate Professor in Supply Chain at Edinburgh Business School, Heriot-Watt University. Her work has an empirical focus on policy translation into practice and her research areas include improvement, sustainability and coordination of healthcare, legal, humanitarian operations and supply chain activities. She has conducted research with the NHS and Scottish Courts and Tribunal Services. Prior to entering academia, Claire held a variety of supply chain and operational roles for British Bakeries and Premier Foods.

Maneesh Kumar

Dr Maneesh Kumar is a Professor of Service Operations at Cardiff Business School, Cardiff University. He conducts cross disciplinary applied research in the area of Operational Excellence including topics such as Quality Management, Lean Six Sigma (LSS), Lean, Green, and Innovation (iLEGO), Healthcare Process/Service Innovation using Big Data Analytics, Knowledge Clusters for capability enhancement within SMEs. This has resulted in publications of over 120 journals and conferences papers, edited books, and conference proceedings. His research participants encompasses range of industry including Automotive Industry (India, UK, Japan), Service Industries and Public Sector organizations including NHS. His current research interests are integration of Operations Excellence with Industry 4.0 and Big data environment, Operational Capabilities development in micro and small companies through cluster formation, sustaining operations excellence, Innovative Circular Economy Business Models.

Linda Juleff

Dr Linda Juleff is currently employed at the University College of Estate Management in Reading. She was previously an Associate Dean in the Faculty of Business, Sport and Enterprise at Southampton Solent University and Head of PGR Student Experience at the University of Central Lancashire. Prior to this she was a senior lecturer in economics at Edinburgh Napier University. She is a Chartered Fellow of the Chartered Management Institute and an Associate of the Economics Network. Her research interests lie in the fields of economic development and public sector economics/management in which she has successfully supervised a number of PhDs.