Lean implementation in healthcare: offsetting Physicians’ resistance to change

Abstract

Physicians’ resistance towards Lean is often viewed as an important barrier to its successful implementation in healthcare organisations. However, there exists a dearth of knowledge regarding what influences reactions from physicians towards Lean and what organisations can do about it. This study adopts a behavioural perspective and focuses on the triggers of physicians’ resistance towards Lean. Using longitudinal qualitative data from multiple case studies of Canadian hospitals, 15 behavioural triggers are identified. A cross-case analysis reveals that core-technical and efficiency-driven changes clash with medical professionalism and generate active resistance from physicians, while leadership and familiarity with Lean are linked to championing behaviours that mitigate it. This study provides a deeper understanding of physicians’ behaviours during Lean transformations and the factors that drive resistance. It also provides insight into how organisations can better engage their medical staff in their Lean efforts by focussing on the process of change to offset resistance.

Keywords:

• Lean production
• Lean healthcare
• physicians
• resistance to change

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Pierre-Luc Fournier

Pierre-Luc Fournier is an Assistant Professor of operations management at the Université de Sherbrooke Business School. He holds a Ph.D. in operations management from HEC Montréal. His research focuses on operations management and behavioural issues related to performance management and improvement in healthcare organisations.

Marie-Hélène Jobin

Marie-Hélène Jobin is a Professor of operations management and logistics and the Director of international relations at HEC Montréal. She holds a Ph.D. in operations and decision systems from Université Laval. She researches innovation and performance management in healthcare organisations. She is the Associate Director of HEC Montréal’s Healthcare Management Hub.

Liette Lapointe

Liette Lapointe is an Associate Professor of information systems and the Vice-Dean of programs at McGill University’s Desautels Faculty of Management. She holds a Ph.D. in information systems from HEC Montréal. Her main research integrates information systems management and behavioural issues as well as issues related to the adoption of change in healthcare settings.

Lionel Bahl

Lionel Bahl is an Assistant Professor of accounting science at the Université de Sherbrooke Business School. He holds a DBA from the Université de Sherbrooke. His research focuses on sustainable development and non-financial information.