Managerial Challenges in Creating Sustainable Development Work (Lean): An interactive case study from socio-technical perspectives
(English)Manuscript (preprint) (Other academic)
Purpose - At present, healthcare organizations are facing both quality and financial challenges. Consequently, organizations in this sector have started to introduce Lean inspired production concepts in order to become more efficient and effective. The implementation of Lean in healthcare is not unproblematic, especially not within psychiatry, the context of which differs greatly from other sectors where it is more usual to see Lean implemented. The aim of this article is to identify managerial preconditions for the implementation of a sustainable Lean organization at a psychiatry division in a Swedish university hospital.
Design/methodology/approach – An interactive case study approach was chosen with the purpose of gaining deeper knowledge and understanding of the first-line managers’ role during implementation of Lean. Focus group interviews together with 24 first-line managers were conducted. In the analysis, a socio-technical perspective was used due to the characteristics of the psychiatry healthcare context but also from a sustainability perspective. The empirical data from the focus group interviews were also complemented with a semi-structured interview with a key actor.
Findings – Development work is context dependent and so is the implementation of Lean. This particular case study points out that clarity of the organizational structures within the Lean work, i.e. objectives and roles, affects the level of participation and consequently the sustainability of the Lean implementation. The empirical findings also show that a managerial lack of power and authority make it difficult for first-line managers (the majority being nurses) to prioritize engagement and time spent in Lean work.
Originality/value – At present there are few studies on the implementation of Lean within the psychiatry healthcare sector and in a socio-technical context. In this article a model is presented, visualizing managerial preconditions for sustainable Lean in the context presented.
Lean production, Lean work, psychiatry, first-line managers, sustainable development, objectives, roles, participation, socio-technics
Engineering and Technology
Research subject Technology and Health
IdentifiersURN: urn:nbn:se:kth:diva-141104OAI: oai:DiVA.org:kth-141104DiVA: diva2:694647
QS 20142014-02-072014-02-072014-02-07Bibliographically approved