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Sustainable Lean in psychiatry?: Assessment through socio-technical principles
KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. HELIX Vinn Excellence Centre, Linköping University, Sweden.
KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.ORCID iD: 0000-0001-5009-5683
KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. HELIX Vinn Excellence Centre, Linköping University, Sweden.ORCID iD: 0000-0001-5338-0586
2016 (English)In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703, Vol. 8, no 1, 53-71 p.Article in journal (Refereed) PublishedText
Abstract [en]

Purpose – This paper aims to identify conditions affecting sustainability of Lean implementations in Swedish psychiatric healthcare, from a socio-technical perspective. Design/methodology/approach – Longitudinal focus group interviews were conducted with 24 first-line managers within Swedish psychiatric healthcare. The analysis was made using Cherns’ ten socio-technical principles and a framework for sustainable development work in healthcare. Findings – The most critical socio-technical principles for a sustainable Lean implementation were boundary location; power and authority; and compatibility. At hospital level, socio-technical principles were inhibited by the weak ownership of the Lean implementation. However, strong ownership at division level meant the same principles were supported. Unclear goals made follow-ups difficult which had negative effects on the learning processes in the Lean implementation. The role and responsibility of first-line managers were unclear in that they perceived they lacked power and authority resulting in negative effects on the participation – an important sustainability concept. Originality/value – Empirically based papers assessing Lean implementations in psychiatry are rare. This study is a contribution to the research area of sustainable Lean implementations in healthcare. The practical implication of this study is that decision makers, senior managers, first-line managers and psychiatrists can be supported in reaching sustainable implementations of Lean.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2016. Vol. 8, no 1, 53-71 p.
Keyword [en]
First-line managers, Healthcare, Learning, Participation, Role clarity, Scandinavian
National Category
Health Sciences
URN: urn:nbn:se:kth:diva-187218DOI: 10.1108/IJQSS-07-2015-0056ScopusID: 2-s2.0-84962546084OAI: diva2:929250

QC 20160518

Available from: 2016-05-18 Created: 2016-05-18 Last updated: 2016-09-01Bibliographically approved
In thesis
1. Reaching at Sustainable Development: Lean in the Public Sector
Open this publication in new window or tab >>Reaching at Sustainable Development: Lean in the Public Sector
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The concept of sustainable development is commonly used worldwide. In the public sector, characterized by a rationalization focus, conclusions about the sustainability of lean production (lean), as a management concept for organizational change, are contradictory. This thesis aims to identify conditions promoting sustainable development in the public sector, in particular the healthcare sector, when implementing lean. Two qualitative and one quantitative case study were conducted using longitudinal data collection: focus group interviews, semi-structured interviews, analysis seminars, steering board meetings, and a questionnaire. The empirical data was collected from national lean programs in Sweden. The results describe that socio-technical principles may be used as indicators of sustainability as well as a guide in the implementation of lean in healthcare. Active ownership among stakeholders, a developmental view in the organization, stakeholder participation, organized joint innovative learning activities, role and goal clarity may be conditions influencing the sustainability of lean in the public sector. Furthermore, when supported by a favorable lean context, the results show that the lean tools value stream mapping, standardized work and 5S (housekeeping) may promote a sustainable implementation of lean in healthcare by the promotion of employees and managers’ working conditions and/or employee individual innovation. Visual follow-up boards may inhibit employees and managers’ job satisfaction, when not supported by job resources. Personnel stability, time for development, and information to be able to participate were in this context shown to be central job resources. In conclusion, conditions which may promote sustainable development in the public sector, when implementing lean are: stakeholder values of inclusive social well-being, an implementation process including stakeholder ownership and joint innovative learning, and a favorable lean context: balancing job resources and job demands. Lean tools may empower public healthcare employees to engage in development and counteract a poor implementation process and a poor lean context but only to a limited degree. The lean contexts studied were unfavorable, i.e., a weak implementation process and job resources not balancing the job demands. Hence, the lean implementations studied could not be considered sustainable.

Place, publisher, year, edition, pages
KTH Royal Institute of Technology, 2016. 72 p.
TRITA-STH : report, ISSN 1653-3836 ; 2016:7
Healthcare, participation, ownership, learning, clarity
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Technology and Health
urn:nbn:se:kth:diva-191550 (URN)978-91-7729-090-2 (ISBN)
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Public defence
2016-09-23, T52, Hälsovägen 11C, Huddinge, 10:15 (English)
AFA Insurance, 100013

QC 20160901

Available from: 2016-09-01 Created: 2016-09-01 Last updated: 2016-09-02Bibliographically approved

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