Change search
ReferencesLink to record
Permanent link

Direct link
Lean in healthcare: Engagement in development, job satisfaction or exhaustion?
KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.ORCID iD: 0000-0002-6167-4637
KTH, School of Industrial Engineering and Management (ITM), Machine Design (Dept.), Integrated Product Development.
KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
2016 (English)In: Journal of Hospital Administration, ISSN 1927-6990, E-ISSN 1927-7008, Vol. 5, no 5, 91-105 p.Article in journal (Refereed) Published
Abstract [en]

Conclusions about implementing the management concept lean in healthcare are contradictory and longitudinal studies are scarce. In particular, little is known of how working conditions contribute to the sustainability of lean in healthcare. The aim of this article is to identify to what extent lean tools (visual follow-up boards, standardised work, 5S [housekeeping], and value stream mapping [VSM]) promote working conditions for employees and managers in healthcare organisations (outcomes: engagement in development, job satisfaction and exhaustion), while considering the context (i.e., job resources and job demands) and aspects of the implementation process. A longitudinal quantitative study was conducted that involved employees and managers in two hospitals and one municipality (n = 448). Applying the job demands-resources model, multiple linear regression models were used. VSM, standardised work and 5S promoted employees and managers’ working conditions when supported by job resources. When no support was provided, visual follow-up boards were inhibiting employees and managers’ job satisfaction. VSM and standardised work were seen as central lean tools. In this sample, the application of lean cannot be considered sustainable as employees and managers’ working conditions deteriorated under the implementation of lean.

Place, publisher, year, edition, pages
Sciedu press , 2016. Vol. 5, no 5, 91-105 p.
Keyword [en]
Employees, Managers, Work environment, Job demands-resources model, Sustainability
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Technology and Health
Identifiers
URN: urn:nbn:se:kth:diva-191546DOI: 10.5430/jha.v5n5p91OAI: oai:DiVA.org:kth-191546DiVA: diva2:957313
Funder
AFA Insurance, 100013
Note

QC 20160902

Available from: 2016-09-01 Created: 2016-09-01 Last updated: 2016-09-02Bibliographically 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.
Series
TRITA-STH : report, ISSN 1653-3836 ; 2016:7
Keyword
Healthcare, participation, ownership, learning, clarity
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-191550 (URN)978-91-7729-090-2 (ISBN)
External cooperation:
Public defence
2016-09-23, T52, Hälsovägen 11C, Huddinge, 10:15 (English)
Opponent
Supervisors
Funder
AFA Insurance, 100013
Note

QC 20160901

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

Open Access in DiVA

No full text

Other links

Publisher's full textPublisher's website

Search in DiVA

By author/editor
Lindskog, PernillaHemphälä, JensEriksson, Andrea
By organisation
ErgonomicsIntegrated Product Development
In the same journal
Journal of Hospital Administration
Production Engineering, Human Work Science and Ergonomics

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 2 hits
ReferencesLink to record
Permanent link

Direct link