This abstract is written at the start up of an interactive oriented research project. The author has previous experience as a consultant and is reflecting upon possible differences between being a consultant and being a researcher. In the paper, a reflection is made on possible differences when using an academic or a consultant approach in an organizational intervention.  The consultants are seen as the change agents, fully devoting themselves to the needs of the clients in performing an organizational intervention. The consultant’s role, as being a change agent, is sometimes compared to the role of an action researcher. However, the action researchers should not only satisfy the organizations but should also add critical knowledge to existing research. In interactive research, the emphasis is even larger on the importance of separating the role of a researcher from a developer in order to carefully consider issues of validity. As opposed to the action researcher’s role, an interactive researcher is expected to perform a joint analysis with the involved actors of the organization instead of taking responsibility of the change process. Even so, both interactive and action research can be seen as new production of knowledge in addition to traditional research. The question which is reflected upon is: If there is a difference between the role of a consultant and an action researcher in an organizational intervention, is there really a difference between interactive and action research? Aspects such as participation, learning and sustainability are considered. The empirical data is collected from the author’s involvement in two parallel research projects as an interactive researcher. One project is within the public sector and the other is within the public psychiatric care sector. Both involve change projects aimed towards the development of lean production.

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.