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  • 1.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Implementering av Lean i medelstora företag: En lärande utvärdering om hållbarutveckling2010Report (Other academic)
    Abstract [sv]

    Denna rapport är ett av delresultaten från det interaktiva forskningsprojektet Produktionslyftet, inom HELIX VINN Excellence Centre. Projektet genomförs i samarbete med Produktionslyftet, ett nationellt program för spridande av managementkonceptet Lean produktion. Syftet med forskningsprojektet är att öka kunskapen om hur hållbart utvecklingsarbete kan bedrivas, både utifrån ett program- och företagsperspektiv.

    Rapporten beskriver två delstudier, en kvalitativ och en kvantitativ, som genomförts i samarbete med elva av företagen i Produktionslyftet, tio av dem pilotföretag för programmet. Den första delstudien genomfördes under sommaren 2008, genom en intervjustudie med programmets pilotföretag, medan den andra genomfördes under våren 2009, i formen av en enkätstudie med sju av företagen i programmet. Då en interaktiv forskningsansats har använts, så har i båda fallen den insamlade empirin från de båda delstudierna återkopplats till representanter från Produktionslyftet, samt programmets finansiärer, och en gemensam tolkning och analys av empirin har gjorts. Denna gemensamma tolkning har sedan analyserats utifrån modeller kring hållbart utvecklingsarbete och resultatet från detta arbete har sedan sammanfattats i två arbetsrapporter, som har återkopplats till programmet och dess finansiärer.

    Resultaten i delstudierna, samt den gemensamma tolkningen och analysen av empirin, fokuserar Produktionslyftets coacher, samt deras arbete med företagen. Dels spelar coacherna uppenbarligen en central roll i programmets arbete med företagen, och dels är coacherna mycket uppskattade av företagen. Coachernas arbetssätt, samt hur deras arbete påverkar möjligheten för företagen att skapa en hållbar utveckling, upptar också en central del i rapporten. Detta kan sammanfattas, som att om coacherna driver på arbetet för hårt, få finns det risk att det uppstår problem för företagen, men om coacherna inte är pådrivande så finns risken att åtminstone vissa av företagen inte tar sitt ansvar för Lean-arbetet. Med andra ord, coachernas arbete med företagen utgör en svår balansgång mellan att uppfylla företagens målsättningar med Lean-arbetet, i vägning mot Produktionslyftets mål och syfte. Men resultaten pekar också på vikten av att företagen har ett tydligt ägarskap och driv i utvecklingsarbetet.

    Slutsatsen i denna rapport blir därför att om programmets utvecklingsarbete skall bli hållbart, så hänger det troligen på dels att man har duktiga och kompetenta coacher, men också att man har en väl fungerande företagsrekryteringsprocess, där företag med ett internt driv för Lean-arbetet väljs till programmet.

  • 2.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Interaktiv forskning: Gemensamt kunskapande för allas nytta2010In: FALF2010: Arbetsliv i förändring, Malmö: FALF , 2010Conference paper (Refereed)
    Abstract [sv]

    Utvärdering är ett mycket vanligt redskap för kontroll och uppföljning inom olika verksamheter, exempelvis projekt och program. Den traditionella ”summativa” utvärderingen har dock ett flertal brister, som gjort att intresset för formativa utvärderingar ökat. Ett exempel på dessa är de s.k. lärande utvärderingarna, men också forskning i olika former kan användas för att utvärdera projekt och program. I det offentliga programmet Produktionslyftet har det förekommit ett flertal utvärderingsformer, bl.a. två summativa måluppföljelseutvärderingar och ett interaktivt forskningsprojekt. I detta paper presenteras en fallstudie kring dessa utvärderingsformer, samt vilka interna respektive externa spridningseffekter (av programmets erfarenheter), samt också vilken form av utvecklingsstöd, som dessa har möjliggjort för Produktionslyftet. Resultaten pekar på att ett summativa utvärderingsprojekt kan användas för både intern spridning av erfarenheter och för att skapa utvecklingsstöd, förutsatt att halvtidsutvärderingar används. Detta kan också ett interaktivt forskningsprojekt bidra med, samt en lärande utvärdering, men det interaktiva forskningsprojektet tycks vara överlägset när det gäller extern spridning av resultaten från programmet – även om det också är den mest resurskrävande formen av utvärdering. Uttryckt på ett annat sätt, så skapar det interaktiva forskningsprojektet underlag för gemensam diskussion, reflektion och analys för programmet, samt gör också programmet/projektet mer transparent, genom extern spridning av gjorda erfarenheter.

  • 3.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Is Lean No Longer Mean?: A Study of the Consequences for Working Conditions in Companies Implementing Lean2010In: FALF2010: Arbetsliv i förändring, Malmö: FALF , 2010Conference paper (Refereed)
    Abstract [en]

    Lean is today becoming increasingly popular in Swedish manufacturing industry, and the concept has also started to spread to other sectors, such as administration, healthcare and the municipal sector. However, previous studies have suggested that Lean can become “mean”, creating working conditions that are bad for the employees. Conversely, other studies instead suggest that this has less to do with Lean, than with the implementation of Lean. Thus, this paper aims at studying the implementation of Lean in eight medium sized companies over a two year period, using qualitative and quantitative data. First, the results from the qualitative data suggest that these companies implementation of Lean is characterized by Lean coordinators, pilot projects and improvements groups, while the Lean tools mostly used are 5S, SMED, standardization and means to improve the production flow. Second, the perceived effects on working conditions, based on the quantitative data, suggest an improvement in the working environment, an increase in the work with safety and some degree of increase in stress for the workers. Consequently, the implementation structure of these companies does not indicate a “mean” production system, although the long term effects on working conditions cannot be determined, based on these data.

  • 4.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean administration: En litteraturgenomgång av lean när konceptet implementeras i kommuner2011In: FALF2011: Det nya arbetslivet, Luleå: FALF , 2011Conference paper (Refereed)
    Abstract [sv]

    Lean blir allt vanligare i svensk offentlig förvaltning. Litteraturstudier har tidigare genomförts inom sjukvård och service. Denna litteraturgenomgång fokuserar istället på kommuner. Fokus ligger på vilka former som lean-konceptet tar, hur det implementeras, vilka effekter som uppnås, samt vilka svårigheter som man stött på. Sökningar gjordes i två omgångar i fyra olika databaser under i maj 2010. Endast empiriska artiklar i peer-reviewadetidsskrifter inkluderades; studier som inom vård- eller industriliknande kontexterexkluderades. Totalt resulterade sökningen och urvalsprocessen i fem publikationer, som beskriver lean i elva verksamheter. Slutsatserna från genomgången av dessa är de studerade lean-implementeringar i hög grad utgår från en ansats som påminner om värdeflödeskartläggningar. Fokus för lean-arbetet ligger på verktyg och system för förbättringsarbete. De upplevda problemen i lean-arbetet är framför allt associerade med implementeringsansatsen, snarare än konceptet eller kontexten. Verksamheternas arbete med lean har gett mestadels positiva verksamhetseffekter, framför allt rörande effektivitet och produktivitet. Hur kunderna, och framför allt personalen, påverkats är dock osäkrare.

  • 5.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean i kommuner och myndigheter: En översikt över existerande empirisk forskningslitteratur2012Report (Other academic)
    Abstract [sv]

    Denna litteraturgenomgång avser att studera det empiriska underlaget om lean i kommuner och myndigheter (exklusive sjukvård) utifrån den forskningslitteratur som finns. Sökningar har gjorts i sex forskningsdatabaser under oktober 2011. Relevanta frågor för studien är hur lean används i kommuner och myndigheter, varför organisationerna väljer att arbeta med lean och vilka resultat man har uppnått.

    Totalt hittades 48 publikationer, men efter sortering återstod endast 17 empiriska artiklar av relevans för den här rapporten. De studier som valdes bort var antingen för diskuterande eller redogjorde inte tydligt för hur man har samlat in sin empiri. De 17 studierna som används är av skiftande kvalitet och utformning och det empiriska underlaget är varierat. En majoritet av de inkluderade publikationerna är publicerade efter 2005. Tio av de 17 publikationerna innehåller totalt 18 fallstudier. Utifrån detta, är det rimligt att hävda att den empiriska forskningen om lean i kommuner och myndigheter är ett relativt nytt fenomen. Fallstudierna föranleder flera slutsatser, även om det bör betonas att det empiriska underlaget är tunt och studierna är av starkt varierande kvalitet och utformning. Därför bör slutsatserna endast ses som tentativa, men det innebär samtidigt att det finns flera frågor som kan vara av stort intresse för fortsatt forskning.

    För det första, när det gäller vilka former lean-arbetet tar, så tycks värdeflödeskartläggning och slöserireducering utgöra centrala inslag i kommuner och myndigheters arbete med lean. Ofta verkar det handla om punktinsatser. Lean-program som omfattar hela organisationen är relativt ovanliga. Andra lean-verktyg förekommer också, men det är mindre vanligt. För det andra, när det gäller målen med lean-arbetet, verkar det i hög grad initieras med syfte att öka produktiviteten, även om andra skäl också förekommer, som exempelvis behov av kostnadssänkningar. För det tredje, när det gäller resultat av lean-arbetet, framför allt då värdeflödeskartläggningarna, verkar ökad produktivitet vara det vanligaste resultatet. Samtidigt leder arbetet också ofta till minskade problem och störningar för de anställda, vilket ofta uppskattas. Däremot tycks effekterna för personalen vara mer varierade än verksamhetseffekterna. De lean-verktyg som emellanåt verkar ge negativa konsekvenser är bland annat standardisering, visualisering och kundkontakt. Kundeffekterna är dock svårare att uttala sig om eftersom det ofta saknas empiri om detta i studierna.

    Slutligen bör det betonas att utifrån de inkluderade studiernas utformning och metodik är det mycket svårt att uttala sig om de långsiktiga effekterna av arbetet med lean, eftersom det finns empiri i publikationerna som väcker frågetecken om hur hållbart lean-arbetet är, till exempel deltagarnas känsla av att arbetet är avklarat efter genomförda förbättringsworkshops.

  • 6.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean Working Environments: An Empirical Study of 24 CompaniesImplementing Lean2010In: NES2010: Proactive Ergonomics: Implementation of ergonomics in planning of jobs, tasks, systems and environments., Stavanger, 2010Conference paper (Refereed)
    Abstract [en]

    This paper studies the perceived effects on the working conditions in 24 medium sized manufacturing companies, approximately 1.5 year into their implementation of Lean. This is studied quantitatively based on four stakeholders’ perceptions (the workers, the managers, the production supervisors and the white-collar workers), based on three factors; changes in the working environment, work with safety for the personnel and level of stress. The results indicate that the physical work environments have improved and the workers and production supervisors report a slight increase in stress. Lastly, all groups report an increase in the work with safety for the personnel.

  • 7.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Ökad delaktighet i programutvärdering: En metodik för ökad resultatspridning?2009In: HSS2009: Vi bygger morgondagens samhälle, Luleå, 2009, p. 1-26Conference paper (Refereed)
  • 8.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Benn, Suzanne
    University of Technology, Sydney, Australia.
    A Proposed Model for Evaluating the Sustainability of Continuous Change Programmes2012In: Journal of Change Management, ISSN 1469-7017, E-ISSN 1479-1811, Vol. 12, no 2, p. 231-245Article in journal (Refereed)
    Abstract [en]

    Many studies report that it is difficult to sustain change. This article focuses on how an organization can initiate and sustain a continuous change process. A theoretical model is proposed as a fusion of two previous models for evaluating the sustainability of a change programme; the first is based on analysing stakeholder interest balance as a prerequisite for organizational sustainability, the second on analysing the design of the implementation, indicating whether long-term effects will be achieved. It is argued that the combination of these factors provides a more comprehensive perspective, since it allows us to evaluate both the ‘form’ and the ‘direction’ of the programme. To assess stakeholder interest balance, the goal for the change programme is analysed, utilizing the broad stakeholder interest balance perspective. To assess the design of the implementation, four preconditions for long-term effects should be analysed: management's ownership of the change initiative, professional steering, competent leadership and participation. Reference is given to the management concept Lean Production, which is claimed to engage the organization in continuous change. Application of the model highlights the mismatch between narrowly focused change programmes such as Lean Production and sustainable change.

  • 9.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eklund, Jörgen
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Leaninspirerade förändringar och personalens upplevelser2013In: Lean i arbetslivet / [ed] Sederblad, Per, Stockholm: Liber, 2013, 1, p. 103-121Chapter in book (Other academic)
    Abstract [sv]

    De anställdas upplevelser av hur de kommer att påverkas av ett förändringskoncept är en avgörande faktor för om konceptet kommer att få reellt genomslag eller inte. Det här kapitlet behandlar denna centrala aspekt av leankonceptet – hur personalen upplever leaninspirerade förändringar. Just denna fråga finns det mycket lite empirisk forskning kring, så väl internationellt som i Sverige.

    I kapitlet redovisas en studie av personalens erfarenheter från leanarbetet i medelstora svenska tillverkningsföretag som ingått i det nationella programmet Produktionslyftet. Programmet kan ses som ett exempel på en ”svensk tolkning” av lean. Produktionslyftet har fått stort genomslag i den svenska diskussionen om lean, men samtidigt har konsekvenserna av lean ur ett arbetsmiljöperspektiv inte utvärderats på ett genomgripande sätt.

  • 10.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Eklund, Jörgen
    KTH, School of Technology and Health (STH), Ergonomics.
    Håkansson, Malin
    KTH, School of Technology and Health (STH), Ergonomics.
    Vogel, Kjerstin
    KTH, School of Technology and Health (STH), Ergonomics.
    Belastningsergonomiska studier utifrån ett produktions- och systemperspektiv: Kunskapsöversikt2012Report (Other academic)
  • 11.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Analysseminarier som samverkansform: Följeforskning för hållbart utvecklingsarbete?2011In: HSS2011: Vi bygger tillsammans, Karlstad: HSS , 2011Conference paper (Refereed)
  • 12.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Lindskog, Pernilla
    KTH, School of Technology and Health (STH), Ergonomics.
    Implementing Lean in Swedish Municipalities and Hospitals: Initial effects on the work system2011In: FALF2011:Det nya arbetslivet, Luleå: FALF , 2011Conference paper (Refereed)
    Abstract [en]

    This paper is the first preliminary product of a three year interactive research project, studying the effects of Lean when introduced in Swedish municipalities and hospitals. Focus of the paper is the implementation process (more specifically, employee participationand facilitated learning) and changes in the work system (focusing on work content, organization and work environment). The empirical data has been collected through interviews and group interviews in three municipalities and one hospital. These results, together with the discussion and analysis, shows firstly that the implementation processes of the studied units are characterized by a medium or high level of opportunities for employee participation and learning, although this is produced in different ways. Second, the changes in the work systems mostly affect the organization of the work, through reorganization and redistribution of the work tasks, rather than changes in how the work tasks are performed.This has lead to more orderly and structured work processes. Lastly, the employees’ reactions to these changes have been mostly positive, although not exclusively so. However, it is important to stress that the employee reactions are most likely as much a result of the implementation process, as of the changes in the work systems. Longitudinal studies are therefore needed to study the long term changes in the work system and the effects on employee health, which will be the next step of this research project.

  • 13.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Holden, Richard J
    Departments of Medicine and Biomedical Informatics, Center for Research and Innovation in Systems Safety, Vanderbilt University School of Medicine.
    Packages of participation: Swedish employees´experience of Lean depends on how they are involved2013In: IIE Transactions on Occupational Ergonomics and Human Factors, ISSN 2157-7323, Vol. 1, no 2, p. 93-108Article in journal (Refereed)
    Abstract [en]

    Background: Lean production is a dominant approach in Swedish and global manufacturing and service industries. Studies of Lean’s employee effects are few and contradictory. Purpose: Employee effects from Lean are likely not uniform. This article investigates the effect of employees’ participation on their experiences of Lean. Method: This study investigated how different packages of employee participation in Lean affected manufacturing workers’ experiences of Lean. During 2008–2011, qualitative and quantitative data were collected from Swedish manufacturing companies participating in the national Swedish Lean production program Produktionslyftet. Data from 129 surveys (28 companies), 39 semi-structured interviews, and 30 reports were analyzed. In the main analysis, comparisons were made of the survey-reported Lean experiences of employees in three groups: temporary group employees (N = 36), who participated in Lean mostly through intermittent projects; continuous group employees (N = 69), who participated through standing improvement groups; and combined group employees (N = 24), who participated in both ways. Results: Continuous group employees had the most positive experience of Lean, followed by the combined group. Temporary group employees had the least positive experiences, being less likely than their counterparts to report that Lean improved teamwork; occupational safety; and change-related learning, decision making, and authority. Conclusions: These findings support the importance of continuous, structured opportunities for participation but raise the possibility that more participation may result in greater workload and role overload, mitigating some benefits of employee involvement. Consequently, companies should consider involving employees in change efforts but should attend to the specific design of participation activities.

  • 14.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Håkansson, Malin
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean production and work-related musculoskeletal disorders: Overviews of international and Swedish studies2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no 1, p. 2321-2328Article in journal (Refereed)
    Abstract [en]

    This paper aimed at summarizing the knowledge of the relationship between Lean and work related musculoskeletal disorders (WMSD), and WMSD risk factors, in manufacturing companies. Literature search processes identified 23 publications studying this, in scientific journals. Eight included measurements of WMSD; three were mostly negative, two showed mixed results, one showed no results and two were mostly positive. Eighteen publications included measurements of WMSD risk factors; seven showed mostly negative results, eight snowed mixed results, two showed mostly positive results and one was inconclusive. Three literature reviews were identified, which studied this question; two were mostly negative, while the third was inconclusive. Also, 12 publications of grey literature studying Lean and WMSD risk factors in Swedish organizations were identified; nine showed mixed results, two showed mostly positive results and one showed mostly negative results. Due to the varying quality and study design of the publications, together with the few identified studies, it is difficult to compare them. The context and the implementation also likely affect the results. The general conclusion was that a Lean implementation may increase the risk of WMSD and risk factors for WMSD, if it is not accompanied with an ergonomic intervention.

  • 15.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Langstrand, Jostein
    Linköping University, Division of Quality Technology and Management, Linköping, Sweden.
    Johansson, Stina
    Luleå University of Technology, Dept. of Human Work Science, Luleå, Sweden.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Abrahamsson, Lena
    Luleå University of Technology, Dept. of Human Work Science, Luleå, Sweden.
    Winkel, Jörgen
    University of Gothenburg, Dept. of Sociology and Work Science, Gothenburg, Sweden.
    Researching lean: Methodological implications of loose definitions2012In: Quality Innovation Prosperity, ISSN 1335-1745, E-ISSN 1338-984X, Vol. 16, no 2, p. 35-48Article in journal (Refereed)
    Abstract [en]

    Recently, Lean Production (Lean) has become a prevailing management concept in Sweden. However, previous research seems to show that the Lean concept and the impact of Lean vary considerably between organizations.

    This paper illustrates some key methodological issues that need to be considered when researching loosely defined management concepts such as Lean. The paperis based on a review of the literature and five comparative Swedish cases studies.

    Our study indicates that Lean has changed over time and that operationalization and interpretations of the concept vary considerably

    This study concludes that future Lean studies should include a thorough assessment of the Lean interventions, study settings, and in particular non-Lean factors mediating the outcomes of Lean-inspired change programs.

  • 16.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Lindskog, Pernilla
    KTH, School of Technology and Health (STH), Ergonomics.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Patient Quality Effects from Lean Healthcare: An Empirical Investigation2012In: NES2012 Proceedings.: Ergonomics for sustainability and growth / [ed] Ann-Beth Antonsson, Göran Hägg, Stockholm: KTH Royal Institute of Technology, 2012Conference paper (Refereed)
    Abstract [en]

    The use of Lean in healthcare settings has become common in Swedish hospitals. However, the effects from Lean on patients have not been studied extensively. This paper contributes to our understanding of this question, based on 24 semi-structured interviews in three municipal care units and three units in hospitals. The results indicate that there may be a positive link between Lean activities and quality of care. However, it is plausibly a weak link, heavily modulated by non-Lean factors. Thus, we need more empirical research to understand the causal link between patient safety and quality of care from Lean Healthcare.

  • 17.
    Eklund, Jörgen
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Sustainable development for ergonomics improvement projects2009Conference paper (Refereed)
  • 18.
    Eklund, Jörgen
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Dellve, Lotta
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Elg, M
    Eriksson, A
    Halling, Bengt
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Halvarsson, A
    Kock, H
    Williamsson, Anna
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Andersson, K
    Håkansson, Malin
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Langstrand, J
    Poksinska, Bozena
    Renström, Jonas
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Svensson, L
    Vänje, Annika
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Lean and working conditions: a current position2013In: HELIX Conference, 2013Conference paper (Refereed)
  • 19. Halvarsson, Agneta
    et al.
    Svensson, L
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eklund, Jörgen
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Kock, H
    Lindskog, Pernilla
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Lean production: an institutional and organizational perspective on two national programs2013Conference paper (Refereed)
  • 20.
    Lindskog, Pernilla
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Halvarsson, Agneta
    APeL FoU, Örebro, Sweden.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Sustainable Development Work (Lean) in Swedish Healthcare: A longitudinal and quantitative study concerning effects of goal settings on participation2013Conference paper (Other academic)
  • 21.
    Lindskog, Pernilla
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Vänje, Annika
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Törnkvist, Åsa
    Uppsala University Hospital.
    Managerial Challenges in Creating Sustainable Development Work (Lean): An interactive case study from socio-technical perspectivesManuscript (preprint) (Other academic)
    Abstract [en]

    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.

  • 22.
    Vänje, Annika
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Walking around the pyramids: Managers’ shop-floor activities in Lean-inspired organizations2017In: Economic and Industrial Democracy, ISSN 0143-831X, E-ISSN 1461-7099, Vol. 38, no 3, p. 495-512Article in journal (Refereed)
    Abstract [en]

    The approach in this article is to study leadership activities from the shop-floor workers’ perspectives during the implementation of a Lean-inspired production concept – an angle of approach that corresponds to a need for a deeper knowledge of the interactions between organizational structures and the physical work environment. The empirical findings are from a national R&D program called the Production Leap and collected through different methods: semi-structured interviews carried out at eight manufacturing companies, the open-ended part of a longitudinal survey, and participative observations. Lean leadership practices at these companies do not enable the possibilities of developing the technical systems or work relationships between the managers and the shop-floor workers. Instead, they provide the means and activities to circumvent coordination problems and create a feeling of participation. The results here indicate that leadership activities and coordination of work do not, as it is sometimes argued by the proponents of Lean, ‘turn the pyramid’ of power upside down. One reason for this is the lack of social structures in the organization.

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