The mandate to create efficiency and lower the costs of healthcare has led many hospital and healthcare system leaders to search for new and unique management strategies, often from other industries. Lean—based on the approach developed for Japanese auto manufacturer Toyota Production System—has gained traction as a Continuous Quality Improvement strategy that shows promise for increasing efficiency in healthcare delivery. Yet there are still a number of unanswered questions about how well Lean can be implemented successfully to produce sustainable improvements in quality and efficiency outcomes in the delivery of health care in the United States.
Through funding from the Agency for Healthcare Research and Quality, AIR helped to fill the gaps in knowledge about how a healthcare organization’s environment, structure, and culture may inhibit or enhance successful diffusion and integration of Lean training, tools, and activities.
After reviewing the literature in this field, an AIR research team developed a model to guide their rigorous case studies of 12 Lean projects, implemented in five different health care settings, to advance understanding of the context’s influence on increasing efficiency and reducing cost in a variety of healthcare systems. Among the key factors contributing to success they identified were the commitment and support provided to the effort by top organizational leaders; previous experiences with quality improvement initiatives; aligning Lean implementation with the organizational mission and vision; and dedicating resources—including assigning experts—to Lean.
Future focus in these and other context-specific areas, by researchers and practitioners, may help healthcare organizations achieve their desired outcomes through appropriate adaptation and application of Lean strategies that fit their unique circumstances.
To learn more about the cases in this study, see Improving Care Delivery Through Lean: Implementation Case Studies.
Details about the contributions of this research were recently published:
Harrison, M. I., Paez, K., Carman, K. L., Stephens, J., Smeeding, L., Devers, K. J., & Garfinkel, S. (2014). Effects of organizational context on Lean implementation in five hospital systems. Health care management review.