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Lean and leadership practices: development of an initial realist program theory
Donna Goodridge1, Gill Westhorp2, Thomas Rotter3
1Department of Medicine, College of Medicine, University of Saskatchewan, Room 543 Ellis Hall, 108 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada. donna.goodridge@usask.ca.
BMC Health Services Research
|September 9, 2015
Summary
Lean management in healthcare improves leadership practices by aligning goals, enhancing quality improvement, and fostering a learning culture. Developing leadership capacity is key to systemic changes in healthcare settings.
Area of Science:
- Healthcare Management
- Organizational Behavior
- Systems Improvement
Background:
- Lean management adoption in healthcare aims to enhance quality, capacity, and safety while controlling costs.
- Saskatchewan's Ministry of Health investment in Lean provides a unique context for studying its impact on healthcare.
- Understanding Lean's influence on healthcare operations is crucial for optimizing delivery.
Purpose of the Study:
- To investigate changes in leadership practices associated with Lean implementation in healthcare.
- To understand how altered leadership practices contribute to subsequent healthcare outcomes.
- To develop an initial realist program theory for evaluating Lean initiatives.
Main Methods:
- Qualitative, multi-stage approach using realist assumptions for evaluation.
- Incorporation of formal theories like Normalization Process Theory and Double Loop Learning.
- Data collection included key informant consultations, stakeholder workshops, document review, and 26 interviews.
Main Results:
- Seven hypotheses on how Lean changes leadership practices were developed.
- Lean implementation was found to align health region objectives and resource allocation.
- Lean influences leaders' attitudes, demands increased accountability, and promotes data-driven problem-solving.
Conclusions:
- Initial hypotheses and realist program theory for Lean evaluation in healthcare were generated.
- Developing leadership capacity and fostering a supportive culture are essential for Lean success.
- These findings provide a foundation for future research on Lean's systemic impact in healthcare.
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