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Lean Enterprise Transformation in VA: a national evaluation framework and study protocol.

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This study outlines the evaluation design for a national Lean Enterprise Transformation (LET) pilot program in healthcare. It introduces a conceptual framework to assess LET adoption and success in healthcare settings.

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Area of Science:

  • Healthcare Management
  • Organizational Transformation
  • Quality Improvement Science

Background:

  • Lean Enterprise Transformation (LET) aims to embed Lean principles as a collective mindset, moving beyond tool implementation.
  • The Veterans Affairs (VA) launched a pilot LET program via the Veterans Engineering Resource Center (VERC) to enhance quality, safety, and patient experience.
  • A national evaluation is underway to assess LET implementation, outcomes, and sustainability within the VA healthcare system.

Purpose of the Study:

  • To describe the evaluation design for the national VA LET pilot program.
  • To develop and present a conceptual framework for evaluating LET in healthcare settings.
  • To examine the processes, outcomes, and impacts of LET implementation and adoption.

Main Methods:

  • A literature review of Lean evaluation frameworks informed the conceptual framework development.
  • A multidisciplinary expert group identified key domains, validated by stakeholders.
  • The national evaluation employs mixed-methods (qualitative, survey, quantitative) across ten VA facilities, including site visits, interviews, observations, employee surveys, and quality metrics.

Main Results:

  • The evaluation design integrates qualitative, survey, and quantitative data for comprehensive analysis.
  • Mixed-methods analyses will explore LET strategic initiative implementation and site-specific variations in success.
  • Findings will offer insights into large-scale LET implementation in healthcare.

Conclusions:

  • The national evaluation will yield valuable insights for organizations pursuing Lean transformation.
  • A novel, multi-faceted conceptual framework has been developed to characterize Lean healthcare organizations.
  • This framework can guide the current evaluation and serve as an assessment tool for other Lean initiatives.