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Role of lean leadership in the lean maturity-second-order problem-solving relationship: a mixed methods study
Arie Bijl1, Kees Ahaus1,2, Gwenny Ruël1
1Department of Operations, Faculty of Economics and Business, Erasmus University Rotterdam, Rotterdam, The Netherlands.
BMJ Open
|June 6, 2019
Summary
Lean adoption in nursing teams significantly enhances second-order problem-solving capabilities. Effective lean leadership practices foster this improvement, leading to more mature and self-managing teams.
Area of Science:
- Healthcare Management
- Organizational Psychology
- Nursing Science
Background:
- Lean adoption is increasingly prevalent in healthcare settings to improve efficiency and quality.
- Understanding the link between lean principles and complex problem-solving behaviors in nursing teams is crucial for successful implementation.
- The role of leadership in facilitating these changes requires further investigation.
Purpose of the Study:
- To examine the relationship between the level of lean adoption and the problem-solving behavior of nursing teams.
- To explore the specific practices of lean leaders in nursing wards that stimulate higher-order problem-solving within their teams.
Main Methods:
- A mixed-methods, retrospective multiple case study design was employed.
- Semistructured interviews were conducted with 14 nursing teams in a Dutch hospital, including team leaders and core/non-core team nurses.
- Lean maturity and second-order problem-solving levels were assessed using validated instruments and scenarios, followed by within-case and cross-case analyses.
Main Results:
- A significant positive correlation was found between lean maturity and second-order problem-solving (β=0.68, R²=0.46, p<0.001).
- Seven key lean leadership practices were identified: leading by example, unlocking potential, systematic problem-solving, active engagement, developing self-managing teams, sensing needs, and effective communication/appreciation.
- These practices align with transformational leadership styles.
Conclusions:
- As lean adoption matures within nursing teams, there is a corresponding increase in their capacity for second-order problem-solving.
- In advanced stages of lean implementation, leaders increasingly empower teams by fostering self-management.
- Lean leadership is instrumental in driving advanced problem-solving and team autonomy in nursing wards.
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