Integrating Lean Thinking and Implementation Science Determinants Checklists for Quality Improvement: A Scoping...

Area of Science:

• Health Services Research
• Implementation Science
• Lean Management

Background:

• Healthcare quality improvement (QI) often employs lean tools, but their integration with implementation science is not well understood.
• Implementation science provides frameworks to understand and facilitate the adoption of interventions, including QI initiatives.
• The concurrent use of lean tools and implementation determinants frameworks in QI is not well documented.

Purpose of the Study:

• To systematically review the literature on the concurrent use of lean tools and implementation science determinants frameworks in healthcare QI activities.
• To identify the types of lean tools and implementation frameworks utilized in published studies.
• To assess the extent to which these methodologies are integrated in QI research.

Main Methods:

• A systematic literature review was conducted for studies published between January 1999 and August 2018.
• Searches identified studies using a lean tool alongside an implementation science determinants framework for QI.
• Seven studies (8 publications) were included, analyzing the frameworks and lean tools employed.

Main Results:

• All seven studies utilized the Consolidated Framework for Implementation Research (CFIR).
• Commonly used lean tools included process mapping (4 publications), process redesign (3 publications), and 5S standardization (2 publications).
• Only one study reported proposing the concurrent use of a lean tool and an implementation science framework in the QI project's design and execution.

Conclusions:

• Published research demonstrates limited concurrent utilization of lean tools and implementation science determinants frameworks in healthcare QI.
• The Consolidated Framework for Implementation Research was the predominant framework identified.
• Further research and practice are needed to explore the synergistic potential of integrating lean methodologies with implementation science for effective healthcare QI.