Advancing Equity: Lean Leader Practices and a Path Forward.

Area of Science:

• Healthcare Management
• Quality Improvement
• Health Equity

Background:

• Lean management is a quality improvement strategy focused on process consistency.
• It can be applied to reduce health inequities and improve care for diverse patient groups.
• Limited research exists on how leaders use lean practices for health equity and workforce diversity.

Purpose of the Study:

• To examine how health care leaders utilize lean management practices to support equity initiatives.
• To understand leader activities in fostering workplace culture for equity and diversity.

Main Methods:

• In-depth interviews were conducted with 67 leaders in five US hospital-health systems.
• Interview transcripts were analyzed using parallel coding with 92.6% interrater agreement.
• Cross-cutting themes on lean methods for promoting equity were identified.

Main Results:

• Leaders utilize the lean daily management system (DMS) to scale equity initiatives.
• The DMS includes standardized practices like tiered huddles and leader rounding.
• Humble inquiry was effective for addressing safety and fostering learning; integrating equity into strategic goals and stratifying data are recommended.

Conclusions:

• Health care leaders can leverage lean management to advance health equity.
• Reducing variation in care processes and improving outcome measurement across diverse populations are key.
• Developing new measurement systems with clear performance metrics for equity accountability is crucial.