Lean in Healthcare: The Unfilled Promise?

Item

Title

Lean in Healthcare: The Unfilled Promise?

Abstract/Description

In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean ‘tools’, such as ‘kaizen blitz’ and ‘rapid improvement events’, which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the ‘tool level’. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining ‘customer value’ that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily ‘professional’ in origin but actually more ‘organisational’ and ‘managerial’ and, if not addressed could severely constrain Lean’s impact on healthcare productivity at the systems level.

Author/creator

Radnor, Zoe J.

Holweg, Matthias

Waring, Justin

Date

2012

In publication

Social Science & Medicine

Series

Part Special Issue: Organization studies and the analysis of health systems

Volume

74

Issue

3

Pages

364-371

Resource type

en Research/Scholarly Media

Resource status/form

en Published Text

Scholarship genre

en Empirical

Keywords

Context-dependence

Efficiency

Lean thinking

Process improvement

Language

en

Open access/full-text available

en No

Peer reviewed

en Yes

ISSN

0277-9536

DOI

10.1016/j.socscimed.2011.02.011

URL

Official Publisher's Webpage (ScienceDirect)

Citation

Radnor, Z. J., Holweg, M., & Waring, J. (2012). Lean in Healthcare: The Unfilled Promise? Social Science & Medicine, 74(3), 364–371. https://doi.org/10.1016/j.socscimed.2011.02.011

Cited in

Cross-Sector Research on Continuous Learning and Improvement

Abbreviation

Social Science & Medicine

Item sets

OB Citations - Cross-Sector Research on Learning and Improvement

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