Lean thinking in Dutch Hospitals - master thesis

Sander Limpers schreef deze thesis in het kader van zijn studie suply chain management aan de Tilburg University. Enkele Lidz contactpersonen werkten mee aan de interviews. 

Abstract

Abstract Rapidly rising healthcare costs and increased attention towards patient safety have promoted awareness for process improvement initiatives in healthcare systems. To improve patient safety and financial performance, healthcare organisations have implemented process improvement techniques such as lean management. Many hospitals implement lean with the narrow view of eliminating waste and reducing costs or focus only on tools instead of on the philosophy or the way of thinking. To better realise the potential benefits of lean in hospitals, a holistic approach is necessary. This study aims to understand how lean thinking can be successfully implemented in Dutch hospitals to improve performance.

A qualitative case study research design was chosen, since the aim was to gain an in-depth understanding of lean thinking in Dutch hospitals. Semi-structured interviews were conducted with ten employees from seven hospitals and with a lean consultant from a consultancy firm. The interviews were conducted by phone or via online communication software Skype and Zoom. The data analysis was performed both within-case and cross-case.

This study revealed that, among the 16 lean tools and methods indicated within the interviews, value stream mapping was the most frequently mentioned, followed by team approach to problem solving and visual management. The results of this study indicate that lean tools and methods are applied with varying scopes. In some cases, the tools are applied only within the boundaries of a department. In other cases, they are applied across departments, through different layers of the hospitals, or even including processes outside the boundaries of the hospital. This study revealed that, among the 20 enabling factors of lean interventions indicated during the interviews, management support was the most frequently mentioned, followed by resources, supportive culture and training. This study also found that, among the 15 outcomes of lean interventions indicated during the interviews, job satisfaction was most the most frequently mentioned, followed by time savings.

These results suggest that to better realise the potential benefits of lean, such as increased job satisfaction and time savings, hospitals should focus on some important enabling factors when applying lean tools and methods. Most important is that the lean interventions are supported by managers at all levels in the organisation and that time and budget resources are made available so that employees have the opportunity to work on making process improvements. Furthermore, a supportive culture should be created, where the views, norms and beliefs within the hospital in relation to quality improvement are stimulated. Finally, training in lean principles, lean tools and methods, and leadership and change management should be provided to hospital employees and managers