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- Jarebrant, Caroline, et al.
(författare)
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Ergonomic Value Stream Mapping (ErgoVSM). Tool and User Guide.
- 2016
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Ingår i: Nordic Council of Ministers, ANP 2016:731. - : Nordic Council of Ministers. ; :APN 2016:731
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Recent years Lean Production (”Lean”) has become a prevalent rationalization strategy in healthcare to create more efficient value streams. Research shows that this often results in impaired Ergonomics, i.e. impaired work content and physical work load (“physical ergonomics”). A common Lean tool used to rationalize value streams in healthcare is Value Stream Mapping (VSM). An ergonomic “add-in module” Ergonomic Value Stream Mapping (ErgoVSM) – has therefore been developed to be used as an integrated part of VSM in the analysis of value streams in healthcare. ErgoVSM as well as VSM are participative tools. All occupational groups performing tasks directly related to the investigated value stream should be represented when using the tool. This Guide includes description of methods and assessment templates for physical ergonomics and work content. An initial version of ErgoVSM for manufacturing industry was developed in Sweden. Later, this was further developed for the health-care sector. This tool was then evaluated in a Nordic Multicenter Study by national projects in Sweden, Denmark and Iceland. The Nordic evaluation showed that using the ErgoVSM tool may result in more focus on ergonomics in the Action Plans compared to just using VSM. This is obtained without jeopardizing performance aspects. Based on the field experiences from the Nordic Multicentre Study I, the ErgoVSM tool was further developed, resulting in this present English version.
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- Johansson Hanse, Jan, 1954, et al.
(författare)
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Leader-Member Exchange (LMX) and Psychosocial Factors at Work Among Healthcare Professionals
- 2014
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Ingår i: Journal of Nursing and Care. - : OMICS Publishing Group. - 2167-1168. ; 3:5
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The study aims to examine the associations between leader–member exchange (LMX) and psychosocial factors at work. Methods: A questionnaire-based cross-sectional study was undertaken at four units in two not-for-profit hospitals in southwestern Sweden. The study sample included 240 employees. Results: Significant correlations were found between LMX items and most of the psychosocial domains and dimensions. The strongest correlations were found between the LMX item affect and rewards/recognition, role clarity and predictability, and the LMX item loyalty and rewards/recognition. In sum, high-quality LMX was associated with good psychosocial work conditions experienced by the employees. Conclusions: The results support possible ways for managers and employees to strengthen their relationships and this may in turn lead to more sustainable systems in health care.
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- Winkel, Jörgen, 1946, et al.
(författare)
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Factors facilitating and inhibiting Value Stream Mapping processes at hospital units in three Nordic countries - A Nordic Multicenter study
- 2014
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Ingår i: O. Broberg, N. Fallentin, P. Hasle, P.L. Jensen, A. Kabel, M.E. Larsen, T.Weller (Editors). 11th International Symposium on Human Factors in Organisational Design and Management 46th Annual Nordic Ergonomics Society Conference. - 9788793130135
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- 1.Conceptual framework and Purpose In healthcare Value Stream Mapping (VSM) is a common Lean tool used to improve the efficiency of patient flows by identifying and minimizing waste (Keyte & Locher, 2004). It is a participatory tool, i.e. those affected by this type of rationalization are performing the analyses and subsequently suggesting appropriate interventions. Participation has been shown to be crucial to obtain ownership of the suggested interventions and thereby increase impact. VSM has been shown to be a powerful rationalization tool. However, the resulting interventions may imply physical work intensification and impaired psychosocial work environment. Due to this, Lean is often perceived as a “threat” by employees at hospitals (Härenstam et al 2000, personal communications). Physical and psychosocial working conditions should therefore be taken into account in the rationalization process to obtain sustainable solutions, i.e. solutions that allow for competitive performance and acceptable work environment in a long term perspective. On this background we have complemented the VSM tool by an ergonomic module assisting the users to consider also physical and psychosocial implications of the suggested interventions. This ErgoVSM tool is now evaluated in a Nordic Multicenter Study including Denmark, Iceland and Sweden (Winkel et al, 2012). The aim of this paper is to present observations that may indicate facilitating and inhibiting factors for the VSM process. 2.Methods Seven wards have used the ErgoVSM and seven the traditional VSM. Information was obtained by screening key hospital documents and interviewing participants in the VSM processes. 3.Results In Sweden one out of three wards using VSM decided not to fulfil the VSM process. On Iceland the only ward using VSM also decided not to fulfil their VSM process. The hospitals of the investigated wards using VSM in Sweden and Iceland had a strong primary focus on financial balance of the business according to key documents. Decisions on when and which value stream to analyse were made by management with little/no dialog with the employees. Work environment issues were not discussed as part of this. In addition, Iceland had a short experience of Lean, mainly based on support from McKinsey, an American global management consulting firm that focuses on solving issues of concern to senior management (http://en.wikipedia.org/wiki/McKinsey_%26_Company). Thus, they had no attention to the wellbeing to the employees and their work environment when introducing Lean. In general, the Icelandic Lean coaches had problems motivating the employees. However, they perceived a facilitated VSM process at the investigated ErgoVSM ward. Due to this, the main Lean coach decided to include work environment aspects in the VSM processes performed at other wards not part of the present Multicenter Study. Positive effects on those VSM processes were reported back to the researchers. In Denmark all three wards using VSM fulfilled their VSM process. This hospital had a long Lean experience. The main Lean coach reported process problems during their 3 initial years when using a top-down approach. Before the present project was initiated they had turned to a bottom-up initiation of the VSM processes. The Lean coach also expressed that work environment issues might be articulated as part of the VSM process. All seven wards using ErgoVSM in the 3 countries fulfilled the process. 4.Conclusion When using the Lean tool “Value Stream Mapping” it seems to be important not only to focus on efficiency but also on issues that are perceived important for the well-being of the individual employee. 5.Financial support The Nordic Council of Ministers and national grants. 6.References Härenstam A, Bejerot E, Johansson K, Leijon O, Schéele P. “Mager och god” eller ”Lean and mean”? Samband mellan organisationsförändringar och arbetsförhållanden. In: Barllöf K (Ed.) Smärtgränsen? En antologi om hälsokonsekvenser I magra organisationer. Rådet för arbetslivsforskning, pp 2000 Keyte, B., Locher, D., 2004. The Complete Lean Enterprise. Value Stream Mapping for Administrative and Office Processes. Productivity Press, New York. Winkel J, Birgisdóttir B D, Dudas K, Edwards K, Gunnarsdóttir S, Jarebrant C, Johansson Hanse J (2012). A Nordic work environment complement to Value Stream Mapping (VSM) for sustainable patient flows at hospitals – A NOVO Multicenter study. 6th NOVO Symposium: Sustainable Health Care: Continuous Improvement of Processes and Systems. Karolinska Institute, Stockholm Sweden. November 15-16, 2012, pp 58-59. ISBN: 978-91-637-2380-3
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