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- Dellve, Lotta, et al.
(författare)
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Lean implementation approaches at different levels in Swedish hospitals : the impor¬tance for working conditions, worker engagement, health and performance.
- 2014
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Konferensbidrag (refereegranskat)abstract
- This paper reports result from one-year follow up in a research program with the overall aim to investigate how implementations of lean in health care affect working conditions, health, and performance of employees at five Swedish hospitals. This paper summarizes the implementation approaches, and their importance at short-term follow up for performance (with regard to active work with improvements), perceived working conditions and stress-related health among the healthcare workers. The implementation strategies and pace varied between the hospitals and between the strategic and operative levels. This short-term follow up showed that physical stress-related symptoms had increased overall but the cognitive stress had increased only in hospitals implementing lean. In hospitals with high implementation pace, there were more improvement work among the employees, but higher quantitative demands and lower job satisfaction.
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- Dellve, Lotta, 1965-, et al.
(författare)
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Lean implementation approaches at different levels in Swedish hospitals : the importance for working conditions, worker engagement, health and performance
- 2014
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Konferensbidrag (refereegranskat)abstract
- BackgroundSwedish healthcare organizations are investing heavily in internal reforms. Lean has been frequently used as an overall concept to improve care processes and decrease costs. Some evidence shows positive results, especially if work environment issues are considered in parallel with other desired outcomes. However, there are considerable difficulties in evaluating lean as a concept since its application and interpretation seem to vary widely. Further, like for other management concepts, lean outcomes crucially depend on the implementation process.Aim This program investigates implementations of lean and lean-like developments of processes of care, and how these affect the working conditions, health, and performance of healthcare employees. We also investigated organizational factors and conditions that mediated specific outcomes.MethodMixed method design: questionnaire to employees (n=880) and managers (n=320), qualitative interviews (n=55) and observations with follow up during three years. Five hospitals were selected, and within them five units that were connected by their flow of acute care patients, i.e. the emergency unit, the medical and surgical emergency ward (or ICU at small hospital) as well as one medical and one surgical ward. Initially we used qualitative-driven analyses and thereafter quantitative-driven mixed method analysis.ResultsThe implementation strategies varied between the hospitals and between the strategic and operative levels. Strategic managers also used different approaches to overcome the gap between strategic and operative levels. Operative managers shared similarities in their stepwise and coaching approaches encouraging participation among employees, but differences regarding how assignments were delegated. Social capital and attitudes among health care profession were of importance for employees’ work engagement and active engagement in development work.
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| 7. |
- Eriksson, Andrea, et al.
(författare)
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Motivation and strategies for why and how to implement the organizational concept lean : a case study of a Swedish hospital
- 2012
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Ingår i: NES 2012 Proceedings, NES, Stockholm, 19-22 Augusti. - 9789163711503
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Konferensbidrag (refereegranskat)abstract
- Health care professionals' enggements in health care development processes have considerable impact on the outcomes of such processes. Particulary doctors' willingness to become involved is central to success from organizational developement projects in health care. The aim is to gain deeper understanding of how health care professionals view their motives and engagement in organizational healthcare developments, an it's importance for collaboration and participation in implementation of lean processes. A conceptual model of physicians' engagement has been described from qualitative interviews. Thereafter an instrument has been developed to be used to assess preconditions for implementation of organizational developments.
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- Eriksson, Andrea, 1977-, et al.
(författare)
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Motivations and strategies for why and how to implement the organizational concept lean – a case study of a Swedish hospital
- 2012
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Konferensbidrag (refereegranskat)abstract
- The aim of this study was to analyze motivations and strategies of a Swedish hospital for why and how to implement lean. A case study, including interviews with key actors, observations and document analysis, was performed. Lean was in the studied hospital viewed as tools to deal with suggestions from employees on how to improve the delivery of care. Process leaders employed for a limited time were responsible for implementing lean in the different units. The hospitals future choices of implementation strategies, including training of managers, can be seen ascritical for motivating unit-level managers to sustain lean over time.
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