Does lean muddy the quality improvement waters A qualitative study of how a hospital management team understands lean in the context of quality improvementReport as inadecuate




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BMC Health Services Research

, 16:588

Quality, performance, safety and outcomes

Abstract

BackgroundHealth care has experimented with many different quality improvement QI approaches with greater variation in name than content. This has been dubbed pseudoinnovation. However, it could also be that the subtleties and differences are not clearly understood. To explore this further, the purpose of this study was to explore how hospital managers perceive lean in the context of QI.

MethodsWe used a qualitative study design with semi-structured interviews to explore twelve top managers’ perceptions of the relationship between lean and quality improvement QI at a university-affiliated hospital.

ResultsManagers described that QI and lean shared the same overall purpose: focus on patient needs and improve efficiency and effectiveness. Employee involvement was emphasized in both strategies, as well as the support offered by managers of staff initiatives. QI was perceived as a strategy that could support structural changes at the organizational level whereas lean was seen as applicable at the operational level. Moreover, lean carried a negative connotation, lacked the credibility of QI, and was perceived as a management fad.

ConclusionsAspects of QI and lean were misunderstood. In a context where lean remains an abstract term, and staff associate lean with automotive applications and cost reduction, it may be fruitful for managers to invest time and resources to develop a strategy for continual improvement and utilize vocabulary that resonates with health care staff. This could reduce the risk that improvement efforts are rejected out of hand.

KeywordsLean Quality improvement Pseudoinnovation Hospital Management team Qualitative study Electronic supplementary materialThe online version of this article doi:10.1186-s12913-016-1838-z contains supplementary material, which is available to authorized users.

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Author: Carl Savage - Louise Parke - Mia von Knorring - Pamela Mazzocato

Source: https://link.springer.com/







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