Endre søk
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's Hospital, Stockholm, Sweden
Vise andre og tillknytning
2012 (engelsk)Inngår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 12, nr 1, s. 28-Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND:There is growing interest in applying lean thinking in healthcare, yet, there is still limited knowledge of how and why lean interventions succeed (or fail). To address this gap, this in-depth case study examines a lean-inspired intervention in a Swedish pediatric Accident and Emergency department.

METHODS:We used a mixed methods explanatory single case study design. Hospital performance data were analyzed using analysis of variance (ANOVA) and statistical process control techniques to assess changes in performance one year before and two years after the intervention. We collected qualitative data through non-participant observations, semi-structured interviews, and internal documents to describe the process and content of the lean intervention. We then analyzed empirical findings using four theoretical lean principles (Spear and Bowen 1999) to understand how and why the intervention worked in its local context as well as to identify its strengths and weaknesses.

RESULTS:Improvements in waiting and lead times (19-24%) were achieved and sustained in the two years following lean-inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem solving. These changes resulted in improvement because they: (a) standardized work and reduced ambiguity, (b) connected people who were dependent on one another, (c) enhanced seamless, uninterrupted flow through the process, and (d) empowered staff to investigate problems and to develop countermeasures using a "scientific method". Contextual factors that may explain why not even greater improvement was achieved included: a mismatch between job tasks, licensing constraints, and competence; a perception of being monitored, and discomfort with inter-professional collaboration.

CONCLUSIONS:Drawing on Spear and Bowen's theoretical propositions, this study explains how a package of lean-like changes translated into better care process management. It adds new knowledge regarding how lean principles can be beneficially applied in healthcare and identifies changes to professional roles as a potential challenge when introducing lean thinking there. This knowledge may enable health care organizations and managers in other settings to configure their own lean program and to better understand the reasons behind lean's success (or failure).

sted, utgiver, år, opplag, sider
BioMed Central, 2012. Vol. 12, nr 1, s. 28-
HSV kategori
Identifikatorer
URN: urn:nbn:se:hj:diva-20024DOI: 10.1186/1472-6963-12-28ISI: 000301444400001PubMedID: 22296919Scopus ID: 2-s2.0-84856402018OAI: oai:DiVA.org:hj-20024DiVA, id: diva2:573532
Tilgjengelig fra: 2012-12-03 Laget: 2012-11-30 Sist oppdatert: 2019-09-02bibliografisk kontrollert

Open Access i DiVA

fulltext(1628 kB)281 nedlastinger
Filinformasjon
Fil FULLTEXT02.pdfFilstørrelse 1628 kBChecksum SHA-512
a0c3ed83402e54fed8402bb94dfe63576e3bf37a13cee0311a1a37faf805e03dcd493dcb10dc02ac59dffd74cc0a1062aa8f923c799488c9657fc8465cc7f882
Type fulltextMimetype application/pdf

Andre lenker

Forlagets fulltekstPubMedScopus

Personposter BETA

Elg, MattiasThor, Johan

Søk i DiVA

Av forfatter/redaktør
Elg, MattiasThor, Johan
Av organisasjonen
I samme tidsskrift
BMC Health Services Research

Søk utenfor DiVA

GoogleGoogle Scholar
Totalt: 281 nedlastinger
Antall nedlastinger er summen av alle nedlastinger av alle fulltekster. Det kan for eksempel være tidligere versjoner som er ikke lenger tilgjengelige

doi
pubmed
urn-nbn

Altmetric

doi
pubmed
urn-nbn
Totalt: 467 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf