Sustainable Lean in psychiatry? Assessment through socio-technical principles
International Journal of Quality and Service Sciences
ISSN: 1756-669X
Article publication date: 21 March 2016
Abstract
Purpose
This paper aims to identify conditions affecting sustainability of Lean implementations in Swedish psychiatric healthcare, from a socio-technical perspective.
Design/methodology/approach
Longitudinal focus group interviews were conducted with 24 first-line managers within Swedish psychiatric healthcare. The analysis was made using Cherns’ ten socio-technical principles and a framework for sustainable development work in healthcare.
Findings
The most critical socio-technical principles for a sustainable Lean implementation were boundary location; power and authority; and compatibility. At hospital level, socio-technical principles were inhibited by the weak ownership of the Lean implementation. However, strong ownership at division level meant the same principles were supported. Unclear goals made follow-ups difficult which had negative effects on the learning processes in the Lean implementation. The role and responsibility of first-line managers were unclear in that they perceived they lacked power and authority resulting in negative effects on the participation – an important sustainability concept.
Originality/value
Empirically based papers assessing Lean implementations in psychiatry are rare. This study is a contribution to the research area of sustainable Lean implementations in healthcare. The practical implication of this study is that decision makers, senior managers, first-line managers and psychiatrists can be supported in reaching sustainable implementations of Lean.
Keywords
Acknowledgements
The authors would like to acknowledge PhD student Mikael Brännmark who died tragically during the work of this project. He participated in the collection of empirical data and inputted into the first drafts. We also want to acknowledge Associate Professor Paul Yeow’s input and discussion of later manuscript versions.
This project was funded by AFA Insurance, grant no. 100013, which is gratefully acknowledged.
Citation
Lindskog, P., Vänje, A., Törnkvist, Å. and Eklund, J. (2016), "Sustainable Lean in psychiatry? Assessment through socio-technical principles", International Journal of Quality and Service Sciences, Vol. 8 No. 1, pp. 53-71. https://doi.org/10.1108/IJQSS-07-2015-0056
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited