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The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes.

A mixed-method approach incorporating the Webropol survey was used.

LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN.

This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

Children have been recognized as an important user group for information and communication technology (ICT) and methods for involving them in ICT design have already been devised. However, there is a lack of research on children’s genuine or authentic participation in ICT design as well as a lack of critical research scrutinizing how “children” and “their participation” actually end up constructed in ICT design. The paper aims to discuss these issues.

An intervention involving children in ICT design following the research strategy of nexus analysis was implemented. A qualitative data archive of this intervention is examined through a Foucauldian lens.

The study reveals that numerous discourses were relied on when talking about “children” and “their participation” in the case project: the discourses of participation, equality, domination, segregation, rebellion, and patronization were identified. Moreover, “children” were constructed as equal partners and influential, but also as ignorant, ignored, silent, and silencing each other. Some of the findings are in line with the existing ICT literature on the matter, others even with the literature on genuine participation of children. However, children and their participation were also constructed as “problematic” in many senses.

The study contributes to and opens up avenues for critical research on genuine participation of users, especially children.

Practical suggestions for researchers interested in participation of children in ICT design are provided.

While research literature offers an abundance of best practices and an idealized view on children and their participation, this study shows the multitude of challenges involved and discourses circulating around.