Search results

The purpose of this paper is to study the factors influencing doctors’ involvement in Lean change initiatives in public healthcare organizations in Canada.

An inductive research was conducted over a three-year span studying Lean implementation across three healthcare organizations in Canada. Various interviews were conducted with healthcare actors. Through analytical induction, analysis of the data allowed for multiple factors to be triangulated from which a conceptual model was developed.

Fifty-four interviews with 18 Lean healthcare actors allowed for the identification of ten factors possibly influencing the commitment of doctors towards Lean change. These factors are categorized into pre-change antecedents and change antecedents. Also, the level of transformational leadership demonstrated by a project manager was shown to potentially moderate the effect of medical behavioral support for change on change outcomes. These findings allowed us to develop a conceptual model of medical commitment and its impact of Lean change outcomes.

The paper investigates the role doctors play in Lean implementation, currently an important issue discussed among healthcare actors and researchers. Yet, very little academic research has been published on this subject.

The purpose of this research is to study the impact of perceived adoption of Lean principles on operational performance in Lebanese pharmaceutical industries.

A quantitative method was implemented using a questionnaire that targeted 253 respondents working in eight good manufacturing practices (GMP) certified Lebanese pharmaceutical companies. Reliability analysis was performed using SPSS, and the research hypotheses were tested using regression analysis.

The results demonstrated that Lean principles positively and directly affected operational performance. It also positively affected operational performance factors of quality, cost and time. However, the analysis of each of Lean principles impact on operational performance cost was analyzed perfection, value, and value stream mapping (VSM) significantly increased operational performance. In addition, pull only positively augmented the cost reduction, whereas flow did not show any effects on any of operational performance’s factors.

In addition to enhancing operational performance, the positive effect of the perceived adoption of Lean principles on performance is also explained by managers’ efforts in studying the flow of actions in their processes to reduce wastes. To face uncertainty, training and building a workforce that is able to implement Lean principles, equipping this workforce with needed artifacts, and promoting a high-performance culture are crucial for the successful implementation of Lean principles.

Lean approach has become a major pathway of improvement especially in pharmaceutical companies. Few studies analyzed the impact of each of the Lean principles on the operational performance in companies that operate in era of uncertainty. Furthermore, the perceived adoption of Lean principles is under investigated in the Middle East in general and in Lebanon in particular.

This work seeks to offer a greater understanding of Lean healthcare implementation challenges conceptually taking a situated cultural organizational change perspective.

A descriptive model of healthcare organizations’ Lean adoption trajectories is built using ripple and bridging modelization strategies from elements of three classic organizational change theories and knowledge from Lean, organizational culture, healthcare and operations management literature.

The “contingent Lean culture adoption” (CLCA) model suggests five theoretical trajectories the healthcare organizations may experience when conducting a Lean transformation. These trajectories evolve from a new concept of Lean cultural friction (LCF) which represents cultural friction that a healthcare organization encounters toward an ultimate Lean culture proficiency state through time. From high to low initial LCF, a healthcare organization may in its Lean proficiency course end up in three states: lower, similar or higher LCF situation.

The CLCA model demonstrates the potential to be developed into a framework and possibly a Lean cultural friction theory pending further qualitative and quantitative validation.

The CLCA model may help healthcare managers to use more appropriate cultural change strategies during their organization’s Lean journey.

This work enriches the concept of Lean cultural change which may apply not only to healthcare organizations but also to other ones. It suggests the existence of a healthcare organization Lean culture proficiency archetype and introduces the notion of Lean cultural friction.

The purpose of this paper is to assess the level of pragmatic ambiguity (PA) lean culture has currently in the manufacturing and service literature.

A comprehensive systematic review of academic (journals, books and theses) and commercial literature was undertaken drawn from a six databases search of two keywords (“lean” and “culture”) and related citations.

A total sample of 1,066 references (678 academic papers, 121 books, 103 theses and 164 commercial documents) were analyzed. The authors found contributions from 67 countries but oddly, only two came from Japan. In total, 89 percent of citations were directly about lean culture. However, for 86 percent of them, lean culture was only discussed superficially. All four literature segments show an over 85 percent agreement on lean culture being an organizational aim. The authors encountered 103 definitions of organizational culture and found 13 definitions of lean culture. Issues of culture gap, leadership, human resource management, sustainability and innovation are found to amplify lean culture’s already high PA level.

Further research and development are needed to decrease lean culture’s PA level and improve understanding of lean from a cultural perspective.

Current lean culture’s high PA level has positive and negative effects on lean implementation. Taking lean implementation from a cultural perspective may facilitate an organization’s lean transformation journey.

This is the first systematic literature review on lean culture using a broad and inductive approach. An original evidence-based definition of organizational culture is proposed.

Lean culture has been noted to be an underdeveloped concept. The purpose of this paper is to increase the understanding of Lean culture by determining its leading cultural clusters.

Content analysis was used to perform top relevant keywords exploration and qualitative analysis on main text of 33 reference books, 21 Lean generic and 12 Lean healthcare, consolidated as three cases (Lean general, Lean Liker et al. and Lean healthcare).

Four emergent Lean’s leading cultural clusters: operations, change, collectivity and humanity were identified inductively from ten 10 relevant keywords, namely, in order of importance: work, time, process, Lean, system, improvement, production, patient, people and team. Saliency of the word “time” is noteworthy. Cross-validation of these cultural clusters is demonstrated through sociotechnical systems theory.

Content analysis is shown to be an effective research method enabling inductive analysis. Identification of four leading clusters should support productive further research on Lean culture.

The four cultural clusters indicate to healthcare and other domains managers, who wish to improve their Lean cultural transformation success rate, to focus their attention to what their organization actually does (operations), to how improvement happens (change) and to how everything (collectivity) and everyone (humanity) work together in their organization.

This work applies innovative content analysis on Lean reference books. It highlights the importance of time as an underappreciated Lean culture element. It provides evidence and additional support for link between Lean and sociotechnical systems theory.

In the field of inventory management, it is a well‐known fact that centralisation, by sharing the risk between several entities, helps reduce the inventory required to provide a certain level of service. In practice, centralisation can be difficult to accomplish, because improvements to the system’s general performance may be achieved at the expense of some of the entities involved. This paper describes a simulation‐based methodology used to study the impacts of equipment pooling on a group of local community service centres (CLSCs) in the Montreal (Canada) region. In addition to quantifying the benefits of the pooling process, the approach allowed the stakeholders to reach an agreement by appraising various pooling scenarios and identifying the conditions that would help ensure fairness.