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The purpose of this paper is to investigate the impact of layout configurations in a hospital on the implementation of lean management initiatives, to include different units of care. The research concentrated on the impact, the physical distance between dependent units could have on staff perception, use of staff time, time spent in the system by patients, and performance.

The research examined the relationship between clinical units allocated within Northampton General Hospital and their internal providers. In addition, an adapted version of the SERVPERF questionnaire was used to measure the quality perception of staff.

The transit distances from each clinical unit to their internal providers have: a negative relationship with the staff quality provision of care; a positive relationship with the time the patient spends in the system; and no discernable direct correlation with performance.

These findings will help hospital managers to understand the impact of the layout of a hospital on the implementation of service improvement activities, and will assist them in planning improved relocation of clinical units. This facilitates future service improvements whilst optimising the use of available and constrained resources within the present hospital facilities.

The ideas and results presented in this study are original and valuable to the study of hospital layouts, services improvements and the implementation of lean operation initiatives and quality improvement programmes in hospitals. The study also successfully tested the application of SERVPERF in a hospital setting.