Lean Improvement Practices: Lessons from Healthcare Service Delivery Chains

摘要

Some Lean improvement projects have been successful while others have not. According to the literature on Lean management principles, a potential explanation for this equivocal state is a paradox that can develop depending on the focus of the project. If the focus is on improving the efficiency of individual resources and not on the interconnections between them, then paradoxically, the worse the efficiency of this resource will become. To overcome this paradox and achieve the expected outcome of Lean projects, the aim for Lean improvement projects should be to achieve "flow efficiency" rather than "resource efficiency". By conducting a detailed study of four case studies of Lean improvement projects from two large acute-care hospitals, we examine how organizations can systematically focus on flow efficiency by considering the role and value of redundancy in Lean improvement projects. We found that redundancy plays a vital role in enabling the goals of Lean improvement projects to be achieved. Our findings extend the discussions on the Lean practices in healthcare context by incorporating the nature of the redundancy concept in explaining how Lean practices are being adapted in variant operations settings.