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Abstract: This single-case study explores whether Lean management can improve efficiency in patient treatment at hospitals. Using a case study methodology, we investigate the implementation of Lean at Odense University Hospital (Denmark) and rely on both qualitative and quantitative data for our analysis.
We find that efficiency in patient treatment increased, for example through reduction in waiting times, higher process cycle efficiency when patients were treated at the hospital, and shorter walking distances for staff. This was achieved through the use of various Lean tools, such as Kaizen tablets, elimination of non-value adding activities, and Gemba mapping. Success factors in the implementation of Lean were financial pressure from the government under increasing expectations from patients, openness of the hospital's top management toward practices from the private sector, thorough employee involvement, provision of the necessary funding for the change toward Lean, and a better definition of what the business model of our case organization is.
This study illustrates a successful implementation of Lean in a public hospital. Thereby, it contributes that practices from the private sector can be successfully transferred if they are adapted to the quite different business models of organizations in the public sector.
Keywords: Business model; lean management; new public management; lean implementation; public sector organizations; Kaizen.
JEL classification codes: I18, M10.
Introduction
Healthcare organizations are constantly battling conflicting priorities. On the one hand, they focus on high quality patient care, preventing infections, maintaining hospital security, and ensuring patient safety. On the other hand, they need to use their resources economically (Pedersen & Huniche, 2011b). Two of the most important issues that healthcare organizations around the world face today are financial challenges (hospital productivity) and patient satisfaction. The solutions to these two challenges seem to be mutually exclusive (Berger et al., 1991; Graban, 2011; Kälvemark et al., 2004; Meliones, 2000; Womack & Jones, 2010): Hospitals face severe financial challenges since the healthcare costs are rising with aging populations (AHIP, 2014). This development pressures healthcare organizations to achieve the same level of quality of care, but with fewer resources (Meliones, 2000). The second main challenge for hospitals is patient satisfaction, which is commonly measured by reduced lengths of stays and prevention of readmission (Naidu, 2009).
One way to handle these two conflicting...