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Kaltenbrunner, M., Mathiassen, S. E., Bengtsson, L., Högberg, H. & Engström, M. (2023). Associations between lean maturity in primary care and musculoskeletal complaints among staff. A longitudinal study. BMJ Open, 13, Article ID e067753.
Open this publication in new window or tab >>Associations between lean maturity in primary care and musculoskeletal complaints among staff. A longitudinal study
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, article id e067753Article in journal (Refereed) Published
Abstract [en]

Objective. We had two aims: 1) to determine the prevalence of musculoskeletal complaints among staff in primary care 2) to determine to what extent Lean maturity of the primary care unit can predict musculoskeletal complaints one year later. 

Design. Descriptive, correlational, and longitudinal design.

Setting. Primary care units in mid-Sweden.

Participants. In 2015, staff members responded to a web survey addressing Lean maturity and musculoskeletal complaints. The survey was completed by 481 staff members (response rate 46%) at 48 units; 260 staff members at 46 units also completed the survey in 2016. 

Outcome measures. Associations with musculoskeletal complaints were determined both for Lean maturity in total, and for four Lean domains entered separately in a multivariate model, i.e., Philosophy, Processes, People and partners, and Problem-solving.     

Results. The shoulders (12-month prevalence 58%), neck (54%), and low back (50%) were the most common sites of 12-months retrospective musculoskeletal complaints at baseline. Shoulders, neck, and low back also showed the most complaints for the preceding 7 days (37%, 33%, and 25%, respectively). The prevalence of complaints was similar at the 1-year follow-up. Total lean maturity in 2015 was not associated with musculoskeletal complaints, neither cross-sectionally nor one year later, for shoulders (one-year β: -0.002, 95% CI -.03 to .02), neck (β: 0.006, 95% CI -.01 to .03), low back (β: 0.004, 95% CI -.02 to .03) and upper back (β: 0.002, 95% CI -.02; .02). 

Conclusion. The prevalence of musculoskeletal complaints among primary care staff was high and did not change within a year. The extent of Lean maturity at the care unit was not associated with complaints among staff, neither in cross-sectional analyses nor in a one-year predictive analysis

Place, publisher, year, edition, pages
BMJ, 2023
Keywords
Lean in Health care Questionnaire (LiHcQ), musculoskeletal disorders (MSD), Nordic Musculoskeletal Questionnaire (NMQ), pain
National Category
Occupational Health and Environmental Health
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-37260 (URN)10.1136/bmjopen-2022-067753 (DOI)000944467100029 ()36813498 (PubMedID)2-s2.0-85148548320 (Scopus ID)
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2023-08-28Bibliographically approved
von Haartman, R., Bengtsson, L. & Niss, C. (2021). Lean practices and the adoption of digital technologies in production. International Journal of Services and Operations Management, 40(2), 286-304
Open this publication in new window or tab >>Lean practices and the adoption of digital technologies in production
2021 (English)In: International Journal of Services and Operations Management, ISSN 1744-2370, Vol. 40, no 2, p. 286-304Article in journal (Refereed) Published
Abstract [en]

The use of Lean principles has long enabled the improvement of efficiency and competitiveness in manufacturing firms, but during the last decade, advanced digital and automated solutions have been more in the spotlight. It has been suggested by some authors that Lean and digitalisation are mutually exclusive, although most authors now agree that the two are indeed compatible. It thus seems that the most urgent question is not whether Lean and digital technologies can be combined, but rather how. This paper uses a large-scale survey of manufacturing units in Europe to explore the relationship between three types of Lean production practices and the use of digital technologies in production. The analysis shows that three types of Lean practices – Lean flow, Lean work organisation and Lean human resource management – are strongly associated with firms’ adoption of digital technologies in production by manufacturing firms. Based on the results it is suggested that, as a theoretical explanation, a firm’s experience of Lean may act as an absorptive capacity when adopting digital technologies. A number of practical explanations are also provided, e.g., that systematic improvement efforts are also beneficial when implementing digital technologies.

Place, publisher, year, edition, pages
Inderscience, 2021
Keywords
Digitalisation; Lean practices; manufacturing strategy; absorptive capacity; Industry 4.0
National Category
Other Mechanical Engineering
Research subject
Intelligent Industry
Identifiers
urn:nbn:se:hig:diva-30985 (URN)10.1504/IJSOM.2021.118260 (DOI)2-s2.0-85117590227 (Scopus ID)
Available from: 2019-11-18 Created: 2019-11-18 Last updated: 2021-11-01Bibliographically approved
von Haartman, R., Niss, C. & Bengtsson, L. (2020). Innovative suppliers and industry 4.0: Developing digital capabilities for increased innovation. In: : . Paper presented at EurOMA 2020, 29-30 June 2020, Warwick, UK (online).
Open this publication in new window or tab >>Innovative suppliers and industry 4.0: Developing digital capabilities for increased innovation
2020 (English)Conference paper, Published paper (Refereed)
Abstract [en]

While it is known that ‘innovative suppliers’ can contribute to their customers’ innovation processes, and that internal capabilities are important, it is not well understood what these capabilities are. Based on a survey of Swedish manufacturing firms, the paper finds that ‘innovative suppliers’ tend to have more digital capabilities than other firms and that there is a positive relation between digital capabilities and innovation performance. The study furthers knowledge on the implications of increased industrial digitalisation on ‘innovative suppliers’ and contributes to a practical understanding of the capabilities needed for ‘innovative suppliers’.

Keywords
Supplier, Digitalization, Innovation, Industry 4.0
National Category
Other Mechanical Engineering
Research subject
Intelligent Industry
Identifiers
urn:nbn:se:hig:diva-33377 (URN)
Conference
EurOMA 2020, 29-30 June 2020, Warwick, UK (online)
Available from: 2020-08-26 Created: 2020-08-26 Last updated: 2020-08-27Bibliographically approved
von Haartman, R., Wang, W., Bengtsson, L., Niss, C. & Herdin, G. (2020). One size does not even fit one: Supply chain strategies in the decline phase. International Journal of Manufacturing Technology and Management (IJMTM), 34(1), 25-45
Open this publication in new window or tab >>One size does not even fit one: Supply chain strategies in the decline phase
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2020 (English)In: International Journal of Manufacturing Technology and Management (IJMTM), ISSN 1368-2148, E-ISSN 1741-5195, Vol. 34, no 1, p. 25-45Article in journal (Refereed) Published
Abstract [en]

Given that aligning supply chain strategies with changing productcharacteristics across the phases of the product life cycle is increasinglyimportant, this study investigates the changes in supply and demand uncertaintywhen a product enters the decline phase and how these changes in turn affectthe supply chain strategies applied. Based on four case studies, the analysisreveals that the uncertainties increase in three of four cases when the productenters the decline phase, and that the type of uncertainty, as well as the relatedchallenges, depends on the product’s initial uncertainty of supply and demand.This implies that companies need to redesign their supply chain strategiestowards either more lean or more agile supply chains, or combinations thereof,when the products are declining.

Place, publisher, year, edition, pages
InderScience, 2020
Keywords
supply chain strategy; product life cycle; PLC; decline phase; lean; agile; demand uncertainty; supply uncertainty; product characteristics
National Category
Business Administration Other Mechanical Engineering
Research subject
Intelligent Industry
Identifiers
urn:nbn:se:hig:diva-31924 (URN)10.1504/IJMTM.2020.105818 (DOI)2-s2.0-85082169176 (Scopus ID)
Available from: 2020-02-20 Created: 2020-02-20 Last updated: 2022-09-09Bibliographically approved
Carlsson, I.-L. & Bengtsson, L. (2019). Developing system supplier capability by integrating knowledge with customers. International Journal of Logistics Systems and Management, 32(1), 91-109
Open this publication in new window or tab >>Developing system supplier capability by integrating knowledge with customers
2019 (English)In: International Journal of Logistics Systems and Management, ISSN 1742-7967, E-ISSN 1742-7975, Vol. 32, no 1, p. 91-109Article in journal (Refereed) Published
Abstract [en]

As large corporations outsource parts of their manufacturing and services, many small and medium-sized enterprise (SME) suppliers are expected to deepen their capabilities and take on the role of system suppliers. The purpose of this paper is to analyse how knowledge integration with customers may help a SME develop system supplier capabilities. The study is based on a deep longitudinal case study of a SME manufacturer and focuses on continuous development capability as one of the core system supplier capabilities. The results show that knowledge integration (KI) with customers is an effective means to build system capability but that this is a stepwise process. The study identifies three levels of KI with customers: unidirectional knowledge transfer, mutual knowledge exchange and full-range knowledge integration. The analysis further indicates that each level of KI requires specific supplier capabilities.

Place, publisher, year, edition, pages
InderScience Publishers, 2019
Keywords
small and medium-sized enterprise, SME, Sweden, system supplier, supplier capabilities, supplier development, customer integration, knowledge integration, knowledge exchange, knowledge transfer
National Category
Other Mechanical Engineering
Identifiers
urn:nbn:se:hig:diva-24687 (URN)10.1504/IJLSM.2019.097075 (DOI)2-s2.0-85058859157 (Scopus ID)
Available from: 2017-07-07 Created: 2017-07-07 Last updated: 2019-11-29Bibliographically approved
Kaltenbrunner, M., Mathiassen, S. E., Bengtsson, L. & Engström, M. (2019). Lean maturity and quality in primary care. Journal of Health Organization & Management, 32(2), 141-154
Open this publication in new window or tab >>Lean maturity and quality in primary care
2019 (English)In: Journal of Health Organization & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 32, no 2, p. 141-154Article in journal (Refereed) Published
Abstract [en]

Purpose - The purpose of this paper is to 1) describe Lean maturity in primary care using a questionnaire based on Liker’s description of Lean, complemented with observations, and 2) determine the extent to which Lean maturity is associated with quality of care measured as staff-rated satisfaction with care and adherence to national guidelines. High Lean maturity indicates adoption of all Lean principles throughout the organization and by all staff.

Design/methodology/approach - Data were collected using a survey based on Liker’s four principles, divided into 16 items (n = 298 staff in 45 units). Complementary observations (n = 28 staff) were carried out at four units.

Findings - Lean maturity varied both between and within units. The highest Lean maturity was found for ‘adhering to routines’ and the lowest for ‘having a change agent at the unit’. Lean maturity was positively associated with satisfaction with care and with adherence to national guidelines to improve healthcare quality. 

Practical implications - Quality of primary care may benefit from increasing Lean maturity. When implementing Lean, managers could benefit from measuring and adopting Lean maturity repeatedly, addressing all Liker’s principles and using the results as guidance for further development.

Originality/value - This is one of the first studies to evaluate Lean maturity in primary care, addressing all Liker’s principles from the perspective of quality of care. The results suggest that repeated actions based on evaluations of Lean maturity may help to improve quality of care.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2019
Keywords
healthcare, Lean principles, Liker, observations, qualitative
National Category
Other Health Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-26374 (URN)10.1108/JHOM-04-2018-0118 (DOI)000463633800002 ()30950305 (PubMedID)2-s2.0-85060950444 (Scopus ID)
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2021-06-14Bibliographically approved
Kaltenbrunner Nykvist, M., Bengtsson, L., Mathiassen, S. E., Högberg, H. & Engström, M. (2019). Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care. BMC Health Services Research, 19(1), Article ID 652.
Open this publication in new window or tab >>Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care
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2019 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 19, no 1, article id 652Article in journal (Refereed) Published
Abstract [en]

Background

Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of Lean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent to which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and exhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job resources, as perceived by staff, have a moderated mediation effect.

Method

A longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care units responded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings of Lean maturity reflect participants’ judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion and job demands and resources reflect participants’ judgements regarding their own situation.

Results

First, over time, increased Lean maturity was associated with increased staff satisfaction with their care-giving and increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associated with decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that job demands and job resources had a moderated mediation effect.

Conclusion

The results indicate that primary care staff may benefit from working in organizations characterized by high levels of Lean maturity and that caregiving may also be improved as perceived by staff.

Keywords
COPSOQ, JD-R theory, linear mixed model, LiHcQ Lean in healthcare questionnaire, quality of care, thriving, exhaustion
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-29441 (URN)10.1186/s12913-019-4502-6 (DOI)000484951700004 ()31500624 (PubMedID)2-s2.0-85071970266 (Scopus ID)
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2022-09-15Bibliographically approved
Bengtsson, L., von Haartman, R., Niss, C. & Alieva, J. (2018). Digitalisation of production: The significance of CI capability and teamwork. In: : . Paper presented at 19th International CINet Conference 'Continuous Innovation: Spinning out and spinning in', 9-11 September, 2018, Dublin, Ireland.
Open this publication in new window or tab >>Digitalisation of production: The significance of CI capability and teamwork
2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Other Mechanical Engineering
Identifiers
urn:nbn:se:hig:diva-27625 (URN)
Conference
19th International CINet Conference 'Continuous Innovation: Spinning out and spinning in', 9-11 September, 2018, Dublin, Ireland
Available from: 2018-08-09 Created: 2018-08-09 Last updated: 2022-09-09Bibliographically approved
Eriksson, D., Hilletofth, P., Svensson, G. & Bengtsson, L. (2018). Exploring opportunities for moral disengagement in codes of conduct from the textile industry. World Review of Intermodal Transportation Research (WRITR), 7(4), 371-389
Open this publication in new window or tab >>Exploring opportunities for moral disengagement in codes of conduct from the textile industry
2018 (English)In: World Review of Intermodal Transportation Research (WRITR), ISSN 1749-4729, E-ISSN 1749-4737, Vol. 7, no 4, p. 371-389Article in journal (Refereed) Published
Abstract [en]

The purpose of this research is to assess how codes of conducts are outlined and formulated in relation to moral disengagement along the supply chain. The research is focused on the idea that supply chain structure may reduce the actors' sense of moral responsibility for the actions and impacts of the supply chain on workers and environment. The research has been conducted as a case study including Swedish firms in the textile industry. The research has used secondary data from codes of conducts. The findings show that codes of conduct do not cover all supply chain practices linked with moral disengagement. This does not cause immoral behaviour as such, but might cause moral disengagement. Supply chain research needs to focus on what should be included in codes of conduct and other ethical guidelines, so as to reduce the risk of immoral behaviour. In order to reduce the likelihood for moral disengagement, there are several supply chain practices that should be included in codes of conduct, such as power asymmetry, managerial support, and incentives.

Keywords
business ethics; corporate social responsibility; CSR; governance; manufacturing; multinational companies; qualitative research
National Category
Other Mechanical Engineering
Identifiers
urn:nbn:se:hig:diva-26380 (URN)10.1504/WRITR.2018.095280 (DOI)2-s2.0-85054972469 (Scopus ID)
Available from: 2018-03-26 Created: 2018-03-26 Last updated: 2020-03-18Bibliographically approved
Bengtsson, L., Berggren, C. & Solmaz Karabag, F. (2018). Innovativa konkurrenter från tillväxtekonomier: vad gör svenska företag?. MGMT of Innovation and Technology, 1, 10-11
Open this publication in new window or tab >>Innovativa konkurrenter från tillväxtekonomier: vad gör svenska företag?
2018 (Swedish)In: MGMT of Innovation and Technology, ISSN 2001-208X, Vol. 1, p. 10-11Article in journal (Other academic) Published
Abstract [sv]

Konkurrensen från tillväxtekonomier handlar inte längre om lågkostnadsproduktion. I Kina, Turkiet och Brasilien har många företag utvecklat förmågor till både innovativ och snabb produktframtagning. Vad karaktäriserar dessa företag? Och vad kan svenska företag göra för att hantera de nya utmaningarna och möjligheterna?

National Category
Other Mechanical Engineering
Identifiers
urn:nbn:se:hig:diva-26262 (URN)
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2019-12-19Bibliographically approved
Projects
Design of global supply chains in Swedish engineering firms [2009-04027_Vinnova]; University of Gävle; Publications
von Haartman, R. & Bengtsson, L. (2015). The impact of global purchasing and supplier integration on product innovation. Paper presented at 20th EurOMA Conference, Operations Management at the Heart of the Recovery, 7-12 June 2013, Dublin, Ireland. International Journal of Operations & Production Management, 35(9), 1295-1311von Haartman, R. & Bengtsson, L. (2013). Global sourcing’s impact on sustainability: Vile or virtue?. In: : . Paper presented at POMS - Production and Operations Management Society, Denver, USA, May 3 – May 6, 2013.
Innovative competitors in emerging economies [2014-03388_Vinnova]; University of Gävle; Publications
von Haartman, R. & Bengtsson, L. (2018). Sustainable global purchasing: assessing the relative impact of sustainability goals and programs. International Journal of Business Performance Management, 19(2), 169-188Lazzarotti, V., Bengtsson, L., Manzini, R., Pellegrini, L. & Pierluigi, R. (2017). Openness and innovation performance: an empirical analysis of openness determinants and performance mediators. European Journal of Innovation Management, 20(3), 463-492Berggren, C., Bengtsson, L., Karabag, S. F., Wang, W. & Stefan, I. (2017). Responses from established firms to rapid innovator challenges in emerging economies. In: : . Paper presented at R&D management conference, 1-5 July 2017, Leuven, Belgium. Stefan, I. & Bengtsson, L. (2017). Unravelling appropriability mechanisms and openness depth effects on firm performance across stages in the innovation process. Technological forecasting & social change, 120, 252-260Stefan, I. & Bengtsson, L. (2016). Appropriability: a key to opening innovation internationally?. International Journal of Technology Management, 71(3-4), 232-252Bengtsson, L. & Wang, W. (2016). Cost innovation in global supply chains: the case of Huawei Technologies. International Journal of Logistics Systems and Management, 23(2), 189-208Bengtsson, L., Wang, W. & Stefan, I. (2016). How can they be so rapid? New product development in Chinese CE firms. In: : . Paper presented at R&D Management Conference 2016 “From Science to Society: Innovation and Value Creation” 3-6 July 2016, Cambridge, UK. Bengtsson, L., Lakemond, N., Laursen, K. & Tell, F. (2016). Open innovation: Managing knowledge integration across multiple boundaries (1ed.). In: Fredrik Tell, Christian Berggren, Stefano Brusoni, and Andrew Van de Ven (Ed.), Managing Knowledge Integration across Boundaries: (pp. 87-105). Oxford: Oxford University PressArnemo, U., Bengtsson, L., Berggren, C., Hansson, S., Holmberg, G., Karabag, S. F., . . . Wang, W. (2016). Rapid innovators in emerging economies: Challenges and opportunities for Swedish firms. University of GävleBengtsson, L., Wang, W. & Stefan, I. (2016). Rapid NPD processes in Chinese CE firms. In: : . Paper presented at The 5th World Conference on P&OM (co-organized by POMS, EurOMA and JOMSA),6-10th September 2016, Havanna, Cuba.
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8238-034x

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