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Lean maturity and quality in primary care
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.ORCID iD: 0000-0003-2211-620x
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research.ORCID iD: 0000-0003-1443-6211
University of Gävle, Faculty of Engineering and Sustainable Development, Department of Industrial Management, Industrial Design and Mechanical Engineering, Industrial Management. University of Gävle, Center for Logistics and Innovative Production.ORCID iD: 0000-0001-8238-034x
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0002-9912-5350
2019 (English)In: Journal of Health Organisation & 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. Vol. 32, no 2, p. 141-154
Keywords [en]
healthcare, Lean principles, Liker, observations, qualitative
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-26374DOI: 10.1108/JHOM-04-2018-0118ISI: 000463633800002PubMedID: 30950305Scopus ID: 2-s2.0-85060950444OAI: oai:DiVA.org:hig-26374DiVA, id: diva2:1192901
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2020-01-29Bibliographically approved
In thesis
1. A staff perspective on Lean maturity, well-being, and quality in primary care
Open this publication in new window or tab >>A staff perspective on Lean maturity, well-being, and quality in primary care
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract
Place, publisher, year, edition, pages
Uppsala: Uppsala University, 2020
Series
Studies in the Research Profile Health-Promoting Working Life. Doctoral thesis ; 12
National Category
Other Medical Sciences
Research subject
Health-Promoting Work
Identifiers
urn:nbn:se:hig:diva-31086 (URN)9789188145406 (ISBN)9789188145413 (ISBN)
Public defence
2020-02-27, Stora Jadwigasalen, Kungsbäcksvägen 47, Gävle, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2020-02-04 Created: 2019-12-19 Last updated: 2020-02-04

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Kaltenbrunner, MonicaMathiassen, Svend ErikBengtsson, LarsEngström, Maria

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