“System-wide lean implementation in health care: A multiple case study”

Background: Lean practices have been widely used by health care organizations to meet efficiency, performance and quality\r\nimprovement needs. The lean health care literature shows that the effective implementation of lean requires a holistic\r\nsystem-wide approach. However, there is still limited evidence on what drives effective system-wide lean implementation in\r\nhealth care. The existing literature suggests that a deeper understanding of how lean interventions interact with the\r\norganizational context is necessary to identify the critical variables to successfully sustain system-wide lean strategies.\r\nPurpose and methodology: A multiple case study of three Italian hospitals is conducted with the aim to explore the\r\norganizational conditions that are relevant for an effective system-wide lean implementation. A conceptual framework, built\r\non socio-technical system schemas, is used to guide data collection and analysis.\r\nFindings: The analysis points out the importance to support lean implementation with an integrated and coordinated\r\nstrategy involving the social, technical, and external components of the overall hospital system.