Title: Cultural change in healthcare organisations through lean practices

Authors: Cristina Machado Guimarães; José Crespo De Carvalho

Addresses: INESC TEC (formerly INESC Porto) and Faculty of Engineering, University of Porto, FEUP Campus – Rua Dr. Roberto Frias, 378, 4200-465 Porto, Portugal ' ISCTE-IUL, Lisbon University Institute, Av. Forças Armadas, 311 Cacifo 32, 1649-026 Lisbon, Portugal

Abstract: This paper's main purpose is to understand the change of organisational culture as a result of adopting new workplace practices from implementation of lean in healthcare organisations. Therefore, a multi-case study approach with qualitative data from four hospitals running lean projects was adopted, exploring, through cross-case analysis, what were the enablers and failure motives. A path for a lean culture construction, from practice repetition changing behaviour to change thinking, is presented. The propositions formulated provide a research agenda for future studies. Also, a lean maturity model for healthcare organisations is presented as a starting point for developing a healthcare lean assessment (HLA) instrument. This paper contributes to the recent research stream on cultural aspects of lean, in a culturally rich service setting, healthcare. It brings some new insights to organisational culture change theory in context of lean deployment and provides a framework for understanding lean maturity stages. This paper explores both the hard and the soft side in healthcare settings, absent from many of lean literature. Addressing the healthcare organisational culture change under national culture awareness, it brings a new approach to lean deployment assessment in healthcare settings.

Keywords: organisational culture; cultural change; lean thinking; healthcare organisations; lean implementation; lean services; healthcare services; lean maturity model; healthcare lean assessment; national culture awareness.

DOI: 10.1504/EJCCM.2014.071959

European Journal of Cross-Cultural Competence and Management, 2014 Vol.3 No.3/4, pp.212 - 239

Accepted: 12 Mar 2014
Published online: 25 Sep 2015 *

Full-text access for editors Full-text access for subscribers Purchase this article Comment on this article