Title: Facilitating and inhibiting factors in change processes based on the lean tool 'value stream mapping': an exploratory case study at hospital wards

Authors: Jörgen Winkel; Kasper Edwards; Birna Dröfn Birgisdóttir; Sigrún Gunnarsdóttir

Addresses: Dept. Sociology and Work Science, University of Gothenburg, Box 705, SE-405 30 Gothenburg, Sweden; Dept. Management Engineering, Technical University of Denmark, Denmark ' Dept. Management Engineering, Technical University of Denmark, Denmark ' School of Business, Reykjavik University, Iceland ' University of Iceland, Iceland; School of Business, Bifröst University, Iceland

Abstract: 'Lean production' has become a prevalent rationalisation methodology in healthcare. Value stream mapping (VSM) is a commonly used lean tool to identify non-value-adding-work. VSM is a participatory tool. Thus, it may offer an opportunity to combine interventions for improved performance and ergonomics. The aim of the present exploratory study is to report observations that seem to play significant roles as inhibitors and facilitators for proper intervention processes when using VSM. Seven hospital wards have been investigated in Denmark, Iceland and Sweden. Information was obtained by screening key hospital documents and interviewing participants in and around the VSM processes. Nine tape-recorded interviews were performed. The results tentatively point to the facilitating effect on the VSM process by emphasising involvement and decision-making among the participants, first line manager support and engagement, allocation of sufficient resources, work environment issues as part of the VSM methodology and VSM routines that are well-established and broadly accepted.

Keywords: change management; change process; intervention; lean production; organisational change; patient value stream; production ergonomics; sustainable production systems; value stream mapping; VSM; facilitating factors; inhibiting factors; case study; hospital wards; healthcare management; Denmark; Iceland; Sweden; employee involvement; decision making; management support; management engagement; resource allocation; work environment.

DOI: 10.1504/IJHFE.2015.073000

International Journal of Human Factors and Ergonomics, 2015 Vol.3 No.3/4, pp.291 - 302

Available online: 10 Nov 2015 *

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