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Title: Lean implementation at different levels in Swedish hospitals: the importance for working conditions and stress

Authors: Lotta Dellve; Anna Williamsson; Marcus Strömgren; Richard J. Holden; Andrea Eriksson

Addresses: School of Technology and Health, KTH – Royal Institute of Technology, Alfred Nobels Allé 10, Huddinge, Stockholm, Sweden; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90 Borås, Sweden ' School of Technology and Health, KTH – Royal Institute of Technology, Alfred Nobels Allé 10, Huddinge, Stockholm, Sweden ' School of Technology and Health, KTH – Royal Institute of Technology, Alfred Nobels Allé 10, Huddinge, Stockholm, Sweden ' School of Informatics and Computing, Indiana University, Indianapolis, IN, USA ' School of Technology and Health, KTH – Royal Institute of Technology, Alfred Nobels Allé 10, Huddinge, Stockholm, Sweden

Abstract: Healthcare organisations in Sweden are reorienting toward horizontal organisation around care processes. This paper's aim was to investigate how implementation approaches for improvements of care processes in line with lean production (LP), at hospital strategic and operative levels, are associated with working conditions and stress-related health among the employees. Five hospitals working with improvements to care processes were studied using questionnaires to employees (n = 1,303) and interviews at strategic and operative levels at baseline and follow-up. The process redesign implementation strategies varied between the strategic and operative levels. There were associations between a higher degree of LP at operative level and increased work resources and decreased work demands. Physical, cognitive and mental stress-related symptoms were only weakly associated with strategic or operative LP initiatives. There was evidence of more beneficial or improved working conditions in relation to higher degree of LP at operative levels.

Keywords: lean production; continuous improvement; work environment; psychosocial work conditions; healthcare services; human factors; employee stress; healthcare workers; Sweden; lean implementation; hospitals; care processes.

DOI: 10.1504/IJHFE.2015.073001

International Journal of Human Factors and Ergonomics, 2015 Vol.3 No.3/4, pp.235 - 253

Available online: 10 Nov 2015 *

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