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Implementing Lean Production in Hospitals

Recently, many hospitals have implemented the concept of lean production (LP) into their work, applying a variety of strategies. However, few attempts were made to distinguish between those approaches and to study the actual reasons behind their application (Williamsson, Eriksson, & Dellve, 2016). The research under analysis, based on the example of three Swedish hospitals, aims to elaborate on the following aspects: the diversity of implementation strategies and contextual factors influencing them, the rationales behind the selection of those policies, and the development of participation rates among employees (Eriksson, Holden, Williamsson, & Dellve, 2016). Each of those aspects will be analyzed in this paper.

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First of all, different strategies for the implementation of lean production will be discussed. Participating institutions will be referred to as hospitals A, B, and C. 100-bed hospital A, serving the population of a small city, decided to begin with the improvements on the unit level (hiring nurse change agents for each clinic) before implementing the hospital-wide projects (Eriksson et al., 2016). 500-bed hospital B, located in a medium-sized city, chose to enforce significant changes on the institution level.

Primarily, top managers were involved in the extensive training programs, which implied that they would help their subordinates to acquire new policy (Eriksson et al., 2016). The implementation of lean production in hospital C, which is relatively similar in size to the second institution, was mainly established by the county council. Under its control, the project teams were assembled, each lead by an experienced physician and supported by change agents.

Further, it is critical to describe the contextual factors which influenced the implementation of LP. In the case of hospital A, the personnel was insufficiently experienced with organizational development (OD), and thus the small-sized institution was not competitive enough to prove its accountability. The implementation of lean production by hospital B was primarily caused by a significant budget deficit.

However, the institution was one of the leaders in patient-oriented caregiving alongside with the process orientation. Concerning hospital C, it should be observed that the county council influenced the institution’s development work to a large extent (Eriksson et al., 2016). Additionally, some units proved their ability to optimize the patient flow and to visualize work processes, however, OD on the hospital level was not elaborated.

Accordingly, it is essential to discuss the rationale for strategy selection. In the case of hospital A, it was necessary to improve the quality of care, to educate workers in the standardized approach to OD, and to cultivate the knowledge of LP (Eriksson et al., 2016). However, hospital B needed both a profound and immediate impact on the work environment alongside with the decrease in spending without the deterioration of caregiving quality. Concerning hospital C, the county council’s model of process improvement was implemented, and that approach aimed primarily to increase the cross-unit relations in the institution.

Finally, the participation rates and their development over time should be observed. Hospital A showed the tendency of registered and assistant nurses to be more involved in LP than physicians. As the implementation of lean production in hospital B was caused by the budget deficit, many physicians and nurses perceived it as a means of cutting costs, which influenced their participation to a degree (Eriksson et al., 2016). In the case of hospital C, it revealed in the course of time that the number of unit managers is not enough to provide the desired rates of the implementation. Additionally, many physicians and change agents reported an overwhelming amount of simultaneous working objectives.

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In conclusion, one could notice that the research under analysis bears significant scientific value as it provides information about the implementation of LP, based on three different cases. It gives an opportunity to develop a greater understanding of organizational development peculiarities and possible difficulties in its application.


Eriksson, A., Holden, R. J., Williamsson, A., & Dellve, L. (2016). A case study of three Swedish hospitals’ strategies for implementing lean production. Nordic Journal of Working Life Studies, 6(1), 105-131.

Williamsson, A., Eriksson, A., & Dellve, L. (2016). Organization of change agents during care process redesign in Swedish health care. Journal of Hospital Administration, 5(3), 20-32.

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