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Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement

Overview of attention for article published in BMC Health Services Research, October 2016
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Title
Does lean muddy the quality improvement waters? A qualitative study of how a hospital management team understands lean in the context of quality improvement
Published in
BMC Health Services Research, October 2016
DOI 10.1186/s12913-016-1838-z
Pubmed ID
Authors

Carl Savage, Louise Parke, Mia von Knorring, Pamela Mazzocato

Abstract

Health care has experimented with many different quality improvement (QI) approaches with greater variation in name than content. This has been dubbed pseudoinnovation. However, it could also be that the subtleties and differences are not clearly understood. To explore this further, the purpose of this study was to explore how hospital managers perceive lean in the context of QI. We used a qualitative study design with semi-structured interviews to explore twelve top managers' perceptions of the relationship between lean and quality improvement (QI) at a university-affiliated hospital. Managers described that QI and lean shared the same overall purpose: focus on patient needs and improve efficiency and effectiveness. Employee involvement was emphasized in both strategies, as well as the support offered by managers of staff initiatives. QI was perceived as a strategy that could support structural changes at the organizational level whereas lean was seen as applicable at the operational level. Moreover, lean carried a negative connotation, lacked the credibility of QI, and was perceived as a management fad. Aspects of QI and lean were misunderstood. In a context where lean remains an abstract term, and staff associate lean with automotive applications and cost reduction, it may be fruitful for managers to invest time and resources to develop a strategy for continual improvement and utilize vocabulary that resonates with health care staff. This could reduce the risk that improvement efforts are rejected out of hand.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 121 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Sweden 1 <1%
Unknown 119 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 30 25%
Student > Ph. D. Student 13 11%
Student > Doctoral Student 8 7%
Student > Bachelor 7 6%
Researcher 5 4%
Other 16 13%
Unknown 42 35%
Readers by discipline Count As %
Nursing and Health Professions 18 15%
Business, Management and Accounting 15 12%
Medicine and Dentistry 12 10%
Engineering 8 7%
Social Sciences 3 2%
Other 16 13%
Unknown 49 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 November 2016.
All research outputs
#17,302,241
of 25,398,331 outputs
Outputs from BMC Health Services Research
#6,351
of 8,644 outputs
Outputs of similar age
#208,974
of 323,139 outputs
Outputs of similar age from BMC Health Services Research
#121
of 156 outputs
Altmetric has tracked 25,398,331 research outputs across all sources so far. This one is in the 21st percentile – i.e., 21% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,644 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 16th percentile – i.e., 16% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 323,139 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 156 others from the same source and published within six weeks on either side of this one. This one is in the 17th percentile – i.e., 17% of its contemporaries scored the same or lower than it.