Developing a maturity model to facilitate the sustainability of Lean implementations in hospitals

Abstract

The implementation of Lean principles in healthcare has been a topic of research since the early 2000s and it has been increasingly implemented by healthcare providers. Although Lean principles have been implemented in a growing number of hospitals, their implementation is not always maintained. It is important to understand that the successful initial implementation of Lean principles in healthcare does not ensure that the implementation is sustainable. In the healthcare environment, especially in hospitals, an improvement project is only deemed successful if the implementation ensures reforms that permanently better the quality of service and level of patient satisfaction. Healthcare organisations often fail to meet this goal due to an implementation gap. Lean implementation in healthcare environments has seen failure rates of up to 90%. Therefore, a Lean strategy that is set to improve an organisation’s performance will not result in improved performance unless it is properly planned and implemented with sustainability as end goal. The problem this study aims to address is the lack of sustained Lean implementations in hospital environments. The aim of this study is to design a Lean implementation roadmap that will contribute towards sustainable Lean implementations. The study is conducted within the problem-solving paradigm of design science research, following a maturity model development procedure model. The developed sustainable Lean implementation roadmap (SLIR) was designed in the form of a prescriptive maturity model. The SLIR’s development was informed by factors that influence successful Lean implementation in hospitals and an implementation science framework, namely the quality implementation framework. The SLIR consists of four maturity levels and seven capability dimensions. It was evaluated by means of a survey sent to respondents with experience in Lean implementations in hospitals. There was consensus among the respondents that the SLIR contributes towards sustainable Lean implementation in a hospital environment.