scholarly journals Implementation of lean in health care environments: an update of systematic reviews

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rui M. Lima ◽  
José Dinis-Carvalho ◽  
Thiago A. Souza ◽  
Elisa Vieira ◽  
Bruno Gonçalves
Keyword(s):  
Health Care ◽  
Cultural Change ◽  
Structural Changes ◽  
Great Majority ◽  
Content Type ◽  
Strategic Objectives ◽  
Starting Point ◽  
Lean Tools ◽  
New Perspective ◽  
Production Organization

Purpose Even though the implementation of lean in health care environments is relatively recent, it has been receiving a lot of attention in recent years. Partly because of the fact that it is a recent field of practise and research and partly because the number of works developed in this field has grown rapidly, it is important to frequently update the perspectives on this field of investigation. Thus, this study aims to review the implementation of lean tools and techniques applied to hospital organizational areas in a five-year period, between 2014 and 2018, complementing some of the most relevant reviews already published. The most important criteria such as tools, methods and principles, hospital areas intervened, improvements and difficulties were assessed and quantified. Design/methodology/approach As starting point for this systematic literature review (SLR), a set of selected pre-existing review publications was used to support the current study and as the ground base for the expansion of the studies about lean health care. The current study contemplated 114 articles from a five-year period between 2014 and 2018. A subset of 58 of these articles was critically assessed to understand the application of lean tools and methods in different hospital areas. Findings The thorough analysis of selected articles show a lack of works in continuous improvement approaches when compared to the application of production organization methods, visual management and diagnosing and problem-solving tools. The reported improvement results demonstrate alignment with the principles and foundations of lean philosophy, but such results are presented in isolated initiatives and without robust evidence of long-term maintenance. Moreover, this study shows an evolution in the number of articles referring to lean implementation in hospital areas, but in its great majority, such articles report isolated implementations in different areas, not spreading those for the global organization. Thus, some of the main recommendations are the need to implement studies on complete flows of patients, drugs and materials, instead of isolated initiatives and strive to promote the cultural change of hospitals through structural changes, following new visions and strategic objectives, supported by real models of continuous structural and sustained improvement. Originality/value The current study develops a new perspective of the articles published under the thematic of lean health care, published in a recent period of five years, which are not completely covered by other works. Additionally, it explicitly applied, in an innovative way, an approach that used a set of previous reviews as the starting point for this SLR. In this way, it integrates approaches and categories from different SLRs, creating a framework of analysis that can be used by future researchers. Finally, it shows the most recent implementations of lean health care, exposing the current trends, improvements and also the main gaps.

Who is a “Senior”? Looking for a definition in the healthcare system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Monica Consolandi
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Design Methodology ◽  
Social Role ◽  
Content Type ◽  
The Core ◽  
Starting Point

Purpose Seniors are nowadays at the core of important reflections to understand both how to ensure them a proper quality of life and better recognize their social role, providing them services and proper health care to value them as persons and resources. This paper aims to find a through definition about who is a senior, in the author’s opinion the starting point to help them flourishing. Design/methodology/approach As an example of definitions, an online dictionary and two geriatric text-books are quoted, highlighting qualities and rights referred to seniors especially in the delicate context of the health-care system. Findings The lack of a commonly shared perspective on this delicate kind of patient entails the difficulty to reach a coherent and satisfying definition about who a senior is. Originality/value The lack of a commonly shared definition leads to inevitable misunderstandings and could explain the arduousness of considering seniors in all their aspects. Further investigations are suggested.

Peer-to-peer word-of-mouth: word-of-mouth extended to group online exchange

2018 ◽  
Vol 42 (2) ◽  
pp. 176-190 ◽  
Author(s):  
Anat Toder-Alon ◽  
Frédéric F. Brunel
Keyword(s):  
Online Community ◽  
Word Of Mouth ◽  
Peer To Peer ◽  
Bulletin Board ◽  
Cross Sectional ◽  
Content Type ◽  
Social And Emotional ◽  
Starting Point ◽  
Online Exchange ◽  
New Perspective

Purpose The purpose of this paper is to investigate how peer-to-peer word-of-mouth (PPWOM) conversations evolve over time because of the dynamic social nature of the community in which they take place. Design/methodology/approach This study analyzed PPWOM conversations in an online community website for new and expectant mothers. Two data collection phases were undertaken during a four-year period. In phase I, messages were collected for a one-month period from five different bulletin boards (i.e. cross-sectional data) and at two points in time (i.e. semi-longitudinal). In phase II, a full longitudinal study was conducted, and the complete text of all messages of a newly formed bulletin board was captured for a nine-month period. The corpus of messages was examined in line with the basic tools of ethnomethodology and conversation analysis. Findings This research developed a typology of PPWOM genres and showed that these genres change over the community lifespan. The findings confirmed that the levels of social cohesiveness and the interaction communicative motives are the main factors that distinguish different PPWOM genres. Research limitations/implications This research has offered a new perspective into the study of PPWOM, and hopefully it will serve as a starting point for a broader dialogue regarding the social context in which PPWOM is exchanged. Originality/value In contrast to traditional word-of-mouth research, this study demonstrated that PPWOM conversations go much beyond the exchange of functional information, and instead serve numerous social and emotional goals.

Social marketing: an Islamic perspective

2019 ◽  
Vol 11 (4) ◽  
pp. 863-881 ◽  
Author(s):  
Mahamudul Hasan
Keyword(s):  
Social Marketing ◽  
Research Work ◽  
Critical Approach ◽  
Content Type ◽  
Muslim Countries ◽  
Starting Point ◽  
New Perspective ◽  
Conceptual Study ◽  
Marketing Principles ◽  
Marketing Intervention

Purpose The purpose of this study is to propose and develop a new perspective in Islamic Marketing by Integrating Islamic Marketing principles and the conventional Social Marketing discipline. Design/methodology/approach This is a conceptual study that is based on academic contributions gathered from the works of key academicians of Islamic Marketing and Social Marketing discipline. The author also presents personal viewpoints regarding the discipline. Conventional social marketing practices in various Muslim and non-Muslim countries have been studied with theoretical discussions. A critical approach has been applied in this study to assimilate Islamic marketing principles with existing social marketing theories. Findings The author proposes a distinct discipline of Islamic Marketing, which is termed as Islamic Social Marketing. The new discipline has been compared with conventional social marketing framework and practices to demonstrate its distinctive features. The critical analysis and discussion exhibit that the proposed new discipline has both similarities and dissimilarities with present social marketing theories and practices. Originality/value This study contributes to Islamic Marketing discipline by proposing a unique field that has been termed as “Islamic Social Marketing”. Although many studies have been conducted on Islamic marketing, the analysis of social marketing in light of Islamic Marketing principles remains clearly in a vacuum-like situation. The current research work is a starting point for academic discussions on this issue that can provide guidelines to develop social marketing intervention programs for Muslim-dominated societies and assist Islamic value-driven social marketing practitioners.

Indoor air in healing environments

Facilities ◽  
2019 ◽  
Vol 37 (9/10) ◽  
pp. 600-623 ◽  
Author(s):  
Marco Gola ◽  
Gaetano Settimo ◽  
Stefano Capolongo
Keyword(s):  
Health Care ◽  
Air Quality ◽  
Indoor Air ◽  
Management Strategies ◽  
Health Care Facilities ◽  
Chemical Pollution ◽  
Content Type ◽  
Starting Point ◽  
Care Facilities ◽  
Maintenance Activities

Purpose Several countries have carried out air quality monitoring in professional workplaces where chemicals are used. Health-care spaces have been less investigated. This paper aims to define a protocol, as developed by a research group, for inpatient rooms to understand the state of the art and to suggest design and management strategies for improving process quality. Design/methodology/approach Starting from the ISO-16000 standard and guidelines for monitoring activities, a protocol is defined for a one year investigation, with passive samplers. Through data analysis of the investigations and analysis of the cleaning and finishing products, heating, ventilation and air conditioning and maintenance activities, etc., it is possible to highlight the potential influences of chemical pollution. Findings A methodology is defined for understanding the chemical pollution and the possible factors related to construction materials, cleaning products and maintenance activities. Research limitations/implications The paper analyzes only a limited number of case studies because the monitoring activity is still in progress. Practical implications The investigation offers a starting point for a wide tool for the definition of design, maintenance and management strategies in health-care facilities. Social implications The research project, aimed at improving the knowledge of indoor air quality (IAQ) in inpatient rooms, is a starting point for a supporting tool for future regulations concerning health-care facilities. Originality/value IAQ is an issue on which many governments are focusing. Several health-care researchers have reported studies that aim at improving users’ health. Most investigations are about biological and physical risks, but chemical risks have been less studied. The paper suggests some design and management strategies for inpatient room.

Exploring the adoption of Lean principles in medical laboratory industry

2018 ◽  
Vol 9 (1) ◽  
pp. 133-155 ◽  
Author(s):  
Hilma Dhiginina Isack ◽  
Michael Mutingi ◽  
Hileni Kandjeke ◽  
Abhishek Vashishth ◽  
Ayon Chakraborty
Keyword(s):  
Health Care ◽  
Positive Impact ◽  
Turnaround Time ◽  
Medical Laboratory ◽  
Cross Sectional ◽  
Content Type ◽  
Lean Principles ◽  
Medical Laboratories ◽  
Barriers And Enablers ◽  
Lean Tools

Purpose As the demand for efficiency and quality in the health-care industry has increased over the past few years, adoption of Lean principles and tools in the medical laboratory industry has become increasingly crucial. The purpose of this study is to explore the level of adoption, barriers and enablers of Lean principles and tools in the Namibian medical laboratory industry. Design/methodology/approach A descriptive cross-sectional study was carried out to examine the level of usage, barriers and enablers, impact of Lean tools and to suggest appropriate strategies for adopting Lean in the Namibian medical laboratory services. Findings Research findings reveal that Lean tools are moderately implemented in most laboratories. Standard operating procedures, root cause analysis, overall equipment effectiveness and visual management are the important Lean tools used in the industry. Results of the survey also show that Lean tools had a positive impact on operational performance, employee motivation, turnaround time and cost reduction. Furthermore, top management involvement, adequate training and proper planning emerged as important enablers, while lack of support from the management, financial constraint and staff resistant to change are major barriers to the adoption of Lean principles in the Namibian medical laboratory industry. Research limitations/implications The paper has inherent limitations of survey research, which the authors will overcome by using case studies with medical laboratories. Practical implications The findings of the authors’ work will help in widening the application of Lean principles in more medical laboratories in Namibia and in other parts of the world. Originality/value The paper is based on numerous health-care studies on Lean. This is one of the few papers investigating the adoption of Lean principles, specifically in medical laboratories, from an emerging economy such as Namibia.

The experiences of mothers caring for a child with developmental disabilities: a cross cultural perspective

2015 ◽  
Vol 8 (4) ◽  
pp. 218-232 ◽  
Author(s):  
Kuljit Heer ◽  
John Rose ◽  
Michael Larkin ◽  
Nidhi Singhal
Keyword(s):  
Developmental Disabilities ◽  
Focus Groups ◽  
Skills Training ◽  
Cross Cultural ◽  
Small Scale ◽  
Cultural Perspective ◽  
Content Type ◽  
Starting Point ◽  
New Perspective ◽  
The Uk

Purpose – India has one of the more progressive disability frameworks in the developing world which tends to adopt western philosophies and principles (e.g. parent participation and advocacy) which to some degree mirrors the type of service delivery in the UK. The purpose of this paper is to adopt a cross-cultural perspective to explore caregiving amongst parents caring for a child with intellectual/developmental disabilities in India. Design/methodology/approach – Three focus groups were used to interview parents at Action for Autism (AFA) located in Delhi, India. The focus groups explored how disability is encountered within an Indian context. Findings – Two main themes were identified in the parents narratives which were “making the decision to get help” and “seeing disabilities in from a new perspective”. Family members played an important role in the decision to get help and acted as a platform for mothers to explore their own concerns. Seeing disability from a new perspective was a four stage process which included initially accepting the diagnosis and their child; regaining control through parenting skills training; witnessing positive changes in their children and themselves and reaping personal benefits as a result of their involvement with AFA. Research limitations/implications – The research is very small scale and focused on parents in a specific organisation, as a consequence the results cannot be generalised. Originality/value – The discourses of these individuals do provide a useful insight into the provision of services to children in India and provide a starting point for cross-cultural understanding of parenting children with disabilities.

Improving care coordination using organisational routines

2016 ◽  
Vol 30 (1) ◽  
pp. 85-108 ◽  
Author(s):  
Thim Prætorius
Keyword(s):  
Health Care ◽  
Care Coordination ◽  
Health Care Professionals ◽  
Explanatory Power ◽  
Care Pathways ◽  
Content Type ◽  
Starting Point ◽  
Organisational Routines ◽  
Coordination Change ◽  
The Way

Purpose – The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Design/methodology/approach – Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Findings – Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications – The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. Practical implications – The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value – Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

Gender and university degree: a new analysis of entrepreneurial intention

2019 ◽  
Vol 61 (7/8) ◽  
pp. 797-814 ◽  
Author(s):  
Pilar López-Delgado ◽  
Patricia P. Iglesias-Sánchez ◽  
Carmen Jambrino-Maldonado
Keyword(s):  
Structural Equation ◽  
Explanatory Power ◽  
Additive Model ◽  
Entrepreneurial Intention ◽  
Content Type ◽  
Starting Point ◽  
Special Value ◽  
New Perspective ◽  
University Degree ◽  
Degree Choice

Purpose The purpose of this paper is to determine how and why differences in gender affect entrepreneurial intention (EI). Although there are many studies in this area, scholars have yet to reach a consensus. Design/methodology/approach This study uses a survey of students at Malaga University in two stages to introduce a new perspective that links gender and university degree subject with the predisposition towards business creation. Structural equation modelling (SEM) is applied. Findings Comparing the explanatory power of an additive model and a multiplicative model, this paper confirms that socialisation conditions both men and women in their choice of university studies. Consequently, gender and university degree subject choice are shown to be linked and both affect EI. Research limitations/implications These findings provide a starting point for closing the information gap in the literature, but deeper analysis is required to combine other factors, such as international variations and the influence of different education systems on entrepreneurship. Practical implications These results are of special value to universities interested in fomenting entrepreneurship in their graduates, allowing them to better propose educational policies and communication campaigns reducing the effect of gender on degree choice. Originality/value The contribution of this research is the development of introducing university degree subjects as tied to gender. The study forms one construct together, and not a descriptive variable of the sample selected or as two independent exogenous variables, as is the case in most of the literature in this area.

Knowledge integration, teamwork and performance in health care

2016 ◽  
Vol 30 (2) ◽  
pp. 227-243 ◽  
Author(s):  
Mirjam Körner ◽  
Corinna Lippenberger ◽  
Sonja Becker ◽  
Lars Reichler ◽  
Christian Müller ◽  
...  
Keyword(s):  
Health Care ◽  
Mental Models ◽  
Team Performance ◽  
Health Care Professionals ◽  
Knowledge Integration ◽  
Shared Mental Models ◽  
Mediating Effect ◽  
Patient Centered ◽  
Content Type ◽  
Starting Point

Purpose – Knowledge integration is the process of building shared mental models. The integration of the diverse knowledge of the health professions in shared mental models is a precondition for effective teamwork and team performance. As it is known that different groups of health care professionals often tend to work in isolation, the authors compared the perceptions of knowledge integration. It can be expected that based on this isolation, knowledge integration is assessed differently. The purpose of this paper is to test these differences in the perception of knowledge integration between the professional groups and to identify to what extent knowledge integration predicts perceptions of teamwork and team performance and to determine if teamwork has a mediating effect. Design/methodology/approach – The study is a multi-center cross-sectional study with a descriptive-explorative design. Data were collected by means of a staff questionnaire for all health care professionals working in the rehabilitation clinics. Findings – The results showed that there are significant differences in knowledge integration within interprofessional health care teams. Furthermore, it could be shown that knowledge integration is significantly related to patient-centered teamwork as well as to team performance. Mediation analysis revealed partial mediation of the effect of knowledge integration on team performance through teamwork. Practical/implications – In practice, the results of the study provide a valuable starting point for team development interventions. Originality/value – This is the first study that explored knowledge integration in medical rehabilitation teams and its relation to patient-centered teamwork and team performance.

Dissemination of quality improvement innovations by multisector health care alliances

2019 ◽  
Vol 33 (4) ◽  
pp. 511-528 ◽  
Author(s):  
Larry Hearld ◽  
Jeffrey A. Alexander ◽  
Laura J. Wolf ◽  
Yunfeng Shi
Keyword(s):  
Health Care ◽  
Evidence Base ◽  
Selection Strategy ◽  
Routine Practice ◽  
Structured Interviews ◽  
Managerial Decision ◽  
Related Factors ◽  
Content Type ◽  
Effective Strategies ◽  
Starting Point

Purpose Multisector health care alliances (alliances) are increasingly viewed as playing an important role in improving the health and health care of local populations, in part by disseminating innovative practices, yet alliances face a number of challenges to disseminating these practices beyond a limited set of initial participants. The purpose of this paper is to examine how alliances attempt to disseminate innovative practices and the facilitating and inhibiting factors that alliances confront when trying to do so. Design/methodology/approach The authors adopted multiple holistic case study design of eight alliances with a maximum variation case selection strategy to reflect a range of structural and geographic characteristics. Semi-structured interviews with staff, leaders and board members were used. Findings The findings show that dissemination is a multidirectional process that is closely if not inextricably intertwined with capacity- and context-related factors (of the alliance, partnering organizations and target organizations). Thus, standardized approaches to dissemination are likely the exception and not the rule, and highlight the value of existing frameworks as a starting point for conceptualizing the important aspects of dissemination, but they are incomplete in their description of the “on-the-ground” dissemination processes that occur in the context of collaborative organizational forms such as alliances. Originality/value Despite a rapidly expanding evidence base to guide clinical and managerial decision making, this knowledge often fails to make its way into routine practice. Consequently, the search for effective strategies to reduce this gap has accelerated in the past decade. This study sheds light on those strategies and the challenges to implementing them.

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