A conceptual model of Lean culture adoption in healthcare

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marc Dorval ◽  
Marie-Hélène Jobin
Keyword(s):  
Organizational Change ◽  
Cultural Change ◽  
Operations Management ◽  
Healthcare Organization ◽  
Change Strategies ◽  
Healthcare Organizations ◽  
Content Type ◽  
Implementation Challenges ◽  
Lean Transformation ◽  
Quantitative Validation

PurposeThis work seeks to offer a greater understanding of Lean healthcare implementation challenges conceptually taking a situated cultural organizational change perspective.Design/methodology/approachA descriptive model of healthcare organizations’ Lean adoption trajectories is built using ripple and bridging modelization strategies from elements of three classic organizational change theories and knowledge from Lean, organizational culture, healthcare and operations management literature.FindingsThe “contingent Lean culture adoption” (CLCA) model suggests five theoretical trajectories the healthcare organizations may experience when conducting a Lean transformation. These trajectories evolve from a new concept of Lean cultural friction (LCF) which represents cultural friction that a healthcare organization encounters toward an ultimate Lean culture proficiency state through time. From high to low initial LCF, a healthcare organization may in its Lean proficiency course end up in three states: lower, similar or higher LCF situation.Research limitations/implicationsThe CLCA model demonstrates the potential to be developed into a framework and possibly a Lean cultural friction theory pending further qualitative and quantitative validation.Practical implicationsThe CLCA model may help healthcare managers to use more appropriate cultural change strategies during their organization’s Lean journey.Originality/valueThis work enriches the concept of Lean cultural change which may apply not only to healthcare organizations but also to other ones. It suggests the existence of a healthcare organization Lean culture proficiency archetype and introduces the notion of Lean cultural friction.

Managing different forms of distances in Dutch healthcare organizations

2015 ◽  
Vol 29 (7) ◽  
pp. 1080-1097
Author(s):  
Annemiek Stoopendaal
Keyword(s):  
Design Methodology ◽  
Healthcare Organization ◽  
Ethnographic Study ◽  
Healthcare Organizations ◽  
Content Type ◽  
Daily Work ◽  
Healthcare Executives ◽  
Governance Practices ◽  
The Relationship

Purpose – Dichotomous “gap” thinking about professionals and managers has important limits. The purpose of this paper is to study the specific ontology of “the gap” in which different forms of distances are defined. Design/methodology/approach – In order to deepen the knowledge of the actual day-to-day tasks of Dutch healthcare executives an ethnographic study of the daily work of Dutch healthcare executives and an ontological exploration of the concept “gap” was provided. The study empirically investigates the meaning given to the concept of “distance” in healthcare governance practices. Findings – The study reveals that healthcare executives have to fulfil a dual role of maintaining distance and creating proximity. Coping with different forms of distances seems to be an integral part of their work. They make use of four potential mechanisms to cope with distance in their healthcare organization practices. Originality/value – The relationship between managers and professionals is often defined as a dichotomous gap. The findings in this research suggest a more dynamic picture of the relationship between managers and professionals than is currently present in literature. This study moves “beyond” the gap and investigates processes of distancing in-depth.

Reflecting on perceived deinstitutionalization of gender‐biased employment practices in accountancy

2012 ◽  
Vol 9 (4) ◽  
pp. 300-336 ◽  
Author(s):  
Rosalind H. Whiting
Keyword(s):  
Organizational Change ◽  
Cultural Change ◽  
Sample Selection ◽  
Age Groups ◽  
Young Female ◽  
Human Resource Managers ◽  
Employment Practices ◽  
Content Type ◽  
Novel Approach ◽  
Chartered Accountants

PurposeThe purpose of this paper is to explore the changes in gender‐biased employment practices that it is perceived have occurred in New Zealand accountancy workplaces over the last 30 years, using Oliver's model of deinstitutionalization.Design/methodology/approachSequential interviewing was carried out with 69 experienced chartered accountants and three human resource managers, and at a later date with nine young female accountants.FindingsEvidence is presented of perceived political, functional and social pressures cumulatively contributing to deinstitutionalization of overt gender‐biased employment practices, with social and legislative changes being the most influential. Deinstitutionalization appears incomplete as some more subtle gender‐biased practices still remain in New Zealand's accountancy workplaces, relating particularly to senior‐level positions.Research limitations/implicationsThis study adds to understanding of how professions evolve. The purposeful bias in the sample selection, the small size of two of the interviewee groups, and the diversity in the interviewees' workplaces are recognized limitations.Practical implicationsIdentification of further cultural change is required to deinstitutionalize the more subtle gender‐biased practices in accountancy organizations. This could help to avoid a serious deficiency of senior chartered accountants in practice in the future.Originality/valueThis paper represents one of a limited number of empirical applications of the deinstitutionalization model to organizational change and is the first to address the issue of gender‐biased practices in a profession. The use of sequential interviewing of different age groups, in order to identify and corroborate perceptions of organizational change is a novel approach.

Evidence and leading indicators of change success

2015 ◽  
Vol 31 (10) ◽  
pp. 1-5 ◽  
Author(s):  
Paul Arnold
Keyword(s):  
Organizational Change ◽  
Change Management ◽  
Business Leaders ◽  
Change Strategies ◽  
Change Initiatives ◽  
Content Type ◽  
Corporate Change ◽  
Technological Discontinuities ◽  
The Impact

Purpose – This paper discusses the important issues relating to the management of corporate change and includes an appropriate case study. It will benefit all business leaders, particularly those involved with the development of change strategies and the implementation of those strategies. Paul Arnold’s experience will improve their understanding of change management by providing the tools that will enable them to effectively understand and assess the progress of change initiatives in their organization. Findings – Every organization is subject to change, and virtually, everyone within the organization will be affected by change. Such is the impact of a rapidly evolving marketplace that organizational change management has become a permanent feature of the business landscape. To be effective, organizational change must be able to genuinely transform the business. Yet in the relentless search for new techniques to revolutionize the way things are done, and in the haste to manage technological discontinuities, many organizations fail to adequately develop, communicate and execute their vision for the change. Originality/value – The recently developed Change Index discussed in this paper provides a concrete and clear measurement system that enables management to effectively understand and assess progress of change initiatives in their organization. The paper benefits all business leaders, particularly those involved with the development of change strategies and the implementation of those strategies.

Lean in healthcare organization: an opportunity for environmental sustainability

2019 ◽  
Vol 26 (1) ◽  
pp. 205-220 ◽  
Author(s):  
Poonam Singh
Keyword(s):  
Environmental Sustainability ◽  
Healthcare Organization ◽  
Healthcare Organizations ◽  
New Approach ◽  
Content Type ◽  
Extra Effort ◽  
Environmental Footprints ◽  
Manufacturing Supply Chain ◽  
Lean Healthcare ◽  
Environment Sustainability

PurposeThe purpose of this paper is to provide insights toward the potential of lean healthcare organization for environment sustainability and develop propositions for future studies.Design/methodology/approachThis is a conceptual paper to study the inbuilt capacity of lean healthcare organization to mitigate environmental footprint. As a result, lean compatibility with environmental sustainability (ES) has been explored in areas like manufacturing, supply chain, aviation, construction, etc. The lean philosophy, lean culture and lean tools were analyzed to identify their contribution to ES in the context of healthcare organizations.FindingsBased on the analysis of lean philosophy, culture and tool, this paper theorizes that lean healthcare organizations have huge potential to mitigate environmental footprints. Lean healthcare organizations need not to do any extra effort for ES albeit it is inbuilt in it. Lean philosophy provides a vision to the healthcare organization for ES whereas lean culture bestow healthcare with an epistemology for the same.Research limitations/implicationsThis paper provides insight that ES is embedded in lean healthcare organizations. Lean healthcare organizational culture is ideal for application for constructivism theory where employees construct a new knowledge from their experiences to minimize the waste that eventually help in ES.Originality/valueMajor contributions of the study include a new approach for mitigating the environmental footprints by adopting lean in healthcare organization.

Shifting the paradigm: reevaluating resistance to organizational change

2016 ◽  
Vol 29 (6) ◽  
pp. 963-972 ◽  
Author(s):  
Brandon Mathews ◽  
Christopher M. Linski
Keyword(s):  
Organizational Change ◽  
Resistance To Change ◽  
Contemporary Literature ◽  
Change Strategies ◽  
New Paradigm ◽  
Content Type ◽  
Development Approach ◽  
New Perspective ◽  
Successful Change ◽  
Good Lives

Purpose The purpose of this paper is to challenge the existing paradigm of resistance to organizational change by offering a novel, interdisciplinary perspective. More specifically, this paper seeks to detach from traditional formulations of resistance to change and introduce a new paradigm, reevaluating resistance through the Good Lives Model (GLM) and the concept of Primary Human Goods (PHG). Design/methodology/approach This conceptual paper uses contemporary literature on resistance to organizational change to make the case that the existing paradigm is one of negativity and deficiency. The authors define resistance, as currently formulated, subsequently offering a new perspective through the GLM. The etiological underpinnings of the model are provided and the concept of PHG is defined to illustrate relevance in reevaluating resistance to change. Findings The paper illustrates that resistance behaviors are not individual problems of employees, which must be overcome for successful change. Rather, resistance behaviors are the manifestation of disruptions to the achievement of PHG. Moreover, the paper demonstrates the pursuit of PHG is an innately positive, human activity that change strategies should take into account. The Dialogic Organization Development approach is also integrated as a means to uncover priority goods and disruptions that may impact them. Originality/value The paper provides a novel reevaluation of resistance to change through the interdisciplinary application of the GLM and PHG. Further, the paper uses the model to integrate several fundamental theories of human motivation into one cohesive, consistent framework.

Facilitating cultural change in social enterprises

2018 ◽  
Vol 31 (3) ◽  
pp. 619-636 ◽  
Author(s):  
Buriata Eti-Tofinga ◽  
Gurmeet Singh ◽  
Heather Douglas
Keyword(s):  
Organizational Change ◽  
Cultural Change ◽  
Cultural Transformation ◽  
Social Enterprises ◽  
Dynamic Interactions ◽  
Content Type ◽  
Social Mission ◽  
Adaptive Capabilities ◽  
Trading Activities ◽  
Pacific Island Nations

Purpose The purpose of this paper is to examine the relationships and influences of change enablers for social enterprises in organizations undergoing cultural change. Design/methodology/approach Data were collected through a survey of social enterprises in two Pacific Island nations, and analyzed with Pearson and regression analyses. Findings The study finds that social enterprises are better equipped to implement cultural change when they exploit a robust entrepreneurial capability while optimizing strategic, financial and adaptive capabilities. These capabilities should be aligned with the enterprise’s culture and processes associated with transitioning the organizational culture to access resources and achieve its mission. Based on these results, a Cultural Change Enabling (CCE) Framework is proposed to help social enterprises leverage the dynamic interactions between the enterprise, its capabilities and environment, and organizational change processes. Practical implications Using the CCE Framework will benefit leaders of public benefit organizations, including social enterprises, to identify their capabilities, and develop an enabling culture to advance their trading activities and social mission so that social enterprises might operate sustainably. Originality/value As one of the first studies to examine the readiness for organizational change in social enterprises, this study provides new insights on the capabilities for organizational change, and the dynamics of organizations undergoing cultural transformation.

Intellectual capital and performance measurement in healthcare organizations

2016 ◽  
Vol 17 (2) ◽  
pp. 320-350 ◽  
Author(s):  
Maria Grazia Pirozzi ◽  
Giuseppe Paolo Ferulano
Keyword(s):  
Performance Measurement ◽  
Conceptual Framework ◽  
Organizational Performance ◽  
Intellectual Capital ◽  
Health Agency ◽  
Integrated Model ◽  
Healthcare Organization ◽  
Added Value ◽  
Healthcare Organizations ◽  
Content Type

Purpose – The purpose of this paper is to define a new conceptual framework or model, to measure and manage organizational performance, both financial/non-financial and intellectual capital (IC), in a healthcare organization. Design/methodology/approach – The integrated new model is produced by integrating the common assessment framework (CAF) model with two other frameworks representing the IC and leadership. These already existing models are originated, respectively by the Health Agency of Emilia-Romagna Region (Italy) and the National Healthcare System (NHS – UK). The integration phase is operated by comparing the CAF and IC models so as to assess the determinant factors that are present in both frameworks and eliminating such redundancies. Concerning the leadership determinant factor, the relevant conceptual framework of CAF model is substituted by the new leadership model proposed by the NHS. Findings – A new integrated model is made available for a subsequent step of empirical implementation and validation through its application in a healthcare organization. The main advantage of this model is the ability to measure and manage IC and financial/non-financial performance. Moreover, the use of a single measurement system facilitates the interpretation and coherency assessment of measured data so originated. Originality/value – The added value this work provides will enrich the academic literature regarding performance measurement systems in healthcare organizations, also providing an original integrated model that is able to exhibit the advantages highlighted above.

Persuasive speech in multi-professional change facilitation meetings

2019 ◽  
Vol 33 (4) ◽  
pp. 396-412
Author(s):  
Hanna Komulainen ◽  
Elisa Mertaniemi ◽  
Nina Lunkka ◽  
Noora Jansson ◽  
Merja Meriläinen ◽  
...  
Keyword(s):  
Organizational Change ◽  
Discourse Analysis ◽  
Strategic Change ◽  
Healthcare Organizations ◽  
Change Facilitation ◽  
Content Type ◽  
Study Approach ◽  
Rhetorical Discourse ◽  
Persuasive Speech ◽  
Professional Change

Purpose The purpose of this paper is to describe persuasive speech and discourses in multi-professional organizational change facilitation meetings at a hospital through rhetorical discourse analysis. Previous research has often considered organizational change to be a managerial issue, with other employees given the rather passive role of implementators. This study takes an alternative approach in assuming that organizational change could benefit by involving those who are most familiar with the tasks to be changed. Design/methodology/approach The study employed a qualitative, case study approach and focused on the construction of a hospitalist model within multi-professional change facilitation meetings. Eight videos of these multi-professional change facilitation meetings – which occurred between January and September 2017 – were observed and the material was analyzed by rhetorical discourse analysis. An average of 10–20 actors from different professional groups participated in the meetings. The change actors comprised physicians, nursing staff and nursing managers, along with a secretary and hospitalist. The meetings were conducted by a change facilitator. Findings The persuasive speech in the analyzed organizational change meetings occurred within five distinct discourses: constructing the change together, positive feedback, strategic change in speech, patient perspective and driving change. The content of these discourses revealed topics that are relevant to persuading members of healthcare organizations to adopt a planned change. Originality/value The presented research provides new knowledge about how persuasive speech is used in organizational change and describes the discourses in which persuasive speech is used in a healthcare context.

Modelling the readiness factors for agility in healthcare organization: a TISM approach

2019 ◽  
Vol 26 (7) ◽  
pp. 2372-2400 ◽  
Author(s):  
Vaishnavi V. ◽  
Suresh M. ◽  
Pankaj Dutta
Keyword(s):  
Structural Model ◽  
Matrix Multiplication ◽  
Healthcare Organization ◽  
Readiness For Change ◽  
Healthcare Sector ◽  
Environmental Scanning ◽  
Healthcare Organizations ◽  
Interpretive Structural Modeling ◽  
Content Type ◽  
Expert Interview

Purpose The purpose of this paper is to identify and analyze the interactions among different readiness factors for implementing agility in healthcare organization. Total interpretive structural modeling (TISM) based readiness framework for agility has been developed to understand the mutual interactions among the factors and to identify the driving and dependence power of these factors. Design/methodology/approach The identification of factors is done by TISM approach used for analyzing the mutual interactions between factors. Cross-impact matrix multiplication applied to classification analysis is utilized to find the driving and dependent factors of agile readiness in healthcare. Findings This paper identifies 12 factors of readiness for change in literature review, which is followed by an expert interview to understand the interconnection of factors and to study interrelationships of factors. The study suggests that factors like environmental scanning, resource availability, innovativeness, cost effectiveness, organizational leadership, training and development are important for implementing/improving the readiness of agility in healthcare organizations. Research limitations/implications This research focuses mainly on readiness factors for agility in healthcare sector. Practical implications Top management must stress on readiness factors that have a strong driving power for efficient implementation of agility in healthcare. This study helps the managers to take quick decisions, and continuous monitoring of readiness factors would be more beneficial to improve the quality of service, which makes the organization more agile. Originality/value In this research, TISM-based readiness for agile framework structural model has been proposed for healthcare organizations, which is a new effort for implementation of agility in healthcare.

scholarly journals Metaphors of organizations in patient involvement programs: connections and contradictions

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Paula Rowland ◽  
Carol Fancott ◽  
Julia Abelson
Keyword(s):  
Organizational Change ◽  
Quality Improvement ◽  
Patient Engagement ◽  
Design Methodology ◽  
Patient Involvement ◽  
Sociology Of Knowledge ◽  
Healthcare Organizations ◽  
Organizational Improvement ◽  
Content Type

PurposeIn this paper, we contribute to the theorizing of patient involvement in organizational improvement by exploring concepts of “learning from patients” as mechanisms of organizational change. Using the concept of metaphor as a theoretical bridge, we analyse interview data (n = 20) from participants in patient engagement activities from two case study organizations in Ontario, Canada. Inspired by classic organizational scholars, we ask “what is the organization that it might learn from patients?”Design/methodology/approachPatient involvement activities are used as part of quality improvement efforts in healthcare organizations worldwide. One fundamental assumption underpinning this activity is the notion that organizations must “learn from patients” in order to enact positive organizational change. Despite this emphasis on learning, there is a paucity of research that theorizes learning or connects concepts of learning to organizational change within the domain of patient involvement.FindingsThrough our analysis, we interpret a range of metaphors of the organization, including organizations as (1) power and politics, (2) systems and (3) narratives. Through these metaphors, we display a range of possibilities for interpreting how organizations might learn from patients and associated implications for organizational change.Originality/valueThis analysis has implications for how the framing of the organization matters for concepts of learning in patient engagement activities and how misalignments might stymie engagement efforts. We argue that the concept and commitment to “learning from patients” would be enriched by further engagement with the sociology of knowledge and critical concepts from theories of organizational learning.

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