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首页> 外文期刊>International journal of health care quality assurance >Has Lean improved organizational decision making?
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Has Lean improved organizational decision making?

机译：精益改善了组织决策吗？

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Purpose - Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization's decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization's decision-making context, making it more amenable for QI initiatives. Design/methodology/approach - In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings - Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications - Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value - Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI's sustainability.
机译：目的-护理过程（组织的决策环境）中目标不明确和因果关系不确定，可能会阻碍可持续发展。精益管理可以减少模糊性和不确定性，因此可以改善实施结果。但是成功了吗？许多质量改进（QI）计划都是以模糊性和不确定性较低为特征的组织环境中的适当改进策略。但是，大多数护理设置都不适合这种情况。本文的目的是调查受精益启发的变革计划是否改变了组织的决策环境，使其更适合QI计划。设计/方法/方法-2014年，来自荷兰放射治疗机构的12名专业人员接受了采访，他们对组织精益计划的看法，临床过程中模棱两可的目标和不确定的因果关系。在2011年和2014年之间，对受访者进行了针对相同概念的调查（25个问题）。采用演绎法对结构化访谈进行了分析。使用适当的统计数据分析定量数据。调查结果-受访者的共同愿景有所改善，不确定的因果关系数量有所减少。总体而言，正面（99）比负面（18）负面效果更好。调查显示，流程的可预测性和标准化程度得到提高，并且共同的愿景得到了改善。实际意义-精益实施已显示出更高的透明度和更多的共同愿景。原创性/价值-精益管理减少了模糊的目标，并减少了临床过程因果关系中的不确定性。因此，精益提高了QI的可持续性，使决策制定受益。

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