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Lean implementation within healthcare: imaging as fertile ground

机译：医疗保健内的精益实施：成像作为肥沃的地面

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Purpose The purpose of this paper is to understand the barriers and enablers to lean implementation as part of an imaging quality improvement programme from a socio-cultural perspective. Design/methodology/approach An in-depth 33 month ethnographic study, using observation and qualitative interviews, examined the process of lean implementation as part of an improvement programme. Findings Implementation of lean was more successful compared with other reports of lean in healthcare settings. Key enablers of lean were high levels of multidisciplinary staff involvement and engagement; the professional credibility of facilitators and clinicians as early adopters, all within a wider culture of relatively strong inter-professional relationships in the imaging department. These enablers combined with the more routinised and standardised nature of imaging pathways compared to some other acute specialties suggest that imaging is fertile ground for lean, linked to the manufacturing origins of lean. Practical implications When introducing lean within healthcare settings, special attention needs to be paid to the specific healthcare context and the existing cultures of inter-professional relationships. Fostering an improvement culture and engagement with training, together with adequate financial resource, are a key to contributing to the level of acceptability of an improvement tool such as lean. Originality/value This ethnographic study, bringing together rich multi-source data, has provided a detailed insight into the cultural workings of the process of lean implementation within a complex healthcare system.
机译：目的本文的目的是了解精益实施的障碍和使者，作为来自社会文化视角的成像质量改善计划的一部分。设计/方法/方法深入33个月的民族造影，使用观察和定性访谈，审查了精益实施的过程作为改进计划的一部分。与医疗保健环境瘦的其他报告相比，调查结果更加成功。精益的关键推动者是高度多学科工作人员参与和参与;促进者和临床医生的专业可信度作为早期采用者，全部在成像部门相对强大的专业关系中的更广泛的文化中。与其他一些急性专长相比，这些使能器结合了成像途径的更常规和标准化的性质，表明成像是瘦瘦的贫瘠地，与瘦的制造起源有关。在医疗环境中引入精益时的实际影响，需要特别注意特定的医疗保健环境和专业间关系的现有文化。培养改善文化和与培训的参与以及充分的财务资源，是有助于改善工具的可接受程度，如精益的关键。原创性/价值本体化研究，带来丰富的多源数据，并在复杂的医疗保健系统中提供了对精益实施过程的文化运作的详细洞察。

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