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Implementing lean in knowledge work: Implications from a study of the hospital discharge planning process

机译：实施精益知识工作：对医院出院计划过程的研究的启示

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摘要

With its Lean production system, Toyota championed an innovative way to organize and manage processes to eliminate waste and improve effectiveness. While our understanding of Lean and its successes has grown, it has become increasingly clear that contextual variables impact the effectiveness of its implementation. In particular, there is a need to better understand those principles and practices of Lean that are most relevant for specific processes in knowledge work environments. In this paper, we use action research methods to explore the implementation of Lean techniques in the discharge planning process (DPP) of a large hospital. Our aim is two-fold: first, we conceptually frame and link our observations of Lean implementation in this knowledge worker setting with the overall framework of Lean management to provide researchers with further insight into important contextual elements/variables that need to be considered in this environment. Second, we articulate elements of Lean and its implementation that proved most useful and relevant in this environment. We identify critical elements of Lean that were central in this implementation and also identify key challenges of Lean implementation in this environment and link our findings to existing research on the topic.
机译：丰田凭借其精益生产系统，倡导一种创新的方式来组织和管理流程，以消除浪费并提高效率。尽管我们对精益及其成功的了解不断增长，但越来越清楚的是，上下文变量会影响其实施的有效性。特别是，需要更好地了解与知识工作环境中的特定过程最相关的精益化原则和实践。在本文中，我们使用行动研究方法来探索精益技术在大型医院出院计划过程（DPP）中的实施。我们的目标有两个：首先，我们在概念上将我们在这种知识工作者环境中对精益实施的观察与精益管理的总体框架进行构架并将其联系起来，以使研究人员可以进一步洞察在此过程中需要考虑的重要背景因素/变量。环境。其次，我们阐明了精益及其实施的要素，这些要素在这种环境下被证明是最有用和最相关的。我们确定了精益在实施过程中至关重要的关键要素，还确定了在这种环境中实施精益的关键挑战，并将我们的发现与该主题的现有研究联系起来。

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