FACTORS AFFECTING THE SUSTAINABILITY OF LEAN IN HEALTHCARE: A SYSTEMATIC LITERATURE REVIEW

Abstract

The application of Lean in healthcare has been steadily climbing since 2000. However, Lean implementation in healthcare environments has experienced high failure rates that could be attributed to a lack of sustainable implementation. A knowledge gap has therefore been identified, in both practice and research, to understand the reason for failure and the impact of Lean sustainability on Lean success. The aim of the main study is to explore the factors that affect the sustainability of Lean healthcare in South African hospitals. This paper reports on the first part of the study, a systematic literature review (SLR) that identifies the factors that affect the sustainability of Lean healthcare in hospitals. Through the SLR, 50 factors affecting Lean sustainability in hospitals were identified and grouped into 12 themes. These themes were then tested against Lean principles. The results showed that the adaptation of Lean so that it makes sense to healthcare staff and is compatible with a hospital context is important for sustainability. Staff and organisational readiness during Lean implementation is also critical for long-term sustainability. The SLR results will be used to develop an interview protocol for the second part of the main study, which will involve interviews with South African-based practitioners, consultants, and academics who are directly involved in Lean implementation in South African hospitals. Keywords Lean; Lean healthcare; Lean principles; factors; systematic literature review; hospital