Improvement culture in the public mental healthcare sector: evaluation of implementation efforts

Abstract

The Danish public healthcare system has been forced to improve performance in terms of better service and lower costs. One regional Danish public healthcare organization has systematically implemented an improvement culture in its psychiatry sector. This research paper contains an evaluation of the organization’s transformation journey towards continuous improvement in psychiatry. The study was based on twenty-five personal interviews, two group interviews and four focus group interviews with centre managers, doctors, psychologists, psychiatrists, nurses and medical personnel in two of the ten psychiatry centres in the region. The objectives of implementing an improvement culture were to create better service for patients and to improve efficiency. Findings indicate that a number of critical success factors and barriers exist in mental healthcare and that even though a number of resources was invested up front, adjustments of the implementation process were needed from centre to centre. Furthermore, the implementation of a lean culture had some positive effects on treatments. In particular, internally, efficiency improved in some areas, creating a common view of what creates value and how to make improvements. Involving different groups of specialists in the implementation of an improvement culture is important. However, the achievement of continuous improvement efforts could be challenging, as results can be difficult to quantify. The novelty of the paper lies in the fact that data is collected from different groups of employees (from both managers’ and employees’ perspectives) on the effects of a full-scale implementation of an improvement culture in public mental healthcare.