Lean implementation in healthcare: offsetting Physicians’ resistance to change

Abstract

Physicians’ resistance towards Lean is often viewed as an important barrier to its successful implementation in healthcare organisations. However, there exists a dearth of knowledge regarding what influences reactions from physicians towards Lean and what organisations can do about it. This study adopts a behavioural perspective and focuses on the triggers of physicians’ resistance towards Lean. Using longitudinal qualitative data from multiple case studies of Canadian hospitals, 15 behavioural triggers are identified. A cross-case analysis reveals that core-technical and efficiency-driven changes clash with medical professionalism and generate active resistance from physicians, while leadership and familiarity with Lean are linked to championing behaviours that mitigate it. This study provides a deeper understanding of physicians’ behaviours during Lean transformations and the factors that drive resistance. It also provides insight into how organisations can better engage their medical staff in their Lean efforts by focussing on the process of change to offset resistance.