Abstract
ABSTRACT Introduction Despite the recognized benefits of continuous improvement programs such as lean methodologies, understanding of how to sustain these practices in Malaysia's public health sector remains limited. This qualitative study aims to explore perceptions of both policymakers and hospital-based healthcare providers (HCPs) on the factors affecting the sustainability of lean within the Ministry of Health (MOH) hospitals in Malaysia. Methods Data were collected through in-depth interviews with 14 participants, including policymakers and hospital-based HCPs, using purposive sampling. A deductive thematic analysis was employed to analyze the data. Results This study delineated ten primary themes: (1) Fostering lean expertise through capacity building, (2) Lean implementation approaches and processes, (3) Monitoring and evaluation of lean with performance indicators, (4) Encouraging positive behavioral change among HCPs in lean, (5) Disseminating lean findings, (6) Establishing policy for lean, (7) Incentivizing lean practices, (8) Leadership in lean practices, (9) Building and strengthening organizational capacity and (10) Values of lean. Conclusion Insights from this study reflected that sustaining lean in the MOH is a complex process and involves a multifaceted approach. Health organizations seeking to improve lean sustainability are encouraged to incorporate the themes highlighted in this study.
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