Lean Efforts Research Articles

Acceptance of lean redesigns in primary care: A contextual analysis.

Lean is a leading change strategy used in health care to achieve short-term efficiency and quality improvement while promising longer-term system transformation. Most research examines Lean intervention to address isolated problems, rather than to achieve broader systemic changes to care delivery. Moreover, no studies examine contextual influences on system-wide Lean implementation efforts in primary care. The aim of this study was to identify contextual factors most critical to implementing and scaling Lean redesigns across all primary care clinics in a large, ambulatory care delivery system. Over 100 interviews and focus groups were conducted with frontline physicians, clinical staff, and operational leaders. Data analysis was guided by a modified Consolidated Framework for Implementation Research (CFIR), a popular implementation science framework. On the basis of expert recommendations, the modified framework targets factors influencing the implementation of process redesigns. This modified framework, the CFIR-PR, informed our identification of contextual factors that most impacted Lean acceptance among frontline physicians and staff. Several domains identified by the CFIR-PR were critical to acceptance of Lean redesigns. Regarding the implementation process acceptance was influenced by time and intensity of exposure to changes, "top-down" versus "bottom-up" implementation styles, and degrees of employee engagement in developing new workflows. Important factors in the inner setting were the clinic's culture and style of leadership, along with availability of information about Lean's effectiveness. Last, implementation efforts were impacted by individual and team characteristics regarding changed work roles and related issues of professional identity, authority, and autonomy. This study underscores the need for change leaders to consider the contextual factors that surround efforts to implement Lean in primary care. As Lean redesigns are scaled across a system, special attention is warranted with respect to the implementation approach, internal clinic setting, and implications for professional roles and identities of physicians and staff.

Systematic model for lean product development implementation in an automotive related company

Lean product development is a major innovative business strategy that employs sets of practices to achieve an efficient, innovative and a sustainable product development. Despite the many benefits and high hopes in the lean strategy, many companies are still struggling, and unable to either achieve or sustain substantial positive results with their lean implementation efforts. However, as the first step towards addressing this issue, this paper seeks to propose a systematic model that considers the administrative and implementation limitations of lean thinking practices in the product development process. The model which is based on the integration of fuzzy Shannon’s entropy and Modified Technique for Order Preference by Similarity to the Ideal Solution (M-TOPSIS) model for the lean product development practices implementation with respective to different criteria including management and leadership, financial capabilities, skills and expertise and organization culture, provides a guide or roadmap for product development managers on the lean implementation route.

Exploring Waste and Value in a Lean Context

<p>The purpose of this paper is to take a critical, analytical approach to the concepts of waste and value in the lean literature and how the concepts are applied in organisations’ lean efforts and the ambiguity surrounding the concept of value.</p><p>A review of the literature of lean was undertaken with a specific focus of the definitions of waste and value. In addition, it is illustrated how four case companies work with waste and value within a lean context. The literature review revealed that there have been significantly more frequent and exhaustive discussions of waste than of value. Waste is often related to the seven wastes, but value is rarely clearly defined. The cases show an exclusive focus on waste reduction, which we argue can result in a loss of value.</p>This paper provides a critical review of the relationship between waste and value and some of the consequences caused by the actions taken by companies regarding solely focusing on waste. This paper demonstrates the order winner and order qualifier dimensions should be regarded in the analysis of waste and value, and incorporated in the lean toolbox. In the lean research literature there is lack of discussion of the actual value for the customer. We argue that finding a special concept of value in the lean literature would be desirable, and elaborating on value as a specific tool in the lean toolbox, since the concept of ‘waste’ cannot replace the concept of ‘value’.

Implementing and sustaining lean processes: the dilemma of societal culture effects

Lean processes allow the elimination of waste and the resulting improvements in productivity. However, implementing and sustaining lean processes are easier in some organisations than in others. There may be societal culture differences, as the successes in initial implementation in Japan have not been followed by global success. As organisations accelerate their lean efforts to gain or maintain competitive advantage, studying societal cultural effects seems timely. Understanding of the societal culture that the firm or subsidiary is operating in would be useful in determining how lean processes should lead the effort. Using the cultural dimensions developed by Hofstede, we examine the interconnection of societal culture and lean processes. For example, a societal emphasis on individualism is positively associated with a high level of lean process adoption, in terms of individual employee involvement, individual creativity and firm efficiency. A societal emphasis on high uncertainty avoidance is positively associated with a high level of lean process adoption, in terms of control and standardisation, efficiency and long-term philosophy. A societal emphasis on high power distance is positively associated with a high level of lean process adoption, in terms of control and standardisation, and efficiency. A long-term orientation in the society will be positively associated with a high level of lean process adoption, in terms of all of the dimensions. A societal emphasis on femininity will be positively associated with a high level of lean process adoption, in terms of employee involvement, creativity and long-term philosophy.

Benefits of Lean transformation efforts in small- and medium-sized enterprises

This study examines the awareness, the implementation status, and the results from implementing Lean among small- and medium-sized enterprises (SMEs) in two segments of Virginia’s manufacturing industry. One hundred and eighty responses from a census mail survey (population size 1033) were analyzed and the results confirm previous research that smaller enterprises in these industries are marginally aware of Lean and its potential benefits. Smaller enterprises also have implemented Lean to a lesser degree than have medium or large enterprises. Also, fewer respondents working in small enterprises reported improvements in ‘lead-time,’ ‘on-time delivery,’ ‘inventory turnover,’ ‘cost per unit,’ and ‘sales per employee’ due to the implementation of Lean than respondents from medium and large enterprises. Small enterprises also indicated a lower need for Lean implementation support from third parties than did medium or large enterprises.

Case study: using value stream mapping in the educational process - how focusing on student actions can help depict the teaching process

Although many lean higher education efforts have focused on administrative/support services and processes, only a few actual applications of lean methods have been meant for teaching, which is the core business of higher education. The absence of experiments and research in these contexts has challenged us to apply lean to our own undergraduate course. We have paid special attention in this experiment to the use of Value Stream Mapping (VSM) to depict teaching process, the shortcomings of VSM and the use of service blueprinting.

Case study: using value stream mapping in the educational process - how focusing on student actions can help depict the teaching process

Although many lean higher education efforts have focused on administrative/support services and processes, only a few actual applications of lean methods have been meant for teaching, which is the core business of higher education. The absence of experiments and research in these contexts has challenged us to apply lean to our own undergraduate course. We have paid special attention in this experiment to the use of Value Stream Mapping (VSM) to depict teaching process, the shortcomings of VSM and the use of service blueprinting.

The Pivoting Problem of Lean

Modern organizations try to tap into the employees’ knowledge, engagement and motivation by introducing informal organization and easily understood tools. These efforts are thought to help the continuous improvement efforts and make the production plant more effective and efficient. Following these trends, efforts have also been made to minimize the hierarchy and make the organization as informal as possible.Always be at hand for his or hers employees listen to every suggestion they make and bringing them alone when a decision is doing to be made. At the same time the leader should report to and act accordingly to the guidelines of his or her leader. It is often called the phenomena of the next up or next down. Doing a good job as a leader seems to involve a pivoting between the next down and the next up.The interviewees represent all layers of the organizations, from the plant manager to the apprentice. Better understanding this new role of the leaders in an organization that have implemented lean in order to enhance effectiveness and efficiency can prevent burnout leaders and keep the momentum up in the continuous improvement effort. Leaders often talk about that the company lean efforts were easier in the beginning when lower hanging fruits were picked. However, another explanation can be that leaders are fatigued and lack the initiative to find the next area for improvement. At the same time the demands from the next leader up increases.

A Conceptual Map of the Lean Nomenclature: Comparing Expert Classification to the Lean Literature

Although the implementation of lean can yield improvements in organizational performance, the literature suggests that most organizations are unable to effectively sustain the results from lean implementation efforts. The lack of clarity related to lean concepts may be a cause of unsuccessful implementation. In this work, we seek to clarify conceptual ambiguity in the lean nomenclature. Using an extensive literature review, we document lean principles, practices, and performance measures. Results from a survey of lean experts were used to investigate the relationship between lean principles and practices. Findings from the literature and from the expert survey were synthesized to develop a visual representation of the lean nomenclature. This conceptual map is intended to aid practitioners by increasing clarity of important lean concepts and thus, the probability of successful implementation.

Green-Lean Synergy - Root-Cause Analysis in Food Waste Prevention

Purpose_The goal of this paper is to explore the possible synergetic effects between lean philosophy and green endeavors in improving resource efficiency in the food sector. To that end, it is investigated how a proper and tailor-made adaptation of the lean six sigma root cause analysis method could help in overcoming the complexities of increased resource efficiency in food production. Design/methodology/approach_The case study concerned reduction of waste at an industrial production line of a dough-based product, through the implementation of the lean six sigma tool. Findings_An achievement of a 50% reduction of waste on the studied process line was reached, thus exceeding the initial improvement goal. Research limitations/implications (if applicable)_While the explicit findings on the specific root causes of waste on this actual production line are not immediately transferrable to other cases, they show that applying this method to identifying and eliminating root causes of waste for other products and processes in the food sector could not only reduce costs but also contribute to more resource-efficient and sustainable industrial food production. Practical implications (if applicable)_ Political and public high interest in environmental and social sustainability associated with food waste render this an important development. Originality/value_ While the potential of linking green and lean efforts has been acknowledged, the application of the lean six sigma methodology for more sustainable food production has not yet been explored. This paper contributes to this research

Managing Administrative Reform through Language Work


 
 
 The paper accounts for the early implementation of Lean in two Swedish public sector organisations justifying Lean as a remedy for the negative consequences of New Public Management (NPM). But is Lean radically different, or rather yet another NPM reform? We use a social constructivist approach and focus on the role of language in influencing employees’ minds and subjective perceptions, and thereby mobilising new patterns of governance. The concept of ‘language work’, comprising three organisational levels, is suggested for analysing the meaning and consequences of the Lean efforts studied. The analysis reveals that the first level of Lean language work largely mirrors typical NPM ideals, including entrepreneurship, empowerment and customer orientation. In contrast, there are more salient differences at the second level about labels used for organisational classifications having both empowering and disempowering effects on categorised people. At the third level of analysis targeting the day-to-day practice, we see a return of NPM performance measurement–oriented practices and their (often-unintended) consequences discussed in research on NPM reforms, although they surface in somewhat new ways, including communicative symbols and other linguistic expressions. The main contribution lies in the conceptualisation of language work widening the scope of the constitutive role of language to include the levels of political programmes and technologies of government as well as organisational classifications.
 
 

The effect of organizational culture on implementing and sustaining lean processes

Purpose– Lean systems thinking was widely studied using relevant variables, but there is a dearth of published theoretical or empirical evidence about the cultural aspects of lean processes. The lack of conceptual development is one of the motivations for this study. Do organizational cultural variations correlate with the success and effectiveness of lean processes? What organizational infrastructures are required for effective lean implementation and continuation? The paper aims to discuss these issues.Design/methodology/approach– Examining literature in the area of lean production and lean management, the authors sought current literature at the intersection of organizational culture and lean processes, particularly implementation and sustainability, but found little relating to the topic. Therefore, using the Competing Values Framework taxonomy, the authors examine this intersection, relying on related research in the areas.Findings– In this paper, a brief discussion of lean processes in relation to organizational culture leads to propositions that identify the various cultural dimensions and their purported effect on lean implementation and sustainability. A model of this interaction is developed. Those quadrants of the Competing Values Framework that might be useful in developing research directions for the future are identified.Research limitations/implications– Future research directions include the measurement of organizational culture in firms that have implemented lean processes. This would be a step toward looking at the effect that the different quadrants in the Competing Values Framework have on various elements of lean efforts. This would take a significant amount of work, because the manufacturing industry, the leader in implementing and sustaining lean processes, may have institutionalized particular organizational cultures. It would be an interesting step forward in the understanding of how lean processes are operationalized across different firms and industries. However, there are multiple ways to examine culture; the authors believe this method allows the capture of the entire spectrum.Practical implications– Knowing which dimensions influence lean effectiveness and the way that they wield that influence allows managers to develop the firm’s organizational culture to one that will support implementing and sustaining lean efforts. The challenge to implement and sustain lean processes lies in the need to identify the organizational culture infrastructure that will allow this system that was first used by Japanese firms to operate well in other organizational contexts. The values and norms that underlie lean processes may create conflict with the culture that already exists within the organization; such divergence retards adoption and performance.Originality/value– There is a lack of research at the critical intersection of organizational culture and lean implementation/sustainability. Culture is key to making the changes required of lean implementation and in sustaining the drive toward lean production and management. The paper begins to fill that gap.

Inventory trends in emerging market supply chains: Evidence from the Indian automotive industry

Abstract In the current paper, using a sample data of 58 firms consisting of automakers and auto component suppliers across a 14-year period, we study the factors contributing to efficient inventory management in the Indian automotive Industry. We use fixed effects regression models to document trends in inventory holdings over time and how this varies across inventory types and across tiers in the supply chain. Our results show that inventory holdings have declined differentially across tiers and across different types of inventories. We find tier-1 suppliers reduced all components of their inventories with the help of TQM and lean efforts.

Inventory trends in emerging market supply chains: Evidence from the Indian automotive industry

In the current paper, using a sample data of 58 firms consisting of automakers and auto component suppliers across a 14-year period, we study the factors contributing to efficient inventory management in the Indian automotive Industry. We use fixed effects regression models to document trends in inventory holdings over time and how this varies across inventory types and across tiers in the supply chain. Our results show that inventory holdings have declined differentially across tiers and across different types of inventories. We find tier-1 suppliers reduced all components of their inventories with the help of TQM and lean efforts.

Improving healthcare using Lean processes.

For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare.

Using Cost-time Profile for Value Stream Optimization

Value stream optimization is very important for lean manufacturing efforts. This paper introduces the framework for value stream optimization by combining value stream costing and cost-time profile. Value stream mapping represent very efficient tool for visualization of activities within production flow focused on activity duration with the purpose to eliminate non-value added activities. Besides shortening of lead time, cost reduction is also imperative for every company, so monitoring and control of manufacturing cost over the time can be driving force for improvement. Standard (traditional) accounting system, suitable for mass production, is focused on real cost of product calculation, how to allocate indirect manufacturing costs, excluding time dimension. Mass production era is over and new accounting systems are needed for modern manufacturing strategy, such as lean manufacturing. Lean accounting has been developed to support lean companies and avoid problems with traditional accounting system. Value stream costing is based on value stream and eliminate need for overhead allocation and calculation. Traditional accounting system is oriented to the product, but value stream costing analyze processes. On the other hand, cost-time profile is also powerful tool for visualization of cost accumulation during the time across entire production flow.

Cost-Time Profile Simulation for Job Shop Scheduling Decisions

Manufacturers have to look constantly for new strategies and tools to improve processes, decrease cost and increase productivity and efficiency. Production scheduling is one of the crucial elements in manufacturing and has an impact on delivery deadlines and also on the production process in terms of its utilization. On the other hand, the value stream optimization is very important for lean manufacturing efforts. This paper is aimed to research the impact of job shop scheduling on value stream optimization and decreasing of cost-time investment. Value stream mapping represents a very efficient tool for visualization of activities within production flow focused on activity duration with the purpose to eliminate non-value added activities. Value stream costing is based on value stream and eliminates the need for overhead allocation and calculation. Cost-time profile is a powerful tool for visualization and calculation of cost accumulation during the time across the entire manufacturing flow. Software tools used in this paper are: Lekin scheduling system for constructing the schedules based on four different dispatching rules and Cost-Time Profiler software for simulating the impact of different schedules on total production cost and cost-time investment (representing the time value of money), which is proposed as a new scheduling objective function.

A Conceptual Model of Organizations as Learning-Performance Systems

This article identifies factors that influence Lean implementation that has as its outcome a conceptual model based on an integrative review of literature. The conceptual model uncovers the complexity of Lean implementation. Further, the model highlights the importance of recognizing human resource development (HRD) related issues and challenges for managing change during Lean implementation. The conceptual model enhances our understanding and interpretation of the dynamic aspects that learning and performance bring to the organization. The model is an important starting point for developing a better general understanding of organizations as learning-performance systems. The discussion addresses how learning and performance may be integrated in future Lean implementation efforts by leveraging the intersection of HRD and Lean. The article concludes with implications of the model for HRD theory, research, and practice.

Using Lean to Improve Medication Administration Safety: In Search of the “Perfect Dose”

At Virginia Mason Medical Center (Seattle), the Collaborative Alliance for Nursing Outcomes (CALNOC) Medication Administration Accuracy Quality Study was used in combination with Lean quality improvement efforts to address medication administration safety. Lean interventions were targeted at improving the medication room layout, applying visual controls, and implementing nursing standard work. The interventions were designed to prevent medication administration errors through improving six safe practices: (1) comparing medication with medication administration record, (2) labeling medication, (3) checking two forms of patient identification, (4) explaining medication to patient, (5) charting medication immediately, and (6) protecting the process from distractions/interruptions. Trained nurse auditors observed 9,244 doses for 2,139 patients. Following the intervention, the number of safe-practice violations decreased from 83 violations/100 doses at baseline (January 2010-March 2010) to 42 violations/100 doses at final follow-up (July 2011-September 2011), resulting in an absolute risk reduction of 42 violations/100 doses (95% confidence interval [CI]: 35-48), p < .001). The number of medication administration errors decreased from 10.3 errors/100 doses at baseline to 2.8 errors/100 doses at final follow-up (absolute risk reduction: 7 violations/100 doses [95% CI: 5-10, p < .001]). The "perfect dose" score, reflecting compliance with all six safe practices and absence of any of the eight medication administration errors, improved from 37 in compliance/100 doses at baseline to 68 in compliance/100 doses at the final follow-up. Lean process improvements coupled with direct observation can contribute to substantial decreases in errors in nursing medication administration.

Accounting for Lean Implementation in Government Enterprise

This research explores the effects of implementing a lean production system in a government facility. The organization’s formal accounting practices delay recognition of production savings, but informally the facility promotes its lean efforts through attention-getting, off-the-books, “innovative” accounting. The authors state three propositions relating to customer effects of the lean improvements and the financial approaches. They then state four hypotheses relating to the measures’ unintended effects within the defense logistics enterprise as workload varies, and test the hypotheses employing a system dynamics simulation. Through review of qualitative data and a system dynamics simulation, the authors identify minor effects upon customer behavior and labor rates oscillation, thereby filling gaps in the literature relating to government productivity improvements, and expanding knowledge on lean-induced labor savings, work demand, and workplace effects of lean change in a government environment. They identify the greater effects of supplemental funding provided to such facilities, and begin the discussion of alternatives to current enterprise-wide government finance practices that may promote greater transformational behavior.