Analysis of Lean Design Principles in Healthcare

The assignment provides an analysis of lean design principles in healthcare, including a review of existing literature and studies on the topic. It examines the application of lean principles in gastrointestinal endoscopy programs, patient-centered care, and quality management in heavy-duty manufacturing. The document also explores the role of hospital managers in quality and patient safety, as well as the effects of lean management on patient outcomes, professional practice, and healthcare systems. The analysis is based on a review of existing research papers and studies on lean management in healthcare.

DISSERTATION
(To identify the impact of lean management practices on patients' outcomes,
professional practices and health care system)

TABLE OF CONTENTS
CHAPTER 1: INTRODUCTION....................................................................................................1
Background of the study.........................................................................................................1
Aim and Objectives................................................................................................................3
Research Questions................................................................................................................3
Rationale of the study.............................................................................................................3
Research specification............................................................................................................4
Structure of the study..............................................................................................................4
CHAPTER 2: LITERATURE REVIEW.........................................................................................6
Lean management practices and frequently reported types of lean activities and approaches6
Interrelationship between lean management practices or interventions and professional
practices..................................................................................................................................8
Effectiveness of lean management practices in order to improve patient’s safety in health and
social care sector...................................................................................................................10
CHAPTER 3: DATA ANALYSIS................................................................................................13
Analysis................................................................................................................................13
CHAPTER 4: DISCUSSION.........................................................................................................17
CHAPTER 5: CONCLUSION......................................................................................................22
REFERENCES..............................................................................................................................23

CHAPTER 1: INTRODUCTION
Background of the study
Lean management is considered as the set of methods that ensure creating maximum
value for patients and minimizing medication errors. Health care sector is facing huge
complications due to which now, it has become essential to improve the care system in hospitals.
It is essential for medical professionals to provide quality treatment to patients and take care of
them. Lean management promises to improve the quality, capacity and safety in organization.
Implementation of effective lean practices aid ion helps in reducing the operational cost and
gaining positive outcomes.
Patient’s safety is considered as the fundamental aspect in health and social care sector.
Therefore, now, it has become very important for professionals to be more vigilant in respect to
provide clinical care to users. Policy makers and clinicians identify potential risk that can arise
and accordingly, they deliver services to them. Practitioners are responsible to provide quality
care to patients (Boamah, Read and Spence Laschinger, 2017). It involves correct diagnosis and
therapeutic acts that support in improving health of the persons. World health organization
(WHO) has declared that safety of patients is a global priority of health care sector. Concerned
authorities are continuously working for minimizing the clinical errors and increasing
professional competencies so that diligent can get quality care in hospitals.
In the recent era, medical professionals are taking support of advanced technologies and
enhancing patient’s engagement. This aids in identifying the medical needs of person and
providing them care accordingly. Increasing communication with users is the first priority of
clinical department (The role of hospital managers in quality and patient safety: a systematic
review, 2014). ‘WHO’ has made it essential to coordinate with the patients properly. It is an
influential regulation that is essential to be followed by each nursing staff. Practitioners interact
with the users well so that they can share their issues with the doctors properly. This helps care
providers in providing quality care services to the patients. It improves safety culture in the
health and social care organization. Now, staff members are providing necessary education
through promotional campaigns to the users so that they can take care of themselves. These
people take care of safety measures in paediatric and surgical setting.
Lean management theory is considered as one of the effective approaches that
concentrate on making continuous improvement in management practices. It is an essential
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method that helps in making positive changes at the workplace so that employees can understand
their responsibility and perform well in organization. Health and social care sector is the industry
in which patients always prefer to deliver quality care to patients but for that, it is essential for
medical professionals to understand requirement of patients and accordingly, make changes in
the system so that people can get quality care in hospitals (Zaheer and et.al, 2015).
Lean management practices involve engagement of medical professionals, customer
communication and empowering users so that actual rout cause of problem can be identified and
improvements can be made accordingly. In the recent era, authorities are trying to improve the
culture and reducing wastage as well as waiting time so that patients can get high quality services
in hospitals. These lean practices ensure that individuals get quality services at lower rate. Nurses
and physicians play a significant role in patient’s safety. They diagnose individuals properly in
order to address systematic nature of problem (Quality of care and patient safety: a global
priority, 2017). ‘WHO’ has made several standards in this respect that helps the medical
professionals in identifying necessary steps that are required to be followed by them in order to
provide quality care services to the patients in hospitals. Care managers are the persons who are
responsible for activities of care home. They ensure that all nurses and junior doctors perform
their duties well and take care of patients effectively. Statistical records show that from 2004-
2005, hospitals have concentrated on development management practices in the care homes.
They have emphasised on the outcome based initiatives through which patients can get quality
care in hospitals (Boamah, Read and Spence Laschinger, 2017).
Managers in NHS always implement lean management approach at workplace. They
ensure that staff members create value for the consumers and deal with them properly. In these
management practices, high authorities identify problem in the system and they make
modification so that issue can be resolved soon. In the recent era, due to high workload, medical
professionals are unable to handle such large number of people in hospitals. In such condition,
they get failed to provide them treatment as per their medical needs. This increases the chances
of occurring errors which affect quality of services in NHS. Care managers are responsible to
ensure changing requirements in the organization and they have to make modifications in the
system in a systematic manner so that they can ensure patient's safety and improve their health
conditions to a great extent (Carayon and et.al, 2014).
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Main aim of this research is to identify the impact of lean management practices on
patients' outcome, professional practices and health care system. It will explain various lean
management practices and their effectiveness in hospitals for patient’s safety as well as for
improving the professional services. It will emphasis on the interrelationship between lean
management practices or interventions and professional practices.
Aim and Objectives
Aim
“To identify the impact of lean management practices on patients' outcome, professional
practices and health care system: A study on Game Care home”
Objectives
 To explain lean management practices in health and social care sector
 To explain frequently reported types of lean activities and approaches
 To identify interrelationship between lean management practices or interventions and
professional practices in Game Care home
 To determine effectiveness of lean management practices in order to improve patient’s
safety in Game Care home
 To suggest the ways through which lean management approaches ensure patient’s safety
and improve professional practices in health and social care sector
Research Questions
 What are the lean management practices applied in health and social care sector?
 Explain frequently reported types of lean activities and approaches?
 What is the interrelationship between lean management practices or interventions and
professional practices in Game Care home?
 How effective are lean management practices in order to improve patient’s safety in
Game Care home?
Rationale of the study
Lean practices have been applied by many other countries and they have become able to
improve their patient’s safety and professional practices. Thus, by conducting this study,
individuals will be able to make the concerned department aware with effectiveness of lean
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management practices in hospitals. The main reason of carrying out this research is that there are
limited studies that have been conducted in past on management work in health and social care
sector (HSC) with reference to patient’s safety. Thus, actually medical professionals are unaware
with working activities and their power. Due to financial issues, NHS is unable to make changes
in the care system for improving safety of patients (The role of hospital managers in quality and
patient safety: a systematic review, 2014). Thus, it is an interesting area of research and scholar
will be able to gather in-depth details about the topic which may improve their experience as
well. This topic has been provided by university and thus, researcher has chosen this topic for
further investigation. Scholar has framed objectives on the basis of research aim and will gather
information on the topic. Few researchers are aware with the impact of lean management
practices on patients' outcome, professional practices and health care system.
Research specification
Research methodology plays a significant role in dissertation, it helps researcher in
finding suitable way to conduct investigation in an accurate manner. In order to conduct present
study on the impact of lean management practices on patients' outcomes, professional practices
and health care system, scholar will apply secondary data collection sources (Quality of care and
patient safety: a global priority, 2017). Individuals will gather information regarding lean
management practices, patient’s safety from books, journals, internet articles, etc. These sources
will help the investigator in developing in-depth understanding about topic. Furthermore, scholar
will conduct systematic review which will assist in critically evaluating the topic and data.
There are two main types of approaches i.e. qualitative and qualitative. Both these are
helpful in preparing thesis in an appropriate manner. In the current investigation, researcher will
choose both these approaches. This will support in finding the impact of lean management
practices on patients' outcomes, professional practices and health care system. Furthermore,
researcher will take support of meta-synthesis tool that will aid in seeking data from various but
inter-related qualitative studies.
Structure of the study Chapter 1: Introduction: First chapter will be of brief introduction of the topic. In this
researcher will give brief overview of lean management practices, quality care, patient’s
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safety and professional practices. It will give rationale and significance of the study in
introduction part. Furthermore, aim and objectives will be framed in this chapter. Chapter 2: Literature review: This chapter will review the earlier literature of topic. This
will help in enhancing the knowledge of researcher about topic. In literature review,
session scholar will give view points of various researchers on the impact of lean
management practices on patients' outcomes, professional practices and health care
system. Chapter 3: Methods of analysis: It will describe various methods that will be used by
researcher in order to conduct this research. Rationale for each selected method will be
given by the scholar. Results will be analysed by selecting an appropriate method
(Rathert and et.al, 2015). Chapter 4: Discussion: This chapter will discuss topic on the basis of literature review. It
will help in finding accurate answers about the impact of lean management practices on
patients' outcomes, professional practices and health care system.
 Chapter 5: Conclusion and recommendations: This will be the last section in which
researcher will conclude entire study and will present results. It will answer the research
questions that have been obtained by investigation. At last, researcher will give
necessary recommendations regarding the same (Boamah, Read and Spence Laschinger,
2017).
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CHAPTER 2: LITERATURE REVIEW
Lean management practices and frequently reported types of lean activities and approaches
As per the view of D’Andreamatteo and et.al, (2015) health and social care sector is
facing huge issues because of increasing care demand. It is very important for the medical
professionals and concern authorities that to improve overall facilities in hospitals so that
patients can get high quality services in care homes. Lean management can be described as
philosophies and methods for creating values for care users and avoiding medical errors. Lean
management principles were firstly used by Toyota. The company was facing operational issues
and it has implemented lean management practices in order to minimize defects and enhancing
overall quality of production. Ginter, Duncan and Swayne, (2018) lean management principles
pay emphasis on making changes in cultural aspect and organizational behaviour so that care
services can be improved in health and social care sector. There are many patients those who do
not receive services on time (Erik Drotz and Bozena Poksinska, 2014). These impact negatively
on wellbeing of individuals. Health and social care sector has applied various approaches
through which it can provide high quality care services to patients. Many hospitals have
implemented continuous improvement process. But still there are significant changes are
required to be made in order to minimize medical errors.
According to Rotter and et.al, (2017) Lean principles have been implemented by many
health and social care organization. These techniques and principles have ability to make
significant changes in professional practices. Patient-centred principle of lean management
ensure that doctors treat patients well and health and social care organizations need to be
commitment for patient centred services. Doctors can take support of scheduled appointment
timing practice; this can help in minimizing waiting time of users.
Dellve and et.al, (2015) stated that lean management is related with value stream map. In
this doctors have to schedule their work and have to provide good treatment to patients as per
their medical requirements. This can support in minimizing medical errors and improving
wellbeing of individuals. Flow is another principle of lean management that ensure to remove all
obstacles. There need to be clear communication between doctors and patients. \this can aid
medical professional in identifying medical needs of persona and providing them treatment
accordingly (Steve Taninecz , 2015).
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Figure 1: Benefit of applying lean principle in HSC
(Source: Lean in health care, 2017)
As per the view of Leggat and et.al, (2015) lean management helps care providers to
revisit their current practices and refocusing on these practices. By this way they can find issues
in their existing strategies which can support them in providing effective services to care users in
hospitals. It is very important for the medical professionals that to set clear vision for
organizational transformation. Doctors have to build positive culture in workplace where they
need to provide good care to patients. Establishing clear vision can be beneficial in order to
improve internal capabilities of staff members and they can offer good services to patients in
hospitals (Implementation of 5S management method for lean healthcare at a health center in
Senegal: a qualitative study of staff perception, 2015).
Islam, Ahmed and Ali, (2018) stated that value stream mapping (VSM) is the lean
activity that is applied in health and social care sector, this helps in delivering quality health care
practices to patients. This activity supports in enhancing communication with consumers and
supplying them good services as per their medical needs. When patients feel comfortable then
they will share their issues with doctors this helps medical professional is identifying actual
problem in person so they can provide them care as per their needs. This improves health of
individual and supports in minimizing errors in hospitals. Furthermore, rapid process
improvement workshop is another lean activity in which all medical professionals conduct
meeting with patients and their families. In this meeting they ask their feedback for services of
hospitals. These patients and relatives can aid them in identifying root cause of issues. By this
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way these people can identify suitable solutions through which they can improve medical
services of hospitals (Erik Drotz and Bozena Poksinska, 2014).
As per the view of Nayar and et.al, (2016) 5S events are another lean activity that is
frequently used in health and social care sector in order to enhance patient’s safety. In this
practice medical professionals have to take care of sort, sweep, standardise, simple, self disciple
practices so that environment of hospitals can be kept clean. This assist in make the person feels
happy. According to Patel and et.al, (2015) levelled production lean activity is considered as
frequently used lean activity, this concentrates on eliminating unnecessary variations which can
enhance waiting time in hospitals. Care providers always ensure that they can offer quick and
quality services to patients thus, they schedule activities properly so that care user can get
treatment on time without any difficulty. They have to forecast demand of users so that they can
treat them accordingly.
Hussain and Malik, (2016) stated that daily visual management (DVM) is the activity that
concentrates on improving communication. This emphasis in clear coordination between staff
members and patient. If care user do not discuss their problems with doctors then it may become
difficult for providers to offer quality care services. Apart from this it is also necessary for the
medical professionals that to discuss care procedure with patients and their families. Before
giving any treatment they have to take permission from the relatives. This smooth flow of
communication aids in meeting with objectives and improving patient’s safety in workplace.
This lean activity is closely interrelated with strategic management system in health and social
care sector.
Interrelationship between lean management practices or interventions and professional practices
According to Chiarini, (2016) lean activities and lean management is highly related with
professional practices of health and social care sector. Health care services can be improved by
implementing lean management practices in workplace. There are many patients those who are
unable to get timely care. Increase care demand and shortage of staff members have created such
issue due to which people are unable to get treatment of time. Lean principles empower medical
professionals that to take necessary actions in order to improve work based performance. This
encourages professionals in order to pay more attention on care users and providing them
suitable treatment (Implementation of 5S management method for lean healthcare at a health
center in Senegal: a qualitative study of staff perception, 2015). Effective communication is the
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main principle of this management practice in which doctors always try to make effective
interaction with patients so that person can feel comfortable and they discuss their issues with
doctors openly. Apart from this if doctors are improving communication with patients and family
members then it also help in making them aware with condition of individual and what kind of
treatment would be suitable for patients (Quality of care and patient safety:a global priority,
2017). This is the way that supports in minimizing death rate in hospitals. If doctors do not
coordinate well with patients then it might create confusion and they may get failed to provide
quality treatment to them.
As per the view of Abramovitz and Zelnick, (2015) lean management is interrelated with
reducing waiting time in hospitals. Lean principles are helpful in identifying needs of patients
and including necessary measures through which doctors can meet with such needs of care users.
Comfort and waiting time are two main areas that need to be work on in order to improve health
care practices in hospitals. In order to meet with this objective medical professionals schedule
activities and ensure care needs of patients. This helps in minimizing waiting time and improving
professional’s practices in health and social care sector. This approach is helpful in encouraging
staff members and enhancing their internal capabilities.
Sabet, Adams and Yazdani, (2016) stated that lean management is used in health and social
care sector to enhancing value for consumers. Lean management practices always pay attention
on implementing standardised process and minimizing wastage. This aids in bringing best
practices through which medical professionals can create value for consumers. Lean
management always implement innovative ideas for improvement so that all departments can
manage operations well. This is the best way for improving professional practices in health and
social care sector. Thomas Rotter and et.al, (2017) argued that involvement of patients and
family members in decision making process is beneficial in identifying errors in existing
practices. By this way medical professional can make necessary changes in medical procedure
and other departments working so that they can provide quality care services to patients.
Implementation of standard work and preparing multi- disciplinary care plan is beneficial in
order to achieve desired services ( Lean in health care, 2017). This is closely related with
patient’s outcome and professional practices because by implementing standardised services or
process these care providers can provide best treatment to patients. This enhances satisfaction
level of care users and they feel happy in hospitals.
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According to Abramovitz and Zelnick, (2015) Youth theory is effective conceptual
framework that helps in understanding implementation of lean management practices in health
and social care sector. This concentrates on customer’s value and fulfilling their requirements.
These practices are helpful in managing operations in hospitals effectively. Lean management is
considered as implementation of innovative ideas that can reduce wastage and can support in
improving professional practices in health and social care sector.
As per the view of Rotter and et.al, (2017) lean principles aid in continuous improvements
in work based practices. It is essential for medical professionals that to continuously make
changes in work based practices. They have to take feedback from patients and other
professional persons. This can aid in identifying major issues in hospitals and addressing areas of
improvements. Safety of patients is first priority of health care workers. They always work to
improve wellbeing of individuals. Lean activities and practices are helpful in finding best
solutions of issues. Use of electronic record keeping system is helpful in managing personal data
of person. By this way doctors can identified medical needs of persona and can provide them
treatment accordingly any time (Implementation of 5S management method for lean healthcare
at a health center in Senegal: a qualitative study of staff perception, 2015).
Effectiveness of lean management practices in order to improve patient’s safety in health and
social care sector
According to D’Andreamatteo and et.al, (2015) there are many issues that are faced by
patients in hospitals such as quality of treatment, waiting time, high cost etc. Lean management
is an effective approach that aids in reducing errors and ensuring patient’s safety in health and
social care sector. Most of the people do not get right treatment at right place because of errors in
administration process, poor communication, ineffective management, cultural issues etc. All
these things impact on overall performance of staff members. In such condition medical
professionals get failed to identify medical needs of persons. Lean management practices such as
VSM, Rapid process improvement workshops, standard work etc. These are helpful in making
positive changes in work based practices in health and social care sector. This supports in
improving overall efficiency level of operation and by this way medical professional can provide
good treatment to patients.
As per the view of Zaheer and et.al, (2015) managers are responsible to ensure smooth
functioning of workplace and minimize risk as well. Health and social sector is the service
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industry that continuously work for improving heath of the patients. Managers have to identify
medical needs of these people and have to deliver them quality treatment so that they can get
recovered soon. Managers have to communicate with patients well. Managers in hospitals have
to enhance communication in the organization (The role of hospital managers in quality and
patient safety: a systematic review, 2014). This communication helps in minimizing confusion
and providing quality care treatment to the users. Effective communication plays significant role
in the HSC, this assist in developing understanding among medical professional regarding their
role and responsibility. By this way they can be able to provide timely care to patients. This
helps in minimizing clinical errors in system. Many times due to improper knowledge about
needs of the people doctors get failed to provide them correct knowledge. Mangers have to
ensure that all nurses and other medical staff members communicate well with patients and
provide them treatment as per their medical needs (Erik Drotz and Bozena Poksinska, 2014).
Carayon and et.al, (2014) argued that performance monitoring is essential management
activity that implements by managers in NHS. It is responsibility of care managers in the
organization that to monitor performance of other nursing staff members and ensure whether
they are performing well or not. They have to identify their training needs and have to provide
them training accordingly (Quality of care and patient safety:a global priority, 2017). This aids
managers in improving performance of care providers to great extent. Each industry has some
standards and it is very important for the employees to work according to these standards. It is
essential management practice that to monitor progress of each team members so that overall
target to improve patient safety can be accomplished.
As per the view of Carayon and et.al, (2015) strategic planning is essential management
practice in health and social care sector. Care managers have to make effective planning so that
they can provide immediate services to users and can minimize errors. As NHS is continuously
working for improving technologies. For that higher authorities make plan regarding budget and
implementing these technologies in workplace. These strategic planning aids in achieving
strategic goal of hospitals (The role of hospital managers in quality and patient safety: a
systematic review, 2014). Currie and et.al, (2014) stated that providing necessary training is
essential management practice, each manager in hospital is responsible to identify lacking points
in their employees and arrange training programs for them accordingly. This training helps in
raising skills of the staff members by this way they can provide quality care to patients without
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making any error. Management trains people and ensure theta they can fulfil their responsibility
towards patients effectively. According to Sujan, Spurgeon and Cooke, (2015) ensuring patient
safety is very important management activities in hospital. Managers have to cross check each
practice and have to monitor performance of all employees. This helps in providing quality care
services to users and minimizing clinical errors in hospitals.
As per the view of Ginter, Duncan and Swayne, (2018) lean principle of empowering
staff members and reducing wastage is effective in order to improve patient’s outcome and
ensuring their safety. Lean practices are helpful in improving value for care users so that they
can receive high quality services in health and social care sector. Proper scheduling can support
medical professional in identifying their role and responsibilities in hospital. By this way patients
will not have to wait for longer duration for getting right treatment in hospitals (Lean in health
care, 2017). Lean principles are helpful in decreasing operational cost and enhancing safety as
well. When medical professionals are having adequate information about patient’s medical issue
then they will be able to provide them care accordingly. These principles can minimize chances
of occurring medical errors in health and social care sector.
According to Sabet, Adams and Yazdani, (2016) Daily visual management is effective
practice that always ensures that patients have adequate knowledge about treatment that is
provided by medical professionals. Apart from this, doctors also have sufficient detail about
medical issues in care users. Smooth flow of information helps both providers and users in
making sound decision through which overall wellbeing of person can be improved soon.
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CHAPTER 3: DATA ANALYSIS
Introduction
In order to analysis the data researcher has taken support of systematic review technique
and will apply secondary analysis method in order to evaluate data. This will support in finding
accurate answers related to lean management practices and its impact on professional practices
and patient’s safety.
Analysis
Theme 1: Exiting practices in care home
Interpretation: From the secondary analysis it is identified there are many hospitals and care
homes where professionals are unable to provide high quality services to patients. The main
reason of this issue is improper communication and ineffective management practices. Health
care providers are continuously working to improve health care practices in hospitals but due to
poor management they have to face difficulty. In such condition they get difficulty in identifying
medical needs of patients. From the D’Andreamatteo and et.al, (2015) study it is analysed that
care home are not performing well because patients have to wait here for longer duration and
medical professional do not provide high quality services to these people. Dellve and et.al,
(2015) study described that professionals are trying to provide high quality services to end users
but due to poor technologies they face difficulty in treating these people well. Health care system
is very weak and ineffective that is the main reason that death rate is increasing in country with
the rapid speed.
Theme 2: Major issue in care home
Interpretation: Hussain and Malik, (2016) resulted that major issue in medical practices of care
home is that patients have wait for longer duration. They do not receive care on time. Whereas
from Islam, Ahmed and Ali, (2018) research paper it is found that increasing medical errors is
the major issue in business because of ineffective communication doctors fail to provide proper
medical care to these people. Some articles have revealed that improper communication between
employees and patients are major issue in care home. From the secondary analysis it can be
interpreted that there are many issues in medical industry due to which people a facing troubles.
This is creating problem for professionals as well. Lengthy waiting time creates difficulty for
patients and due to which they fail to get treatment on time. Non formalised decision making
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and ineffective management process are root cause due to which health and social care sector is
unable to serve standard services to users. Nurses and doctors are unaware with their role and
responsibilities. Decision of medical professionals is being influenced by central authorities.
From the previous articles it is found that there is substantial gap between standard services and
actual received services. This is critical situation for both for medical professionals and health
care organizations as well. Medical users do not receive best treatment and providers miss out to
give good services to patients.
Theme 3: Lean management practices are able to improve patient’s safety and professional
practices in care home
Interpretation: Patel and et.al, (2015) study has declared that lean management practices are
able to improve safety of patients in workplace. It can enhance professional’s practices in the
hospital. There are evidences that health and social care sector is unable to offer standard
medical services to patients. It has been found that lean management practices are helpful in
continuous improvement. Care home have given multidisciplinary training to staff members for
Qls. Apart from this thee are approx 535 doctors those who have received training on GEKO. By
getting training of lean management practices nursing staff, doctors etc. have improved their
professional knowledge. This have supported in enhancing clinical care services of hospitals.
From secondary analysis of Rathert and et.al, (2015) research paper it is found that extensive
education and collaborative relationship are key elements for improving every day practices.
This can support professionals in providing safer medical services to patients and reducing death
rate in hospitals.
Theme 4: Benefit of implementing daily visual management practices in health and social
care sector
Interpretation: from the Rotter and et.al, (2017) It is found that daily visual management
practice can support in enhancing communication between staff and patients. These practices are
helpful in reducing medical errors. This is effective tool that aids in maintaining transparency in
system. Reducing waiting time is major benefit of daily visual management practice. Effective
lean practice helps in improving communication so that doctors can identify medical issues of
patients and can provide them treatment as per their needs. From the Sabet, Adams and Yazdani,
(2016) research paper it has been found that the main reason of implementing lean in health and
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social care sector is that it supports in increasing efficiency level and quality of services. It is
considered as improvement approach that concentrates on needs of users and provides them
services as per their medical requirements. It is found that daily visual management is beneficial
lean practice because it supports in effective communication between medical staff and patients.
This practice always ensures that both these persons have adequate information so that they can
make their decision accordingly. In order to improve operational efficiency of health and social
care sector nurses are required to display objectives and they have to make changed for
improving process. This is the way that can be beneficial in improving quality of services, by this
way doctors will be able to provide high quality treatment to patients.
Theme 5: Implementing levelled production practice is important for ensuring patient’s safety
Interpretation: from study Sujan, Spurgeon and Cooke, (2015) .it is found that implementing
levelled production practices is important for the care home. Levelled production is effective
because this can support in eliminating unnecessary variation and avoiding bottlenecks. By this
way medical professionals can schedule treatment for patients and can forecast care demand.
This is effective principles that definitely help in enhancing patient’s safety and providing timely
care to these people. Outcome of D’Andreamatteo and et.al, (2015) research paper show that
levelled production is most effective tool because this supports in minimizing unevenness so that
waiting time for patients can get reduced to great extent. By implementing this process medical
professionals can schedule activities and can forecast demand. This is the way that assists in
providing treatment to care users immediately. The study has found that if professionals are
scheduling their work and if they perform their responsibilities properly then it can beneficial in
proving immediate services to users. There are many patients those who have to wait for longer
duration, the main reason of this issue is ineffective management and unscheduled work. If
levelled production practices are being implemented in hospitals then patients will get safer
environmental which will help them in recovering soon.
Theme 6: Challenges in order to implement lean management practices in workplace
Interpretation: Hussain and Malik, (2016) research paper has declared that lean applications
neglect technical and social elements. Health and social care is required to take support of
advance technologies. But it is very difficult for authorities to allocate such high fund for
implementing latest technologies all the time. In such condition many times small care homes
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gets failed to provide high quality services to patents which create difficulty for them. Islam,
Ahmed and Ali, (2018) study has shown that poor financial resources are the major issue that
create difficulty for hospitals in order to implement lean management practices in workplace.
Furthermore, poor skills of professionals are another major factor that creates issue in
implementing these management practices.
Theme 7: Implementation of lean management has helped in reducing waiting time and
medical error in Game care home
Interpretation: from the Patel and et.al, (2015) research it is found that lean management
practices are helpful in reducing waiting time and minimizing medical errors. It concentrates on
taking constant feedback so that process can be measured. Visual control technique supports in
displaying objects and colour coding. By this way performance can be measured effectively.
Daily meeting is another lean management practice that support in making two way
communications with employees. This is beneficial tool that aids in identifying issues and taking
action to minimize these problems. Lean management includes daily scheduling, checking
conditions. This supports medical professional in addressing medical needs of patients and riving
them treatment as per their needs. Sabet, Adams and Yazdani, (2016) .resulted that lean
philosophy in helpful in ensuring quality and improving safer environment. By this way
whenever patients come to hospitals then they can get quality treatment immediately.
Theme 8: Lean management practice that can help in improving professional practices
Interpretation: From the secondary analysis it is found that 5S, Value stream mapping, display
management etc. are various lean management practices that help in improving professionals
practices at workplace. With the assistance of these practices medical professional can improve
their communication with patients. This is helpful in identifying medical needs of people. Lean
practices improved responsibilities of professionals. It concentrates on power sharing and
involving people in decision making process. Study of Sujan, Spurgeon and Cooke, (2015) found
that lean practices emphasis on utilizing resources well and raising organizational capacity. 5S
programs improve working environment hospitals and improve orderliness. These efforts always
give better results and bring engendered changes in quality of services.
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CHAPTER 4: DISCUSSION
Lean initiatives are applications that continuously work for improving products and
services of health and social care sector. It is the type of methodology that assist medical
professional in making effective communication with patients and addressing their health care
needs. Most of the patients do not get timely care because of ineffective management practices.
But lean management ensure to provide immediate services to care uses so that they can recover
soon from their medical conditions. It is analysed that lean practices are process improvement
method that concentrate on developing culture and empowering users. It is responsibility of
medical professional that to provide high quality services to patients but due to poor skills and
presence of lack of staff member’s patients have to wait for longer duration. Lean practices
ensure to identify perception of consumers in health and social care sector. These lean activities
emphasis on cost control in care homes (Implementation of 5S management method for lean
healthcare at a health center in Senegal: a qualitative study of staff perception, 2015).
It has been analysed that lean methods emphases on taking constant feedback and
displaying visual objects. This supports in measuring performance and scheduling activities so
that overall performance of health and social care sector can be improved soon. Lean
management practices are helpful in continuous improvement, problem resolution and flow
orientation. Lean management practices include visual control, effective communication,
standard work, 5S etc. Value stream mapping always ensure to deliver high quality health care
services to users. Lean management practices ensure to have meeting with employee’s and
family members of patients. This aids in identifying root cause of problem and making them
understand with condition of person. By this way family members can make right decision
regarding treatment process and they can contribute well in improving condition of patients.
Rapid improvement workshop lean practice ensures to create best solution for the medical
problems and ensure to implement necessary changes so that overall situation of person can be
improved soon.
5S lean practice means “ Sort, sweep, standardise, simplify, self discipline. 5S lean
practice ensures to clean environment of hospitals and provide standardised services to patients.
Medical professionals are required to maintain discipline in the workplace so that all the patients
can feel comfortable and secure. It is responsibility of professional that to create safer
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environment for users. This can help in making them feel happy and improving their condition as
well. It is analysed that levelled production is considered as most effective lean management
practice that helps in eliminating unnecessary variation. By implementing this management
practice professionals can improve their results and can avoid bottlenecks. This is the best way to
minimize waiting time and reducing wastage in workplace. It is analysed that organizational
process and effective scheduling are two main aspects that helps in forecasting demand and
providing care to patients on time. There are many people those who have to wait for longer
duration in hospitals .Though there are many staff members but due to ineffective scheduling
they fail to treat patients on time. Effective scheduling and elimination on unevenness are the
best way of avoiding backups.
From the above study it is analysed that daily visual management practice is most
essential lean management practice that helps in improving patient’s outcome and making
positive changes in professional practices. Effective communication is the key element that
always helps in improving overall performance. If there is strong coordination between staff and
patients then it would be beneficial in improving condition of people and identifying their
medical needs. In such condition both will be able to support each others. If patients are
discussing their issues with doctors effectively then this will be beneficial for medical
professionals in identifying root cause of problem and providing them treatment accordingly. But
if they are unaware with actual issue within the person then it might create consequences for the
nursing staff in treating people well. Visual controls help in managing daily work. Timely
feedback supports in measuring performance professionals and making necessary changes so that
problems can be resolved on time. Lean culture is most important eliminate that supports in
ensuring patients safety and fulfilling their requirements. Visual controls are such instructions
that are available at nurse’s rooms that aim to make working practices simpler. This practice
ensures to finish entire work within specified period of time. For that medical professionals have
to perform their duties as per required schedule. This minimizes wastage of time and completes
all tasks with quality.
Lean culture and lean leadership play significant role in the success of health and social
care sector. This supports in improving professional practices and ensuring patient’s safety.
Authorities conduct meetings and make all the professionals aware with purpose of this meeting.
They involved nurses, doctors in decision making process. By this way they share their
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innovative ideas that supports in providing high quality services to patients. Communication
supports in making effective plan to manage work bass practices. This provides insight detail to
health care professionals that supports in making sound decision in critical situations. Lean
practices are helpful in enhancing sense of self control in daily activities among all professionals.
This improves their practices and they treat users well. It has been analysed that 5S activities are
permanent routine, all the staff members work to maintain healthy environment so that patients
can feel happy and comfortable. Job rotation and multitasking are most effective lean practices.
This practice assists in raising skills of people and making them able to handle multiple tasks.
Visualisation and measurement of performance aid in understanding goal of organization and by
this way professional become more committed towards their jobs. Visual control always ensures
to have adequate information and avoid complex situations.
Lean principles are pre determined principles that aims to transform workplace culture.
These principles concentrate of eliminating wastage and improving flow of patients. Lean
practices ensure that all the users get timely care and they feel comfortable in hospitals.
Continuous improvement is lean practice that describe single intervention cannot bring positive
changes in workplace. Hospitals are required to continuously work on it in order to improve
overall condition of care home. Lean assessment activities are considered as analytical tools that
are used to identify wastage and finding improvement areas. This activity empowers team
members and professionals to find out problems at workplace and ways through which issues can
be resolved soon. In order to implement lean assessment activities in health and social care
sector, medical professionals can take support of spaghetti diagrams, value stream mapping,
rapid process improvement workshops, and root cause analysis techniques. All these activities
are able to able to find out possible improvement areas through which wastage can be minimized
in workplace. It is analysed that lean improvement activities suggest new professional practices
through which doctors and nursing staff can provide amazing services to patients and can
contribute well in improving their condition. Lean improvement activities are such as 5S,
levelled production, daily visual management etc.
It is analysed that before implementing lean practices in workplace it is essential for
management that to identify current patients’ outcome, satisfaction, employees satisfaction,
utilization of resources etc. All these things are able to find out major problematic area and
making changes in such manner so that patient’s outcome can be improved. Lean activities work
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to reduce errors in patient’s safety and utilisation of resources. By implementing lean
management practices such as cultural changes, visual control etc. professional can provide high
quality care to users and can control over medical errors. When providers adn users
communicate well then this helps in measuring actual condition of patient and taking right
decision of treatment for them. It has been analysed that lean management practices have
become the most essential element that brings positive changes in patient’s outcome and their
safety as well. Visual management system ensure in sharing information in appropriate manner.
This reduces stress level of professionals and they get power to make their decisions. This is the
way that encourages people to provide best services to users in hospitals. 5S lean management
practice always wok to raise productivity of health care organization. This is efficient lean
approach that works to maximize value added levels and minimizing useful errors. 5S method is
considered as systematic method that helps in organizing workplace activities and improving
standards of services. It is low cost management practice that ensures to improve health care
services and providing high quality services to patients. Government of Sri Lanka and Tanzania
have recently implemented 5S approach for raising quality of services. Government has
encouraged 5S intervention model because it is helpful in addressing common chronic problems.
Previous studies show that this intervention program has supported in improving working
process and keeping environment clean. With the assistance of this lean management practice
doctors and nursing staff can become able to eliminate safety violations and can improve their
policies.
5S management practice can give better results to health and social sector because its
main agenda is to improve process, increase capacity and minimize stay time of patients in
emergency department. It is analysed that health lean management is usually used to improve
operational performance of organization. It concentrates more on visual control and improving
daily accounting process. Success of this visual management practice is linked with process
improvement. There are many patients these who visits hospitals but do not get timely treatment.
Standard work practices are another lean practice that ensures to prepare multi-disciplinary care
plan for patients. This is uniform way to meet with expectation of patients. It is responsibility of
health care professionals that to identify needs of users and provide them standard services but
due to ineffective management practices doctors are unable to manage large number of patients.
That is why implementation of standard work practice and preparation of multi-disciplinary care
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plan can be beneficial in ensuring requirement of person and providing them care without any
mistake. Standard work lean practice work as improvement element that looks at loopfall and
makes plan to resolve such issues. It is analysed that Kanban is most common lean practice that
is applied in most of organization in order to raise quality of production and minimizing errors.
Kanban practice can help in utilizing visual indicators properly so that utilization of inventory
can be done effectively. Stop the line technique is management approach that explains that
whenever health care professionals are realising mistakes at the same time they have to stop such
process. If professionals have identified any kind of loop fall in existing process due to which
patients are unable to recover soon then they have to stop applying this process. Stop the line
technique is mostly used in manufacturing firm. Once issues has been identified them
management can make plan to resolve such problems. A3 problem solving is another lean
management practice that is considered as standardised form of planning and report writing. In
this method companies take support of Plan-do-study-act process. This assists in making
necessary changes in existing process so that overall condition of health care organization can be
improved.
It is analysed that lean practices are related with manufacturing firms but it can be
applied in health and social are sector. This emphasised on development of culture and
empowering employees. This can develop confidence of staff members and they will perform
their work effectively. Lean management is socio technical system that continuously works for
eliminating wastage and improving internal or external reliability of operations. Professionals are
responsible for providing quality care services to patients but when they fail to perform their
work effectively then in such condition overall condition of patients get affected. There are many
hospitals where patients have to wait for longer duration but due to poor staff presence people do
not get timely treatment. Lean management practices are helpful in identifying issues and
making changes in their practices so that overall improvement can be done. Conducting meeting
with staff members is most common lean practice. Now most of the hospitals are implementing
this practice, this supports in making them aware with desires of patients and make them ready to
provide them high quality services. Management makes proper schedule and ensure that all the
professional start their duties on time without any failure. It is essential that nursing, laboratory,
administration staff perform in collaboration. They are required to share their views so that
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actual problems can be identified. This approach is intended to motive professionals so that they
pay more focus on their work and provide high quality services to patients.
Earlier most of the doctors and nursing staff were focused on their own practices; they
were less connected with each others. In such condition it becomes difficult for management to
create value for patients. Still in many hospitals staff members are not serious about their jobs,
poor flow of information create miscommunication. Value stream mapping lean management
practice is helpful in identifying core process and making positive changes health care practices
so that over all condition can be improved soon. In this process health care professionals
consider perspective of other professionals. This supports in finding innovative ideas to improve
their practices. These standard services are being implemented in workplace so that practices can
be streamlined properly. This is the best way of providing amazing services to patients as per
their medical requirements. Lean culture and leadership are most essential aspects that help in
improving work based practices in hospitals. This can create supportive structure that helps in
analysing improvement areas and making positive changes in practices. Health and social care
sector always ensure to make plan and test these planning activities. If they find requirement of
changes then they make immediate changes in practices. It is analysed that lean management
practices are able to give positive results to patients. By this way users can be immediate care at
hospitals and it can help in minimizing chances of medical errors in hospitals. 5S lean program is
beneficial in recycling culture and reusing existing resources. This improves utilisation of
resources and all the staff members continuously work to reduce wastage and improving quality
of services.
CHAPTER 5: CONCLUSION
From the above study it can be concluded that world health organization is continuously
working for improving patients security and providing them high quality treatment.
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