Identifying Impact of Lean Management on Healthcare Outcomes

This dissertation investigates the impact of lean management practices on patients' outcomes, professional practices, and the healthcare system, specifically within the context of Game Care home. It begins with an introduction outlining the background, aims, objectives, research questions, and rationale, emphasizing the importance of lean principles in improving healthcare quality and patient safety. The literature review examines existing research on lean management practices, their impact on professional practices, and their effectiveness in enhancing patient safety. The methodology section details the use of secondary data and systematic review approaches. The structure of the study includes chapters on introduction, literature review, data analysis, discussion, and conclusion, with a focus on answering research questions regarding the application and effectiveness of lean management in the health and social care sector. The dissertation aims to identify the interrelationship between lean management and professional practices, to determine effectiveness in improving patient safety and suggest ways to ensure patient safety and improve professional practices in health and social care sector. The research employs a mixed-methods approach, utilizing both qualitative and quantitative data analysis techniques to explore the impact of lean management practices on patients' outcomes, professional practices and health care system.

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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