The Evaluation of Lean in Healthcare using Quantitative and Qualitative Methods

Hicks, C; Lugsden, E; McGovern, T; Small, A; Hunter, D; Erskine, J; Eccles, M; Steen, N; Whitty, P

The Evaluation of Lean in Healthcare using Quantitative and Qualitative Methods

Lookup NU author(s): Professor Christian Hicks, Edward Lugsden, Professor Tom McGovern, Dr Adrian Small ORCiD, Professor Martin Eccles, Dr Nick Steen, Professor Paula Whitty

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Abstract

There is a growing literature on the value of Lean systems in healthcare. Evaluating transformational change initiatives in complex systems like the British National Health Service to establish ‘what works' is fraught with difficulties. This research adopted a mixed methods approach to address these challenges. This paper focuses on the impact of a single Rapid Process Improvement Workshop (RPIW) covering two hospital wards. The research used an interrupted time series analysis. Interviews and documentary materials investigated staff perceptions of what had improved: quality of care; time spent with patients; less bureaucracy; medicines ready at the required time etc. The results of the pilot ITS analysis proved inconclusive. The results of the analysis of interview data and documentary materials were positive, which bore out anecdotal and other evidence that the Trusts’ Lean interventions were achieving impressive results. The paper explores possible reasons for the divergence in results obtained by the methods.