We propose some tentative hypotheses about circumstances relating to leadership for investigation in future stages of the work. Nine interviews were conducted by two members of the research team with key informants to solicit expert opinion on the direction the Lean evaluation could most fruitfully take. The benefits are typically confined to a specific process with little impact occurring at the department or system level. Measurement was valued by front line, physician and leader respondents. One senior leader explained the need to ensure the team’s commitment to the Lean management system: “We’ve had some managers leave…that weren’t the best fit for us progressing… If you’ve got someone who’s gonna be an impediment to improvement or a structure that’s an impediment to improvement, the onus is on myself as a leader to create some degree of change”(C-05). Use of the appropriate Lean tools then means that the causes of safety problems are addressed, which contributes to improved patient safety. Lean defines the elements of waste as overproduction, inventory, motion, transportation, defects and overprocessing. © 2020 BioMed Central Ltd unless otherwise stated. Others championed Lean by being actively involved and “modelling the way” [3]. For better understanding, you can refer to different books that have been written on it. Data also works to hold leaders accountable for safety and quality improvements. Mackenzie & Hall [3] note that leadership commitment and creation of a vision involving Lean are pivotal to “stakeholders’ understanding of the benefits of Lean for themselves or for the organization as a whole”. Lean espouses particular roles and management styles for leaders. Lean and leadership practices: development of an initial realist program theory. Argyris, C. and Schön, D. Theory in practice: Increasing professional effectiveness, San Francisco: Jossey-Bass; 1974. “We do see our leaders more, which is a good thing, because all of a sudden, instead of just a name, it’s a name and a face and somebody who is working right side by side with the staff, so that’s been the change so that’s been the good with the leaders” (D-01). 2014;3(1):103. Similarly, ‘standard work’ products from those tools may be considered a single loop learning outcome in that they provide a highly structured way of undertaking particular work. The focus of some Lean activities on timing certain procedures was not always welcomed and seemed misguided for participants who were less Lean-enculturated: “Well, maybe we should be taking care of all of the big garbage first, before we worry about the seconds… I really disagree on timing tasks and things like that, I really disagree on that.” (D-01). “When people challenge you on the data… Not sort of going with a sort of hunch about what we believe is wrong, but actually doing some time observations and data collection…so that we are very sure we know what the problem is” (A-03) Measurement also acted to correct perceptions about the exact nature of problems and to provide evidence of the success of changes, thus providing a positive feedback loop to reinforce engagement. While patients and families have often complained of “having no voice” in health care, Lean highlights the value of listening to and acting upon consumer insights to improve quality. …When you don’t know, it’s really hard to feel good about yourself and the work you’re doing”. Regular price $100.00 Presentation Slides. Because the research team, at that time, needed an overview of the changes perceived to be associated with Lean, we did not structure the questions specifically to conform to the realist focus on contexts, mechanisms and outcomes. “Learning how to do things the same… will be the success” (A-01) of the Lean initiative. This is important because physician engagement was described as necessary for specific changes to be implemented and valued. The Lean implementation process in Saskatchewan similarly incorporates particular tensions: it represents a top-down attempt to build bottom up processes of improvement. 9. Mendeley users who have this article in their library. These leaders encourage participation and contributions from group members and help group members feel more relevant and committed to the decision-making process. The research method involved: (i) a literature review of lean leadership as to identify how it accounts for three core constructs of the general leadership theories, namely leaders’ personal attributes, influence process and context; and (ii) a comparison between lean leadership with general leadership theories based on the same three constructs. A tour of Toyota's assembly plant will demonstrate how theory translates into practice, but what is more critical for business leaders is a strong knowledge of Lean's core theories and principles and the kata routines that will make you a more effective Lean leader. Physicians also appreciated, and were reported by others to appreciate, the objective nature of the evidence provided by Lean activities. The primary source of evidence described in this paper was derived from these face-to-face interviews which contributed to, or provided preliminary evidence for, aspects of the program theory in relation to leadership change. Saskatchewan Health Quality Council: publications & reports. Lean Leadership illustrates the same point quite well with the story of a factory kaizen team at TMMK (Toyota’s Georgetown, Kentucky facility). “I’m not sure who out there, somewhere, is determining what we’re focusing on” (A-03). As one respondent noted, “It was very sad to see people almost fainting because they were so scared they wouldn’t do well…I saw co-workers that I felt so bad for that were crying, that were hyperventilating, that were sick” (C-06). 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