Turku University Hospital,Department of Public Health,University of
Turku University of Applied Sciences,Health and Well-being.
Int J Technol Assess Health Care. 2018 Jan;34(2):134-146. doi: 10.1017/S0266462318000193. Epub 2018 Apr 12.
The aim of this study was to identify and analyze the characteristics of leadership and management associated with a successful Lean thinking adaptation in healthcare.
A systematic literature review was undertaken using electronic databases: PubMed, PubMed Systematic Review, ABI/INFORM, Business Source Complete, Emerald, JBI, and Cinahl. Inclusion criteria were: (i) a description of Lean management or leadership in health care, (ii) a reference to Lean thinking, (iii) a peer-reviewed original research article or a literature review, and (iv) a full text article available in English. Among the 1,754 peer-reviewed articles identified, nine original articles and three systematic reviews met the inclusion criteria. Data on informants, methods, and settings were extracted and collated. Content analysis was used to conduct a review of the nine original studies describing and analyzing the success factors of Lean adaptation. The characteristics of leadership and management were analyzed by using the concept of a managerial windshield that divides leadership and management into four ontological dimensions: activities, style, focus, and purpose, each with typical developmental stages of skills and capabilities. The current study has some limitations: some papers from the journals not indexed in the searched databases may have been overlooked and the literature searches were carried out only for a 5-year period.
Considering the results using the windshield concept emphasizes the philosophy, principles, and tools of Lean thinking. Lean leadership and management factors in health care were mainly conceptualized as skills and capabilities such as problem solving, making changes occur, empowering, communicating, coaching, supporting, facilitating, being democratic, organizational learning, and organizational success, all of which represented middle-stage or advanced managerial skills and capabilities.
A conceptual analysis of systematically reviewed studies of Lean leadership and management point to certain traits as being typical when adapting Lean thinking to health care. The concept of a managerial windshield is useful when categorizing and analyzing essential managerial skills and capabilities for Lean implementation. Findings are beneficial when learning and educating the skills required for Lean transformation in healthcare organizations.
本研究旨在识别和分析与医疗保健中成功实施精益思维相关的领导和管理特征。
使用电子数据库进行了系统文献回顾：PubMed、PubMed 系统评价、ABI/INFORM、Business Source Complete、Emerald、JBI 和 Cinahl。纳入标准为：(i) 描述医疗保健中的精益管理或领导力，(ii) 提及精益思维，(iii) 同行评议的原始研究文章或文献综述，以及 (iv) 可用英文提供全文文章。在确定的 1754 篇同行评议文章中，有 9 篇原始文章和 3 篇系统评价符合纳入标准。提取并整理了有关信息员、方法和环境的数据。使用管理挡风玻璃的概念对描述和分析精益适应成功因素的 9 项原始研究进行了审查。领导力和管理的特征通过使用管理挡风玻璃的概念进行了分析，该概念将领导和管理分为四个本体论维度：活动、风格、焦点和目的，每个维度都有典型的技能和能力发展阶段。本研究存在一些局限性：可能忽略了未在搜索数据库中索引的期刊中的一些论文，并且仅对 5 年期间进行了文献检索。
使用挡风玻璃概念考虑结果强调了精益思维的哲学、原则和工具。医疗保健中的精益领导和管理因素主要被概念化为解决问题、推动变革、授权、沟通、辅导、支持、促进、民主、组织学习和组织成功等技能和能力，所有这些都代表了中级或高级管理技能和能力。
对系统评价的精益领导和管理研究进行概念分析，指出在将精益思维应用于医疗保健时，某些特征是典型的。管理挡风玻璃的概念在对精益实施所需的基本管理技能和能力进行分类和分析时非常有用。研究结果有利于在医疗保健组织中学习和教育实施精益转型所需的技能。
