Grove, Amy L., Meredith, James O., Macintyre, Mairi, Angelis, Jannis and Neailey, Kevin. (2010) UK health visiting : challenges faced during lean implementation. Leadership in Health Services, Vol.23 (No.3). pp. 204-218. ISSN 1751-1879

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Abstract

Purpose – The purpose of this paper is to present the challenges identified during a lean implementation in a health visiting service within a large primary care trust in NHS UK.

Design/methodology/approach – Following a series of lean workshops a triangulated approach to data collection was adopted in order to determine the root cause of the challenges that were faced during this lean implementation. The three methods that were selected for qualitative analysis included semi-structured interviews, document analysis and researcher participant observation.

Findings – Six key challenges were identified from the data analysis. These were: high process variability; a lack of understanding of lean; poor communication and leadership; target focused; problems defining waste; and difficulty in determining who is the customer and what do they value?

Practical implications – Although this particular lean implantation had limited success, the research has highlighted a number of challenges which would have to be addressed prior to future lean exercises. This will assist other clinical and managerial staff to prepare for the challenges that may be faced during a lean implementation, and adapt their approach to future quality improvement.

Originality/value – The barriers to lean implementation could be overcome with upfront planning, transformational leadership, excellent communication, identification and sharing of best practice and, above all, a shared vision. There is no quick and easy solution to productivity improvement, community services, as in this paper, cannot expect to select lean tools and techniques and emulate the success seen elsewhere. If they wish to deliver world-class healthcare in the face of constrained resources and greater demand, they need to adopt a long-term vision.

Item Type:	Journal Article
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine R Medicine > RT Nursing
Divisions:	Faculty of Medicine > Warwick Medical School > Warwick Evidence Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School Faculty of Science > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH):	Primary care (Medicine) -- Great Britain, Visiting nurses -- Great Britain, Home care services -- Great Britain, Great Britain. National Health Service, Transformational leadership
Journal or Publication Title:	Leadership in Health Services
Publisher:	Emerald Group Publishing Ltd.
ISSN:	1751-1879
Official Date:	2010
Volume:	Vol.23
Number:	No.3
Number of Pages:	15
Page Range:	pp. 204-218
Identification Number:	10.1108/17511871011061037
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Warwick Innovative Manufacturing Research Centre (WIMRC)
URI:	http://wrap.warwick.ac.uk/id/eprint/37268

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