Organisational Barriers to the Lean Management Approach in Healthcare

To identify the potential organisational barriers to the lean management in healthcare organisations. Seven electronic databases were systematically searched for published studies relating to the challenges in lean implementation in healthcare systems. In total 412 articles were reviewed to select 23 studies which met the inclusion criteria and quality appraisal criteria. Research papers were selected following a screening process using the PRISMA tool. McMaster university framework was employed to access the quality of these selected papers. This process was to ensure appropriateness of the literature selected for this study. A thematic analysis was conducted on the results extracted from the research papers reviewed. Thematic analysis of the selected 23 studies revealed potential organisational barriers for implementing lean in healthcare organisations. Factors such as poor knowledge and perception of lean, management practices, organisational structure, employee resistance and poor collaboration are responsible for failures in lean implementation. Multiple barriers accounted for the challenging application of lean in healthcare. Successful lean implementation requires overcoming the functional and professional silos in healthcare organisations to reach common understanding and right perception of lean in healthcare. Furthermore, physicians and other clinicians are very important stakeholders, therefore healthcare organisations should encourage their leadership and involvement in lean implementation initiatives to improve the outcome of lean in healthcare. Lean management has the potential to improve efficiency and effectiveness of healthcare services, but lean principles, terminology and methods need to be adapted to healthcare settings for best outcomes.