Identifying Barriers to Lean Methods in Hospitals: A Case Study

Hospitals and healthcare consumers have experienced increasing healthcare cost expenditures that have greatly increased the cost of healthcare. New legislation like the Affordable Care Act, signed in 2010, pushes hospitals to change traditional business practices to increase the quality of care services. Lean methodologies, have helped manufacturing companies succeed in increasing the quality of the finished product, by decreasing wastes; results in decreased costs. Hospitals have been slow to discover and utilize proven lean methodologies to increase quality services, offering limited current data research in LM hospital implementation success. The problem addressed in this study is U.S. healthcare is increasingly expensive for providers and consumers challenging hospitals to decrease capital expenditures while maintaining quality of care for healthcare consumers. Hospitals need to increase the quality of care to healthcare consumers and decrease wastes and costs. The purpose of this qualitative holistic single case study of one hospital is to identify specific hospital barriers to successful lean methodology implementation and possible changes that may help future lean methodology implementation be successful in hospitals. The qualitative single case study design interview used a purposeful sample of 20 administrative management, middle management, and staff member employees of a single southern New Jersey hospital. The study findings were consistent with the large amount of literature in the manufacturing arena and the limited literature and data on the service industry hospitals. The case study results yielded five major themes; knowledge, change, team approach, satisfaction, and solution; and three minor themes identified as change action, yellow belts, and specifics of equipment, rooms, staff, money, and delays. Recommendations for future practice includes an increase in lean methodology education for all employees to support a change to a positive 'buy in' of a lean methodology culture. Future research considerations should consider a qualitative study with a larger sample of different hospitals, sizes, and different states for comparison; or change the study design to a mixed study with larger multiple qualitative studies and applied metrics for a quantitative study results. Future qualitative questions might focus on education to lean methodology and culture since it is an identified, current problem.