Mätning av implementeringen av lean inom sjukvård
The purpose of this thesis is to discuss how an instrument originally developed for measuring changes toward lean thinking inservice organizations in general should be adjusted in order to be of use in service organizations within the healthcare sector, andin hospital organizations in specific. The adjustments are suggested based on difficulties specifically arising when implementinglean within the healthcare sector.Thesis starting point is a pre-existing lean assessment instrument developed for service organizations in general. The thesis appliesa qualitative method and integrates literature from the health care sector and lean production movement with the expertise of tenacademics and practitioners in order to find difficulties associated with the implementation of lean within the healthcare sector.These difficulties then lie as the substratum for the adjustments suggested to be made on the instrument.The thesis finds that lean, as a philosophy, does not differ between service organizations in general and service organizationswithin healthcare settings. However, due to deficits in the general understanding of lean some adaptions on the instrument mustbe made. First, some words associated with production must be changed to words associated with healthcare. This involveschanging the word customer to patient and standardization to total quality management. Second, a module for measuringhorizontal information flow must be added since the coordination within healthcare settings is worse than within other servicesettings. Third, a module for horizontal and vertical operating control must be added for the same reason as the previoussuggestion. Fourth, a module for the incentive system must be added since the reimbursement mechanisms as of today areincentivizing everything but lean thinking. This must be reviewed and followed up in a lean assessment instrument. Fifth, amodule for management participation must be added since the themes leadership and respect for people which the moduleshould involve are utterly important to bear in mind for any organizational change to be successful and of extra importance withina healthcare setting due to the existence of professionals and informational hierarchies.