Implementation Assessment

As shown in figure below, the Lean implementation process must incorporate a plan for organizational change. For a healthcare organization to successfully navigate change of this magnitude, the implementation design must be cognizant of how lean change will be perceived, accepted, and disseminated by employees at the leadership, managerial, and executional levels of the organization. In addition, Lean must result in operational and financial improvements, affecting the cultural change and capability building. The sections below will discuss our general framework for key contextual and performance factors.

Assessment Framework

Executing the Initiative

In a quality improvement process based on Lean, it is imperative for front-line professionals to be actively involved in and committed to the Lean transformation. Execution depends on individuals who are ready and willing to participate, who feel free to participate without any negative repercussions, and who can develop the technical knowledge and skills necessary for quality improvement. The literature on organizational change and process improvement identifies three important aspects related to execution of change by those individuals directly involved. They are Kaizen performance, psychological safety, individual readiness for change and learning (individual and organizational). By Kaizen we refer to Lean improvement efforts.

Leading the Initiative

Another dimension of change is that of leading the initiative. Implementing Lean in healthcare environments is more than just a technical challenge; it is also a change management challenge. It is well accepted in the literature that successful change management requires strong leadership. Our assessment and consultations approach focuses on the change management process and leadership style and behaviors of the primary change leaders for the lean initiative. We examine the important actions and decisions made by the change leaders to guide and direct the implementation process throughout its multi-year timeframe.

Sustain and Spread the Initiative

Beyond executing and leading the Lean implementation effort, it is important for the healthcare organizations to spread the Lean philosophy and new ways of operating beyond a few isolated Lean improvement teams to the entire organization. Only by dissemination across the organization can lean change by sustained over the long term. Our assessment examines two aspects of spreading and sustaining the change. First, we examine how Lean knowledge and positive change behaviors spread to individuals throughout the organization by studying the informal social networks that develop over time. Second, we monitor the methods of inter-organizational collaboration used to spread Lean using the formal organizational mechanisms.

Operational and Financial Performance & Cultural Change and Capability Building

Finally, if the Lean implementation process is successful, organizations should expect to see tangible improvements in operational and financial performance, both at the microsystem and macrosystem level where Lean projects are performed. In addition, Lean is expected to have a positive impact on a hospital’s cultural change and employees' capability building.


If your organization is interested in conducting an assessment or needs expert advise of Lean implementation efforts, the research team will be happy to engage with you in conversation for a potential project. Please contact us.