‘Lean on me’: an integrative literature review on the middle management role in lean

The relationship between self-efficacy and sustainable Lean management systems within the healthcare arena

PURPOSE

The purpose of this paper is to improve the understanding of the social contexts of sustainable Lean culture in healthcare by examining self-efficacy (SE) as a fundamental construct related to the value of perceived readiness, prior education of Lean and the importance of leadership's system-level support.

DESIGN/METHODOLOGY/APPROACH

A descriptive correlational study was conducted to identify the relationships between SE and Lean readiness factors, SE and prior Lean training, SE and clinical vs administrative roles and SE and perceived system-level support in a large health system.

FINDINGS

There was a statistically significant difference in self-reported readiness to use Lean tools between individuals who had received Lean training during their academic education and those who had not; however, their level of education did not impact SE. Lastly, and perhaps most important, the learner who embodies SE also has system-level support.

RESEARCH LIMITATIONS/IMPLICATIONS

Future directions of this research, in addition to assessing team readiness as other studies suggest, would be to evaluate individual team member readiness by gauging SE and addressing deficits prior to the deployment of process improvement (PI) projects to promote success and sustainability.

PRACTICAL IMPLICATIONS

This contributes to the ongoing scholarship of Lean management systems, providing clinical and non-clinical leaders with a contextual understanding of their supportive role in the SE of teams.

ORIGINALITY/VALUE

This study demonstrates the value of understanding SE of individual team members and how it can contribute to overall improved team outcomes, directly impacting the sustainability of Lean change culture and its promotion of improved patient safety, cost efficiencies and access to care.

Digital transformation and middle managers' leadership skills and behavior: a group concept mapping approach

This study, with the aim to test theory in practice, used group concept mapping to develop a comprehensive conceptualization of middle managers' leadership behaviors concerning digital transformation as a form of radical change. Participants were professionals in the largest public organization in the Netherlands (a police organization) who were dealing with digital transformation in their own practice and who enrolled in an education program on leadership and intelligence. Based on 94 unique statements, the participant-driven results revealed six thematically coherent clusters representing leadership skills and behaviors regarding improvement and results, digital technologies, cooperation, the self, change and ambivalence, and others. The stress value of 0.2234 indicated a good fit. Further analysis showed that clusters containing soft skills and people-oriented behaviors were considered the most important. These results can serve as input to support leadership development programs for middle managers to develop themselves into people-oriented, empowering leaders who can adapt their leadership approaches to fit and support change in general and technology-driven change in particular. Ultimately this will benefit their and their employees' overall well-being at work. This study is the first to investigate middle managers' leadership skills and behaviors in a large public organization that is entirely participant-driven.

The Challenges of Lean Transformation and Implementation in the Manufacturing Sector

In this study we explored the challenges involved in Lean Transformation and implementation in the manufacturing sector. Using survey data from 50 North American manufacturing organizations, we examined the challenges involved in implementing and sustaining Lean Manufacturing (LM) principles and practices in production processes. The fuzzy analytic hierarchy process (FAHP) and the fuzzy analytic network process (FANP) were used to rank the considerable challenges observed in these organizations. We concluded that the need for a change in organizational culture was the major barrier to Lean implementation. It is challenging to sustain Lean without a culture shift and a clear direction set by the organization’s leadership team. The originality of the paper relates to prioritizing the cultural aspects of organizations as a major barrier to LM implementation. Other challenges encountered during Lean implementation in the manufacturing industries were related to management support, technical knowledge, and employee resistance to change. Early identification of these challenges enables companies to question their capabilities before implementing the Lean philosophy. In this study we used results obtained from 50 manufacturing companies in North America, representing a subset of manufacturing organizations. As a result, it must be interpreted based on the data acquisition method and the study’s sample size.