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Journal cover: Leadership in Health Services

Leadership in Health Services

ISSN: 1751-1879

Online from: 1997

Subject Area: Health Care Management/Healthcare

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UK health visiting: challenges faced during lean implementation

Document Information:
Title:UK health visiting: challenges faced during lean implementation
Author(s):A.L. Grove, (The University of Warwick, Coventry, UK), J.O. Meredith, (The University of Warwick, Coventry, UK), M. MacIntyre, (The University of Warwick, Coventry, UK), J. Angelis, (The University of Warwick, Coventry, UK), K. Neailey, (The University of Warwick, Coventry, UK)
Citation:A.L. Grove, J.O. Meredith, M. MacIntyre, J. Angelis, K. Neailey, (2010) "UK health visiting: challenges faced during lean implementation", Leadership in Health Services, Vol. 23 Iss: 3, pp.204 - 218
Keywords:Health visitors, Management effectiveness, National Health Service, Primary care, Quality, Transformational leadership, United Kingdom
Article type:Research paper
DOI:10.1108/17511871011061037 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Acknowledgements:The authors acknowledge the assistance of Stuart Bestwick at Alexander and Claire Bourne at the University of Warwick.The authors have no competing interests.The authors thank their funding body, the Warwick Innovative Manufacturing Research Centre (WIMRC).

Purpose – The purpose of this paper is to present the challenges identified during a lean implementation in a health visiting service within a large primary care trust in NHS UK.

Design/methodology/approach – Following a series of lean workshops a triangulated approach to data collection was adopted in order to determine the root cause of the challenges that were faced during this lean implementation. The three methods that were selected for qualitative analysis included semi-structured interviews, document analysis and researcher participant observation.

Findings – Six key challenges were identified from the data analysis. These were: high process variability; a lack of understanding of lean; poor communication and leadership; target focused; problems defining waste; and difficulty in determining who is the customer and what do they value?

Practical implications – Although this particular lean implantation had limited success, the research has highlighted a number of challenges which would have to be addressed prior to future lean exercises. This will assist other clinical and managerial staff to prepare for the challenges that may be faced during a lean implementation, and adapt their approach to future quality improvement.

Originality/value – The barriers to lean implementation could be overcome with upfront planning, transformational leadership, excellent communication, identification and sharing of best practice and, above all, a shared vision. There is no quick and easy solution to productivity improvement, community services, as in this paper, cannot expect to select lean tools and techniques and emulate the success seen elsewhere. If they wish to deliver world-class healthcare in the face of constrained resources and greater demand, they need to adopt a long-term vision.

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