ArticleBMC health services research2019
Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Organisational-level risk and health-promoting factors within the healthcare sector-a systematic search and review.Frontiers in medicine · 2024Pooled it
- Lean management of crisis response and post-pandemic outcomes in US primary care practices.BMC health services research · 2026Article
- Job resources, job demands, and their relationships with thriving, burnout, and work-life conflict among Swedish nursing staff.BMC nursing · 2026Article
- What about neurodiversity among nurses? A cross-sectional exploration of work environment and health among nurses with ADHD and/or autism.Work (Reading, Mass.) · 2025Article
- Article
- University students' thriving during remote and in-person instruction in the COVID-19 pandemic: longitudinal evidence from two academic years.Frontiers in psychology · 2025Article
- Revisiting lean healthcare: adopting value stream mapping from manufacturing.Frontiers in health services · 2025Article
- The maturity of lean management in a large academic medical center in Finland: a qualitative study.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2024Article
- Technology frustration in healthcare - does it matter in staff ratings of stress, emotional exhaustion, and satisfaction with care? A cross-sectional correlational study using the job demands-resources theory.BMC health services research · 2024Article
- Associations between lean maturity in primary care and musculoskeletal complaints among staff: a longitudinal study.BMJ open · 2023Article
- How do family supportive supervisors affect nurses' thriving: A research before and during COVID-19 pandemic.Archives of psychiatric nursing · 2021Article
- Implementing Lean Quality Improvement in Primary Care: Impact on Efficiency in Performing Common Clinical Tasks.Journal of general internal medicine · 2021Article
- Validation of the Copenhagen Psychosocial Questionnaire Version III and Establishment of Benchmarks for Psychosocial Risk Management in Sweden.International journal of environmental research and public health · 2020Article
- Evaluation of System Modelling Techniques for Waste Identification in Lean Healthcare Applications.Risk management and healthcare policy · 2020Article
- Teachers' Personal and Collective Work-Identity Predicts Exhaustion and Work Motivation: Mediating Roles of Psychological Job Demands and Resources.Frontiers in psychology · 2020Article
- Standardization vs Customization: Finding the Right Balance.Annals of family medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of Lean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent to which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and exhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job resources, as perceived by staff, have a moderated mediation effect.
methodA longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care units responded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings of Lean maturity reflect participants' judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion and job demands and resources reflect participants' judgements regarding their own situation.
resultsFirst, over time, increased Lean maturity was associated with increased staff satisfaction with their care-giving and increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associated with decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that job demands and job resources had a moderated mediation effect.
conclusionThe results indicate that primary care staff may benefit from working in organizations characterized by high levels of Lean maturity and that caregiving may also be improved as perceived by staff.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.