Observational studyHealth services research2023
Achieving transformation to lean management systems in health care.
Observational study in Health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Defining and Measuring Organizational Transformation in Health Care: A Systematic Literature Review.Medical care research and review : MCRR · 2026Pooled it
- 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
- Co-designing a blueprint for spreading person-centered, Whole Health care to HIV specialty care settings: a mixed methods protocol.BMC health services research · 2024Article
- Achieving transformation to lean management systems in health care.Health services research · 2023Observational
- Using Lean Six Sigma Methods to Develop an Efficient and Sustainable Interdisciplinary Team Program for Chronic Pain in a VA: PREVAIL Interdisciplinary Team Track.Global advances in integrative medicine and healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo understand what factors and organizational dynamics enable Lean transformation of health care organizations. DATA SOURCES: Primary data were collected through two waves of interviews in 2016-2017 with leaders and staff at seven veterans affairs medical centers participating in Lean enterprise transformation. STUDY
designUsing an observational study design, for each site we coded and rated seven potential enablers of transformation. The outcome measure was the extent of Lean transformation, constructed by coding and rating 11 markers of depth and spread of transformation. Using multivalue coincidence analysis (CNA), we identified enablers that distinguished among sites having different levels of transformation. We identified representative quotes for the enablers. DATA COLLECTION
methodsWe interviewed 121 executive leaders, middle managers, expert consultants, systems redesign staff, frontline supervisors, and staff. PRINCIPAL
findingsTwo sites achieved high Lean transformation, three medium, and two low. Together leadership support and capability development were sufficient for the three-level Lean transformation outcomes with 100% consistency and 100% coverage. High scores on both corresponded to high Lean transformation; medium on either one corresponded to medium transformation; and low on both corresponded to low transformation. Additionally, low scores in communication and availability of data and very low scores in alignment characterized low-transformation sites. Sites with high leadership support also had a high veteran engagement.
conclusionsThis multisite study develops a novel measure of the extent of organization-wide Lean transformation and uses CNA to identify enablers linked to transformation. It provides insights into why and how some organizations are more successful at transformation than others. Findings support the applicability of the organization transformation model that guided the study and highlight the roles of executive leadership and capability development in the dynamics of transformation.
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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.