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Effects of implementing lean management on psychosocial working conditions and employee health in a healthcare setting

English title Effects of implementing lean management on psychosocial working conditions and employee health in a healthcare setting
Applicant Bauer Georg
Number 166015
Funding scheme Project funding (Div. I-III)
Research institution Institut für Epidemiologie, Biostatistik und Prävention Universität Zürich
Institution of higher education University of Zurich - ZH
Main discipline Psychology
Start/End 01.06.2016 - 30.04.2019
Approved amount 182'282.00
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All Disciplines (2)

Discipline
Psychology
Occupational Medicine, Ergonomy

Keywords (5)

organizational health intervention; lean implementation; healthcare; psychosocial work conditions; employee health

Lay Summary (German)

Lead
Das Forschungsprojekt untersucht, ob und wie Lean Management in der Pflege umgesetzt werden kann, so dass nicht nur effizientere Arbeitsprozesse daraus resultieren, sondern auch die psychosozialen Arbeitsbedingungen und die Gesundheit von Mitarbeitenden berücksichtigt und optimalerweise erhalten werden.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Lean Management ist ein weit verbreiteter Management-Ansatz zur Effizienz- und Qualitätssteigerung und gewinnt auch zunehmend im Gesundheits- und Pflegebereich an Bedeutung. Bisherige Studien zeigen, dass sich durch Lean Management die organisationale Leistungsfähigkeit verbessern lässt. Dahingegen gibt es bisher nur wenige Studien, welche sich mit den Auswirkungen von Lean Management auf die psychosozialen Arbeitsbedingungen und die Gesundheit von Mitarbeitenden befassten und diese zeigen zusammenfassend kein klares Bild. Um die zur Zeit unklare Befundlage zu klären, verfolgt dieses Projekt die folgenden beiden Ziele: Erstens evaluiert das Forschungsprojekt die Auswirkungen der Umsetzung von Lean Management im Pflegebereich auf die psychosozialen Arbeitsbedingungen, die Gesundheit der Mitarbeitenden und schlanke (= lean) Prozesse. Zweitens sollen Faktoren im Kontext und Prozess der Implementierung von Lean Management identifiziert werden, welche eine positive Wirkung versprechen hinsichtlich aller drei genannten Kriterien.

 

Wissenschaftlicher und gesellschaftlicher Kontext

Die Ergebnisse dieses Forschungsprojekts sind primär von Interesse für Spitäler und andere Organisationen im Gesundheitsbereich, welche daran interessiert sind, Lean Management einzuführen und so zu gestalten, dass dadurch nicht nur effizientere Arbeitsprozesse gewährleistet werden, sondern auch den psychosozialen Arbeitsbedingungen und der Gesundheit der Mitarbeitenden Rechnung getragen wird. Zudem ist zu erwarten, dass sich die Resultate auf andere Branchen generalisieren lassen.

Direct link to Lay Summary Last update: 12.05.2016

Responsible applicant and co-applicants

Employees

Publications

Publication
Goal Pursuit in Organizational Health Interventions: The Role of Team Climate, Outcome Expectancy, and Implementation Intentions
Lehmann Anja I., Brauchli Rebecca, Bauer Georg F. (2019), Goal Pursuit in Organizational Health Interventions: The Role of Team Climate, Outcome Expectancy, and Implementation Intentions, in Frontiers in Psychology, 10, 1-13.
Baseline psychosocial and affective context characteristics predict outcome expectancy as a process appraisal of an organizational health intervention.
Lehmann Anja I., Brauchli Rebecca, Jenny Gregor J., Füllemann Désirée, Bauer Georg F. (2018), Baseline psychosocial and affective context characteristics predict outcome expectancy as a process appraisal of an organizational health intervention., in International Journal of Stress Management, 1-17.
Erfolgskritische Faktoren bei der Optimierung des Skill-Grade-Mix auf der Basis von Lean Management-PrinzipienEine qualitative Teilstudie
Inauen Alice, Rettke Horst, Fridrich Annemarie, Spirig Rebecca, Bauer Georg F. (2017), Erfolgskritische Faktoren bei der Optimierung des Skill-Grade-Mix auf der Basis von Lean Management-PrinzipienEine qualitative Teilstudie, in Pflege, 30(1), 29-38.
The relevance of intervention participants’ process appraisal for change in well-being and lean work processes of entire teams
Füllemann Désirée, Fridrich Annemarie, Jenny Gregor James, Brauchli Rebecca, Inauen Alice, Bauer Georg Friedrich (2016), The relevance of intervention participants’ process appraisal for change in well-being and lean work processes of entire teams, in Journal of Organizational Effectiveness: People and Performance, 3(4), 376-394.

Collaboration

Group / person Country
Types of collaboration
USZ Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Center for the Promotion of Health in the New England Workplace United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Global Working Group on Salutogenesis Int. Union for Health Promotion (IUHPE) France (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
Finnish Institute of Occupational Health FIOH Finland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
International Network of Sustainable Organizational Interventions (INSOI) United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Exchange of personnel
Institut universitaire romand de Santé au Travail (IST) Lausanne Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Congress of the European Association of Work and Organzational Psychology Talk given at a conference Intervention effects for direct and indirect participants in an organisational health intervention implemented in healthcare: A mixed-methods study. 30.05.2019 Turin, Italy Brauchli Rebecca; Bauer Georg; Lehmann Anja;
Congress of the European Academy of Occupational Health Psychology Talk given at a conference Goal Pursuit in Organisational Health Interventions: The Role of Team Climate, Outcome Expectancy, and Collective Implementation Intentions in Healthcare. 05.09.2018 Lisbon, Portugal Brauchli Rebecca; Bauer Georg; Lehmann Anja;
Congress of the European Association of Work and Organizational Psychology Talk given at a conference When and why is an organizational intervention process effective? Exploring context factors of a lean healthcare intervention. 17.05.2017 Dublin, Ireland Füllemann Désirée; Lehmann Anja; Bauer Georg; Brauchli Rebecca; Jenny Gregor;


Associated projects

Number Title Start Funding scheme
173165 Cluster RCT of an e-coach for team leaders and teams targeting job resources and demands: process and outcome evaluation 01.01.2018 Project funding (Div. I-III)
201113 Crafting life for health and well-being: Understanding different types of crafting in everyday life and in challenging times (Craft4Health) 01.06.2021 Project funding (Div. I-III)

Abstract

Lean management (LM) has become a popular management approach to increase efficiency and quality in healthcare in the face of constantly increasing demands but limited resources. Existing studies on lean imple-mentation have mainly investigated its effects on organizational performance. Regarding effects on psychosocial working conditions and employees’ health, empirical evidence is scarce and contradictory (Hasle, Bojesen, Jensen, & Bramming, 2012; Ulhassan, von Thiele Schwarz, Thor, & Westerlund, 2014). Thus, the proposed research project aims to 1) evaluate the impact of implementing a LM under consideration of employees’ health in a healthcare setting on employees’ working conditions, employees’ health, and lean work processes and 2) to identify factors predicting a positive impact on each of these three outcomes.The project builds on data collected in the context of the comprehensive scientific evaluation of a lean imple-mentation project within nursing wards of a Swiss university hospital (University Hospital Zurich [USZ]). LM was implemented as an umbrella strategy in the whole hospital. As a key element, so called Rapid Process Im-provement / Kaizen Workshops (RPIW) were conducted in a standardized way with employee representatives in all nursing wards. During one session of these four-day lean workshops, the employees’ health perspective was introduced. Based on a survey-feedback method, workshop participants developed ward-specific action plans to improve working conditions and health in their own nursing ward.The study applies a wait list control group design with 16 wards assigned to the intervention and 13 wards to the wait list control group. For the longitudinal data collection, a comprehensive, standardized survey instrument with validated scales was applied to all employees in the participating wards, three times with 6 months inter-vals. The average response rate was 58.5% across all wards, resulting in sample sizes above n=500 for each measurement point. Intervention process and context data were collected by written surveys of workshop partici-pants and by four focus groups. Results gained by the proposed research project can be used and applied by other hospitals to adapt and imple-ment lean management in a way that not only optimizes productivity but also employees’ working conditions and health as prerequisites for sustainable performance.
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