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. 2019 Jan 24;19(1):66.
doi: 10.1186/s12913-019-3907-6.

Organizational issues for the lean success in China: exploring a change strategy for lean success

Tian Gao  1   2 , Bruce Gurd  3
Affiliations

Organizational issues for the lean success in China: exploring a change strategy for lean success

Tian Gao et al. BMC Health Serv Res. .

Abstract

Background: The purpose of this paper is to explore a change strategy for lean success in hospitals based on a comprehensive review of the Chinese literature.

Methods: The methodology is a systematic review of the Chinese literature which identified 212 case study papers about lean implementation. We did a thematic content analysis of the 212 papers.

Results: Lean applications in Chinese hospitals show significant increases and are mainly used in the fields of outpatient services, operating rooms, pharmacy and logistics. Most hospitals applied lean as a single project but some were beginning to use lean as a systemic path for improvement with an emphasis on lean and strategy. The main goals were to increase the operating efficiency and reduce operating costs. Patients were not central to lean applications. Chinese hospitals appear to lack a full understanding of lean. Four factors appear to be critical for lean success - organizational leadership, adequate technology, stakeholder involvement and individual and organizational benefits. The relationship of these factors changes over time.

Conclusions: This is the first paper to provide a comprehensive view of lean application in Chinese hospitals. The findings presented in this paper provide a systemic evidence to the application of lean in healthcare.

Keywords: Chinese hospital; Healthcare; Lean application; Systematic review.

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Conflict of interest statement

Ethics approval and consent to participate

The need for ethics approval of this study and informed consent, written or verbal, was obtained from all participants are deemed unnecessary according to national regulations --“The Reguation of Ethical Reviews of Biomedical Research Involving Human Subjects”. National Health and Family Planning Commission of the People’s Republic of China (NHFPC). The Reguation of Ethical Reviews of Biomedical Research Involving Human Subjects;2016.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The interaction of technological, social and organizational factors in hospital information technology innovation over time (adapted from Cresswell, K. and A. Sheikh, Organizational issues in the implementation and adoption of health information technology innovations: An interpretative review. International Journal of Medical Informatics. 2013; 82(5): 73–86)
Fig. 2
Fig. 2
Growth trend of published papers on lean in Chinese hospitals
Fig. 3
Fig. 3
Hospital size
Fig. 4
Fig. 4
The starting year of the use of lean
Fig. 5
Fig. 5
The outcomes of the lean implementation in Chine hospitals
See this image and copyright information in PMC

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