Integrating Lean Thinking and Implementation Science Determinants Checklists for Quality Improvement: A Scoping Review

Abstract

It is not known how often lean tools and implementation determinants frameworks or checklists are used concurrently in health care quality improvement activities. The authors systematically reviewed the literature for studies that used a lean tool along with an implementation science determinants framework (January 1999 through August 2018). Seven studies (8 publications) were identified, inclusive of 2 protocols and 6 research articles across multiple continents. All included studies used the consolidated framework for implementation research as their implementation science determinants framework. Lean tools included in more than 1 publication were process mapping (4 publications), process redesign (3 publications), and 5S standardization (2 publications). Only 1 study proposed using a lean tool concurrently with an implementation science determinants framework in the design and execution of the QI project. Few published studies utilize both an implementation science determinants framework or checklist and 1 or more lean tool in their study design.

Keywords: implementation science; lean; quality improvement.

Figure 1.

PRISMA flowchart for study inclusion.

Figure 2.

A3 template for quality improvement work: This figure integrates implementation science determinants frameworks and checklists into the “Analysis,” “Recommendations,” and “Plan” sections of a typical lean A3 template.