Syftet med undersökningen är att öka kunskapen om leankonceptet och undersöka upplevelser av ett genomfört leanarbete inom hälso- och sjukvård. Frågeställningarna som undersöks är: Varför används leankonceptet på Skånes Universitetssjukhus och hur tillämpas leankonceptet vid universitetssjukhuset? Hur beskriver medarbetarna på en vårdavdelning att de upplever resultatet med att arbeta enligt leankonceptet? Undersökningen har en kvalitativ ansats. Undersökningsgruppen består av sjuksköterskor, undersköterskor och personer med dels ledningsansvar, dels arbetar med support i frågor som rör lean. Med hjälp av sju semistrukturerade intervjuer erhålls en förståelse för de olika yrkesgruppernas tankar och uppfattningar när det gäller hur deras arbete påverkas av att arbetet vid vårdavdelningen organiseras efter värderingar, principer och verktyg knutna till det modifierade leankonceptet Lean Health Care. Samtliga respondenter upplever att när de arbetar enligt leankonceptet, och då speciellt med ständiga förbättringar (kaizen), blir det dagliga arbetet mer effektivt genom att planeringen underlättas och blivit tydlig för alla. En avgörande faktor till förbättringarna är pulstavlan som också bidragit till att kommunikationen mellan olika yrkeskategorier ökat. Resultatet visar att det finns en stor samsyn mellan respondenterna om att leankonceptet passar väl in för verksamheter inom hälso- och sjukvård. Respondenterna upplever att det finns vissa hinder för att planera långsiktigt och ett långsiktigt tänkande är en av grundstenarna inom konceptet. Ett exempel på sådana hinder är att förutsättningarna kan ändras genom att verksamheten är politiskt styrd.

The health care industry in the United States is increasingly pressured to improve safety and quality performance and increase revenue. In response, many health care institutions are moving to redesign their processes and practices in an effort to decrease costs and provide safer, higher quality, and more efficient care. The purpose of this paper is to document the Lean implementation strategy and progress in implementation at a large teaching health care organization undergoing Lean transformation in order to understand enterprise transformation strategies and the impact of leadership involvement on culture development and Lean implementation. Through direct observations and involvement and transformation activities, the methodology for Lean transformation and progress in implementation were documented and analyzed. The organization employed an outside consultant to assist with transformation activities, and underwent a three-pronged approach to implementation, which included model area development, team member problem solving training, and management-led problem solving activities. It was found that leadership involvement was lacking, especially at the highest levels, and the organization struggled to build the culture necessary to support transformation and develop an operational model area, though successes were realized in efforts to train employees in Toyota’s 8-Step Problem Solving method and in management-led problem solving activities.

Background: Swedish hospitals face intensified challenges due to elevated demands from patients, demographic changes and cost constraints. Furthermore, patient safety is negatively affected by the relatively high rate of health care associated infections (HAIs). Thus, enforced preventive measures have to be undertaken to improve medical institutions’ ability to provide a qualitative and safe health care. Hence, logistics and technology solutions are gaining presence in modern day medical institutions in order to deliver improved health care.  Purpose: The purpose of this study is to explore how a central automatic bed disinfection system could be implemented at a hospital, and investigate if this would improve the patient safety by minimiz-ing the health care associated infections while enhancing the working environment for health professionals.  Method: This study takes the form of an exploratory single case study through the investigation of a Swedish hospital. Qualitative data was compiled through semi-structured interviews and observations, which were analyzed inductively.  Conclusion: The findings reveal that introducing a central automatic bed disinfection system may improve patient safety and the working environment for health care personnel. Additionally, more consistent hygiene standards and improved cleaning quality result in an augmented minimization of bacteria, which as a consequence reduces transmissions of HAIs. Through the implementation of an automatic bed disinfection system, the cleaning capacity is increased, thus the supply of beds becomes more responsive, which indirectly affects the patient flow. By developing a sound logistics system through a flow perspective, a more effective bed management at the hospital is enabled, which optimizes the patient throughput. Moreover, cost efficiencies may be obtained through a more efficient qualitative health care.