Through the presentation of rich data across 3 case
studies this paper has explored findings in relation to a
set of propositions leading to the development of a
framework which aims to link the approach of Lean, the
conditions of readiness and sustainability of Lean for
health care. The typology within the framework
indicates how an organisation can develop from a
bureaucratic approach to Lean implementation to
generative through either being proactive or creating a
greater understanding. It could aid organisations in
situating themselves on the Lean journey by not only
considering the tools and approach they are using but
also the degree to which the culture and behavioural
aspects of the organisation are changing through the
engagement in of the organisational readiness factors
or practices.
Therefore, the framework could be used for other public
services by managers and change agents implementing
Lean. In terms of theory the framework and this paper
attempts to start to draw together knowledge and
frameworks from organisational design and theory and,
change management to understand Lean
Implementation in a context which it what not designed
for. Previous research (Radnor et al, [12] 2011) has
shown that, particularly in healthcare, Lean in context
dependent – not in terms of manufacturing to service
but private to public. In order to understand how Lean
can be adapted it is important to consider not only the
structural, mechanistic or tools of Lean but also the
infrastructure, behavioural or cultural elements.