Cumulative capabilities in health care
Eventually, a balanced lean approach may lead to a situation
where fewer trade-offs need to be made. This requires
measures that describe both operational and sociotechnical
effects of an intervention and their outcomes. This is only
partially the case in current reports on lean in health care. At
present, most papers seem to report operational improvements
[16, 17, 36]. Less frequently, papers report on better
outcomes, like health adjusted mortality [3]. Some report, in
general terms, about sociotechnical improvements [36].
None, however, has clearly reported on all these aspects
together or on cumulative capabilities