Transforming Healthcare with Lean: Hospital-wide Change, Dynamic Capabilities, and Relational Coordination

Hospitals face growing challenges, including increasing patient demand, financial constraints, and workforce shortages. To address these, Lean management has emerged as a promising approach. However, its implementation in healthcare remains fragmented, often limited to isolated improvement initiatives rather than a hospital-wide system. My PhD research investigates how Lean can be implemented as a comprehensive management system in academic hospitals to foster continuous improvement and learning, ultimately enhancing performance.
The research consists of three interrelated studies:

1. Lean Implementation Strategies: The first study examines top-down and bottom-up Lean implementation approaches. It proposes a hybrid implementation model that balances centralized planning with participatory learning processes, ensuring alignment across all hospital levels.
2. Developing Continuous Improvement as a Dynamic Capability: The second study conceptualizes continuous improvement as a dynamic capability, showing how Lean routines evolve into hospital-wide learning and adaptation mechanisms. A structured framework demonstrates how organizations can build sustainable improvement systems.
3. Lean and Relational Coordination: The third study explores how different Lean learning stages influence relational coordination (RC) and, in turn, hospital performance. Findings highlight the necessity of a shared Lean infrastructure—daily stand-ups, Gemba walks, Kaizen events—to bridge organizational silos and enhance coordination.

This research underscores that Lean is not merely a set of process optimization tools but a holistic system integrating technical and relational elements. By embedding Lean as a learning system, hospitals can systematically improve quality, collaboration, and adaptability, ensuring sustainable healthcare transformation.