From cars to care : A literature study of the diffusion of Lean from Toyota to the Norwegian hospital setting

Abstract

Background: During the past 10 years, Norwegian hospitals has subjected to frequent organizational changes. One organizational method or idea that is currently diffusing in the Norwegian hospital setting is the Lean philosophy and method. This method is a tool that can be applied to change the way that hospitals are organized. Lean is a production and operations management philosophy developed by the Japanese car manufacturer Toyota, and thus its principles comes from the manufacturing sphere. Further, as Lean has diffused into the Norwegian hospital setting, there has been identified a scarcity of studies on its trajectory. There is a lack of studies, which focuses on Lean’s trajectory and diffusion from Toyota to the Norwegian hospital setting.

Objective: To map the diffusion of the Lean philosophy and method from Toyota into the Norwegian hospital sector. Further, this thesis also seeks to undertake a theoretical analysis and discussion of Lean’s fit with the hospital setting. Method: The study is based on the qualitative methods of literature and document study of both primary and secondary sources. Sources used were those that were publicly available either online or in the form of books.

Results: Lean was found to be used across the Norwegian hospital sector, with the University Hospital of North Norway (UNN) aiming to become a fully Lean hospital. Before the period of 2010-2011 there were only a few smaller Lean projects in addition to the one at UNN, however more have followed during that period with two new Lean hospitals being planned. This point implies that Lean is starting to become a myth in the Norwegian hospital setting. Regarding the issue of Lean’s fit to the hospital setting, it has been found that there is a mismatch between the manufacturing and professional organizational types

Conclusion: The diffusion process of lean has through this thesis been identified to have taken the pathway from Toyota, through both the American and Danish hospital setting before entering the Norwegian setting in 2007. For the fit of Lean to the hospital setting, the view has been found to be divided and somewhat problematic. Thus, Leans fit would depend on whose eyes one sees through, as the method already shares some properties with the health care professionals work culture.