| Primary Author: | Shelia Roszell, MSN, RN, BC |
| Co-Principal Investigators/Collaborators: | Mary Lynn, PhD, Lukasz Mazur, PhD |
| Organization | University of North Carolina School of Nursing |
Abstract
Purpose
The ultimate purpose of the study is to develop and test an instrument to measure the penetration of lean improvement thinking in nurses working as front line caregivers in hospital patient care units. The first two phases identified what constitutes lean improvement thinking on a nursing unit. The purpose of the upcoming third phase is to test the measure on a large sample of nurses to assess its psychometric properties.
Background
Lean management, based on the Toyota Production System, is an organizational approach to diffusing improvement thinking from leadership to the frontline. Lean methodology teaches the individual who works with a process to apply the scientific method to improve work flow design. The literature has not clearly demonstrated that lean management in hospitals improves the quality of care delivered to the patients by nurses. Diffusion of Innovations theory suggests this may reflect the fact that organizations have differing degrees of innovation, i.e. lean penetration.
Materials & Methods
The measure development consisted of three phases. In the first phase, a panel of lean healthcare experts gave feedback to questions using an online survey format. In Phase 2, panels of nurses familiar with lean improvement methods rated the survey for construct validity, formatting and on-line characteristics. Phase 3 will survey 200 nurses to assess the psychometric properties of the instrument.
Results
Elements that make up lean or improvement thinking included mindset for improvement, elimination of waste, process identification and design, value to the patient and patient focus as well as attitudes about the cultural climate in the unit and organization.
Conclusion
With a valid and reliable measurement of the degree of lean improvement thinking the relationship of lean management to outcomes can be assessed. Hospital units that use lean management methods can be more accurately compared. Measuring improvement thinking will help leadership know how their improvement program is reaching the frontline of care.
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© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).