Lean, agile and leagile healthcare management – A case of chronic care

Leagility in the healthcare research: a systematic review

BACKGROUND

Expenditure of healthcare services has been growing over the past decades. Lean and agile are two popular paradigms that could potentially contain cost and improve proficiency of the healthcare system. However no systematic review was found on leagilty in the healthcare research. This study aims at synthesizing the extant literature of leagility in the healthcare area to consolidate its potential and identify research gaps for future study in the field.

METHODS

A systematic literature review is conducted following the PRISMA checklist approach. Studies were searched in multiple databases. The selection of articles was executed by dual-scanning of two researchers to ensure quality of data and relevance to the topic. Scientific articles published between January 1999 and November 2023 concerning leagile healthcare are analysed using Microsoft Excel and VOSviewer (version 1.6.18).

RESULTS

Out of 270 articles identified from the inclusion and exclusion criteria, 24 were included in the review. A total of 11 target areas were identified in leagility applications in healthcare. Success and limiting factors of leagile healthcare were classified into macro and micro aspects and further categorized into six dimensions: policy, organization, human resources, marketing, operation management and technology. Moreover, four research gaps were revealed and suggestions were provided for future study.

CONCLUSION

Leagility in the healthcare context is still being in its infancy. Few empirical validation was found in leagile healthcare literature. Further exploration into the application of theory in various sectors under the scope of healthcare is appealed for. Standardization and modularization, leadership support, skillfulness of professionals and staff training are the factors most frequently mentioned for a successful implementation of leagility in the healthcare sector.

Exploring the use of operational excellence methodologies in the era of COVID-19: perspectives from leading academics and practitioners

Purpose

This paper aims to present the results of a study carried out by the authors in the form of research interviews on the topic: “Exploring the use of operational excellence methodologies in the era of COVID-19.”

Design/methodology/approach

A qualitative interview approach was utilized by interviewing a panel of leading academics and practitioners who are familiar with operation excellence methodologies.

Findings

Operational excellence methodologies are proven and can be utilized in pandemic situations to improve efficiency in the healthcare system and preparedness for pandemics.

Research limitations/implications

One limitation of this research was that most of the interviewees who participated in this study came from Europe, North America, South America and Asia, representing four continents. It would have been better to have different views from other continents such as Australia and Africa. Also, the interviews were short and at a high level. There is an opportunity for further study and analysis.

Practical implications

Operational excellence methodologies are proven and can be utilized in pandemic situations to improve efficiency in the healthcare system and preparedness for pandemics.

Originality/value

The paper provides an excellent resource for those people to get an insight into the value of the application of operations excellence methodologies in pandemic situations to aid healthcare process improvement and aid public and patient safety.

Increasing Competitiveness through the Implementation of Lean Management in Healthcare

The main aim of this paper was two-fold: first, to design a participative methodology that facilitates lean management implementation in healthcare by adopting the action research approach; second, to illustrate the usefulness of this methodology by applying it to the sleep unit of a public hospital in Spain. This methodology proposes the implementation of lean management in its broadest sense: adopting both lean principles and some of its practical tools or practices in order to achieve competitive advantage. The complete service value chain was considered when introducing changes through lean management implementation. This implementation involved training and involving staff in the project (personnel pillar), detecting and analysing “waste” in value chain processes (processes pillar) and establishing control and measurement mechanisms in line with objectives (key performance indicators pillar) and putting in place improvement actions to achieve these objectives. The application of this methodology brought about an improvement in the management of patient flow in terms of effectiveness, efficiency and quality but also an internal transformation towards lean culture.

Exploring value-dense environment in the healthcare service delivery

Purpose

The purpose of this paper is to explore the antecedents and consequences of a value-dense environment in healthcare service delivery.

Design/methodology/approach

A structural model was developed based on a literature review. Circulation of a 31-indicator questionnaire among service receivers in the healthcare system across India generated 279 valid responses. The research model was assessed using a cross-sectional research design, and the data were analyzed by partial least squares-structural equation modeling.

Findings

Integrated supply chain performance (ISCP), internal service quality (ISQ) and coordinated care are antecedents of a value-dense environment, which drives patient-centricity. The leagile supply chain strategy strengthens the relationship between ISCP and coordinated care. Employee trust and commitment acts as a moderator between coordinated care and ISQ.

Research limitations/implications

By adopting the perspective of service receivers, this paper highlights the influence of value-density on patient-centricity in healthcare organizations. Future research should include healthcare professionals’ perceptions of value-dense environment creation.

Practical implications

The study provides suggestions to practitioners for designing patient-centric healthcare services by leveraging ISCP, coordinated care and ISQ in the value-creation process. Recognizing the relationships among these constructs can aid the timely formulation of corrective actions and future policies.

Social implications

This study underscores patient-centric care as a basis for effectively delivering healthcare as a social good.

Originality/value

This paper contributes to the body of knowledge by identifying and empirically validating the relationships between patient-centricity and value co-creation.