Although operations management methodologies have gained traction in healthcare improvement, inherent complexities hinder system-wide Lean success by limiting sociocultural transformation. While the role of a facilitator in propagating Lean thinking is conceptualised, it lacks empirical validation. This study explores how a Daily Management System (DMS) institutionalises Lean thinking in healthcare through operational and sociocultural improvements.
Guided by Organisational Learning theory, the study employs a qualitative case study and abductive approach, analysing 37 interviews across 14 public hospitals in Australia. Observations and secondary data further contextualise how DMS embeds Lean thinking within hospital operations.
DMS functions beyond a Lean tool by establishing improvement-oriented routines, operational habits, and collaborative practices. These mechanisms foster continuous improvement through structured problem-solving, transparency, decentralised accountability, and leadership engagement. Empirical evidence demonstrates that DMS addresses key challenges, such as professional silos and resistance to change, enabling collaboration and system-wide learning.
The findings suggest that healthcare administrators customise DMS to meet operational needs, promote staff engagement, and allocate resources to sustain Lean adoption. These insights offer practical guidance with applicability across other complex sectors facing similar Lean transformation challenges.
The study introduces DMS as a critical facilitator for Lean implementation, providing empirical evidence of its role in building internal absorptive capacity. It contributes to Organisational Learning theory by demonstrating how DMS institutionalises Lean thinking through embedded routines, habits, and collaboration, driving operational and cultural transformation. A conceptual framework illustrates these processes in complex service environments.
