Key findings and observations from our study
| Main variables in our study | Key findings and observations |
|---|---|
| 1. Lean management implementation | *Although the lean initiative was driven by the CEO and management, there was resistance from medical clinicians and hybrids towards lean implementation |
| *There was an observed “us” versus “them” dynamic, whereby hybrids and clinical staff were framed by management as resistant to the Lean management intervention prior to the commencement of the initiative | |
| *Issues around training sessions (e.g. inconsistency, lack of time and quality) were observed by medical clinicians and hybrids | |
| *Non-clinical managers controlled and hindered the opportunities of hybrids pertaining to Lean training, etc. | |
| 2. ED hybrids’ positive approach | *Negotiations in relation to contractual arrangements and sub-organisational context contributed to an enhanced lean implementation process. |
| *The ED served as an organisational sub-context in which ED hybrids were long-term employees of the hospital, who saw themselves as integral to the functioning of the overall hospital. In this case, the implementation of Lean faced little resistance and ED hybrids were committed participants in the implementation process and included in regular Lean meetings | |
| 2.1 ED-Identity reconciliation | *Identity reconciliation practices contributed to proactive lean implementation process via quality improvement and quality of patient care |
| 2.2 ED-Identity regulation | *Soft form of identity regulation contributed to ED implementation of lean due to regulatory effect |
| 3. Hybrid visiting medical officer (VMO) | *Hybrid VMOs experienced lack of voice related to the implementation of lean management. This can be attributed to their status as “outsiders” due to their “visiting” occupation |
| *Hybrid VMOs were distanced from the hospital and excluded from the implementation of lean management |
| Main variables in our study | Key findings and observations |
|---|---|
| 1. Lean management implementation | *Although the lean initiative was driven by the CEO and management, there was resistance from medical clinicians and hybrids towards lean implementation |
| *There was an observed “us” versus “them” dynamic, whereby hybrids and clinical staff were framed by management as resistant to the Lean management intervention prior to the commencement of the initiative | |
| *Issues around training sessions (e.g. inconsistency, lack of time and quality) were observed by medical clinicians and hybrids | |
| *Non-clinical managers controlled and hindered the opportunities of hybrids pertaining to Lean training, etc. | |
| 2. ED hybrids’ positive approach | *Negotiations in relation to contractual arrangements and sub-organisational context contributed to an enhanced lean implementation process. |
| *The ED served as an organisational sub-context in which ED hybrids were long-term employees of the hospital, who saw themselves as integral to the functioning of the overall hospital. In this case, the implementation of Lean faced little resistance and ED hybrids were committed participants in the implementation process and included in regular Lean meetings | |
| 2.1 ED-Identity reconciliation | *Identity reconciliation practices contributed to proactive lean implementation process via quality improvement and quality of patient care |
| 2.2 ED-Identity regulation | *Soft form of identity regulation contributed to ED implementation of lean due to regulatory effect |
| 3. Hybrid visiting medical officer (VMO) | *Hybrid VMOs experienced lack of voice related to the implementation of lean management. This can be attributed to their status as “outsiders” due to their “visiting” occupation |
| *Hybrid VMOs were distanced from the hospital and excluded from the implementation of lean management |
Source(s): Authors’ work
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