Case 1.1 Hospitals Are Driving toward A Leaner Organization

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Case Study 1.1

I believe that Open Systems Perspective and Organizational Learning Perspective of organizational effectiveness best describes the application of lean management practices. The Open Systems Perspective recalls an effective organization, which maintains a close “fit” with changing conditions, or transforms inputs to outputs efficiently and flexibly. The practices in the case is literally following that: this management involves finding ways to reduce and remove waste from work processes. Meanwhile, the involvement of the employees in those processes fits the Organizational Learning Perspective as well, as they learn to map out, identify and discover different ways to achieve that goal in the Open Systems Perspective. They overcome the initial resistance and skepticism, and succeed in making the hospital a more effective organization. Now most of the hospitals that have applied lean management have shorter patient waiting time and faster sent-to-surgery time.

I think it ignores the High-Performance Practices Perspective and the Stakeholder Perspective. For the High-Performance Practices Perspective, take one of the chief doctor as an example. He might think one of the patients who is not that injured should be somehow admitted, and he will operate the surgery “off-script”. However, during the operation another patient is sent in while the second team (as in the case study says there will be) is not available, and later causes the patient’s death. That is a risk the management level do not wish to see. For the Stakeholders, I think their priority interest is not efficiency but whether that efficiency can raise the income of the hospitals. So, even if the hospital can help more patients in the same period, it might still suffer a loss in income, for example, the more frequent use of operational tools, medicine, occupied beds, etc.

The lean management system relays on the employees, not the management level or the stakeholder...
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