A lean healthcare journey: The Scottish experience

For several years now,public sector organisations (PSOs) across the globe have looked to the manufacturing sector for improvement methodologies to combat the growing challenges in tackling demand, capacity, service provision and issues around the reduction of errors and managing variation in processes (Marshall, 2009).Nowhere is this more apparent than in the provision of healthcare, where the lean methodology has gained popularity in its application (Pedersen and Huniche, 2011;Graban, 2009; Fillingham, 2008; Ben-Tovim et al., 2007). The aim of this chapter is to discuss the development of lean in public sector

organisations with particular reference to healthcare.These insights are explored through the drivers for and the process of how lean is implemented in Trust A (a Scottish Health Board and ‘early adopter’ of lean). It will also be discussed whether this does include a focus on the ‘softer’ critical areas of cultural change, leadership support and people.The outcomes generated and sustained in their lean projects will be evaluated.The format of this chapter is as follows; initially we will discuss the application of lean in PSOs with a focus on healthcare; next the methodology employed is introduced. Following on, the drivers for, the process of implementation and outcomes, including what has been sustained or further developed from lean are discussed inTrustA.The chapter will conclude by discussing the implications of how lean is being implemented and transferrable insights which may apply for other PSOs.