Like a Swiss watch? : measuring the effects of a lean implementation at Bern university hospital

Background: Since Lean management found its way into the healthcare system several years ago, many hospitals have started to implement the Lean management philosophy in their work environments. However, although Lean implementation requires an extensive amount of resources, its effects on hospital key performance indicators (KPIs) are largely unknown because very few hospitals conduct measurements during the implementation process to quantify the effects of such interventions. Aim: To quantify the effects of Lean implementation in a department of Bern University Hospital in Switzerland regarding financial, human, and process factors. Data and Method: The data were collected during two measurement phases before and after the implementation of a Lean approach in March/April 2017 and October/November 2018. Data resources were the hospital’s IT systems as well as an employee satisfaction survey and process measurements. The data were analyzed using IBM SPSS. Results: No significant differences were found between pre- and post-assessment in terms of the controlling data assessed. Number of interruptions and walking distance assessed in onsite observations decreased. Employee satisfaction decreased, with significant differences for some items. While the proportions of the different tasks in the working processes varied, the amount of time spent with patients remained almost unchanged. Patient satisfaction remained at a high level. Contribution to Public Management: Lean implementation is a strategy to address financial pressure in hospitals by creating a more efficient work environment. Our study offers new insights into the effects of Lean implementation on hospital KPIs. We developed a framework to evaluate Lean projects. In addition, we identified obstacles that could reduce the effects of the Lean implementation we evaluated and make recommendations on how to make future projects more effective. In this context, the project supports activities combatting the rise in global healthcare costs