Implementing Lean-Led Hospital Design: Lessons gained at a pioneer

Purpose: Documenting and analyzing experiences with building a new hospital guided by Lean-led Hospital Design (LLHD) (Grunden and Hagood, 2012), and investigating key mechanisms enhancing healthcare professionals’ participation and collaboration in implementing this innovative approach.
Design/methodology/approach: An in-depth case study of the implementation of LLHD in a Dutch hospital was performed based on multiple data sources. The case hospital presented a unique opportunity since there was embedded access to the data by the first author.
Findings: Three mechanisms supporting participation and collaboration of staff for implementing LLHD were identified. 1) Freedom in translating a concept enables managers to balance it with variations in practice at the organizational level. 2) A set of key principles governing the design process appeared an important anchor on a managerial level in a changing environment. 3) To create a supportive attitude towards lean and lean facility design, with co-creation as a key element of LLHD.
Practical implications: By using the emerging mechanisms, managers/change agents can enlarge collaboration and participation of hospital staff when implementing organization-wide innovations.
Originality/value: This case study delivers a unique inside view on the dynamics evolving in the complex change processes at organizational, managerial and personal levels involved in implementing LLHD.