Lean Leadership – ein zukunftsorientiertes pflegerisches Führungsmodell? - Ein Aktionsforschungsprojekt in einer psychiatrischen Universitätsklinik

Background
Psychiatry is confronted with the challenge to combine its humanistic values with economic responsibility and to integrate intrapreneurship as well as user orientation into its self-understanding to greater degree than previously. In this context, the Lean Management approach becomes relevant. Numerous studies revealed that leadership is of outstanding importance for implementing Lean Management in hospitals. Against this background, the current study determined the effect of ward managersˊ Lean Leadership behavior in the nursing service of the Psychiatric University Hospital Zurich. The project focused on three Lean Leadership concepts: Huddle Board, Leadership Gemba and KATA-Coaching.
Research Questions
What is the connection between the implementation of Lean Leadership concepts and Transformational Leadership behavior among ward managers in psychiatric care?
What is the connection between the implementation of Lean Leadership concepts in psychiatric nursing teams and their Shared Leadership behavior?
How do ward managers and their teams evaluate the Lean Leadership concepts?
What are the key success factors and barriers concerning the implementation of Lean Leadership concepts?
Methods
This pilot study used an action research method with quasi-experimental design. Leadership behavior was measured by means of the Transformational Leadership Inventory (N168) and the Shared Professional Leadership Inventory for Teams (N164) on 14 nursing wards with 17 managers including a pre- and follow-up measurement after six months. The control group consisted of three wards.
On the basis of a systematic literature research, Lean Leadership concepts were trained during three days. Afterwards, a focus group interview was conducted with 25 of 42 (59.5%) participants. Qualitative data contributed to the interpretation of quantitative results.
Findings
Implementing the Lean Leadership concepts resulted in a slight increase between baseline and secondline measurements. Participants rated Lean Leadership concepts as positive and very profitable. Among the success factors for Lean Leadership implementation were integration into the hospital strategy, operationalization of measurable goals and management support.
Discussion
Lean leadership requires a long-term cultural change implying to listen to employees΄ voices. It is a promising model for nursing under the challenging conditions of the healthcare setting.