Leadership, a key element of quality improvement in healthcare. Results from a literature review of “Lean Healthcare” and the Productive Ward

Purpose – This paper reviews the Lean Healthcare and ProductiveWard: releasing time to care (RTC) literature and extracts the reported effects and impacts experienced by employees who implement it. The purpose of this paper is to identify and investigate the strength of the connection between the two models and explores the implications for leadership and implementation. Design/methodology/approach – This study reviewed the Lean Healthcare and Productive Ward: RTC literature using strict systematic inclusion criteria. A qualitative content analysis was used to identify key characteristics of reported employee experience, effect or impact. Themes and categories were ranked by the number of citations and presented. Findings – This study outlines the similar employee effects and impacts that exist between Lean-type improvement initiatives and the Productive Ward: RTC programme. It discusses the three top themes of: Empowerment, Leadership and Engagement and explores the opportunities for leadership. It also identifies one key difference between the two initiatives, the socio-cultural effect and impact which is strongly reported with Lean-type improvement initiatives. The socio-cultural element is discussed and presented as one of the fundamental aspects of Lean and the original Toyota production system. Originality/value – This study brings new insights for leaders involved in Lean-type improvement initiatives which are currently being imported into healthcare and provides a comprehensive list of reported employee impacts and effects of value to healthcare leaders attempting to establish an environment and culture of improvement. Keywords Leadership, Employee engagement, Quality improvement, Empowerment, Productive Ward, Releasing time to care