Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare context
Abstract Background Lean management is growing in popularity in the healthcare sector worldwide, yet healthcare organizations are struggling with assessing the maturity of their Lean implementation and monitoring its change over time. Most existing methods for such assessments are time consuming, re...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-021-07322-2 |
| _version_ | 1818833972571930624 |
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| author | Elina Reponen Ritva Jokela Janet C. Blodgett Thomas G. Rundall Stephen M. Shortell Mikko Nuutinen Noora Skants Markku Mäkijärvi Paulus Torkki |
| author_facet | Elina Reponen Ritva Jokela Janet C. Blodgett Thomas G. Rundall Stephen M. Shortell Mikko Nuutinen Noora Skants Markku Mäkijärvi Paulus Torkki |
| author_sort | Elina Reponen |
| collection | DOAJ |
| description | Abstract Background Lean management is growing in popularity in the healthcare sector worldwide, yet healthcare organizations are struggling with assessing the maturity of their Lean implementation and monitoring its change over time. Most existing methods for such assessments are time consuming, require site visits by external consultants, and lack frontline involvement. The original Lean Healthcare Implementation Self-Assessment Instrument (LHISI) was developed by the Center for Lean Engagement and Research (CLEAR), University of California, Berkeley as a Lean principles-based survey instrument that avoids the above problems. We validated the original LHISI in the context of Finnish healthcare. Methods The original HISI survey was sent over a secure organizational email system to the over 26,000 employees of the Hospital District of Helsinki and Uusimaa in March 2020. The data were randomly split with one part used to carry out an exploratory factor analysis (EFA), and the other for testing the resulting model using confirmatory factor analysis (CFA). Results A total of 6073 employees responded to the LHISI survey, for an overall response rate of 23%. The results indicated that the 43 items used in the original LHISI can be reduced to 25 items, and these items measure a five-dimensional model of the progress of Lean implementation: leadership, commitment, standard work, communication, and daily management system. In comparison with a single-factor model, the fit measures for the 5-factor model were better: smaller X2, larger comparative fit index (CFI), smaller root mean square error of approximation (RMSEA), and smaller standardized root mean square residual (SRMR). Conclusions The 25 item LHISI is valid and feasible to use in the context of Finnish healthcare. The LHISI allows the organization to self-monitor the progress of its Lean implementation and provides the leadership with actionable knowledge to guide the path towards Lean maturity across the organization. Our findings encourage further studies on the adoption and validation of the LHISI in healthcare organizations worldwide. |
| first_indexed | 2024-12-19T02:27:25Z |
| format | Article |
| id | doaj.art-5dcb396894b84a8495b2aac10779eca2 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-19T02:27:25Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-5dcb396894b84a8495b2aac10779eca22022-12-21T20:39:52ZengBMCBMC Health Services Research1472-69632021-12-012111910.1186/s12913-021-07322-2Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare contextElina Reponen0Ritva Jokela1Janet C. Blodgett2Thomas G. Rundall3Stephen M. Shortell4Mikko Nuutinen5Noora Skants6Markku Mäkijärvi7Paulus Torkki8Center for Lean Engagement and Research in Healthcare, School of Public Health, University of CaliforniaHUS Helsinki University HospitalCenter for Lean Engagement and Research in Healthcare, School of Public Health, University of CaliforniaCenter for Lean Engagement and Research in Healthcare, School of Public Health, University of CaliforniaCenter for Lean Engagement and Research in Healthcare, School of Public Health, University of CaliforniaHaartman Institute, University of HelsinkiHUS Helsinki University HospitalHUS Helsinki University HospitalDepartment of Public Health, University of HelsinkiAbstract Background Lean management is growing in popularity in the healthcare sector worldwide, yet healthcare organizations are struggling with assessing the maturity of their Lean implementation and monitoring its change over time. Most existing methods for such assessments are time consuming, require site visits by external consultants, and lack frontline involvement. The original Lean Healthcare Implementation Self-Assessment Instrument (LHISI) was developed by the Center for Lean Engagement and Research (CLEAR), University of California, Berkeley as a Lean principles-based survey instrument that avoids the above problems. We validated the original LHISI in the context of Finnish healthcare. Methods The original HISI survey was sent over a secure organizational email system to the over 26,000 employees of the Hospital District of Helsinki and Uusimaa in March 2020. The data were randomly split with one part used to carry out an exploratory factor analysis (EFA), and the other for testing the resulting model using confirmatory factor analysis (CFA). Results A total of 6073 employees responded to the LHISI survey, for an overall response rate of 23%. The results indicated that the 43 items used in the original LHISI can be reduced to 25 items, and these items measure a five-dimensional model of the progress of Lean implementation: leadership, commitment, standard work, communication, and daily management system. In comparison with a single-factor model, the fit measures for the 5-factor model were better: smaller X2, larger comparative fit index (CFI), smaller root mean square error of approximation (RMSEA), and smaller standardized root mean square residual (SRMR). Conclusions The 25 item LHISI is valid and feasible to use in the context of Finnish healthcare. The LHISI allows the organization to self-monitor the progress of its Lean implementation and provides the leadership with actionable knowledge to guide the path towards Lean maturity across the organization. Our findings encourage further studies on the adoption and validation of the LHISI in healthcare organizations worldwide.https://doi.org/10.1186/s12913-021-07322-2Lean healthcareLean managementLean implementationSelf-assessment instrumentLean maturity assessment |
| spellingShingle | Elina Reponen Ritva Jokela Janet C. Blodgett Thomas G. Rundall Stephen M. Shortell Mikko Nuutinen Noora Skants Markku Mäkijärvi Paulus Torkki Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare context BMC Health Services Research Lean healthcare Lean management Lean implementation Self-assessment instrument Lean maturity assessment |
| title | Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare context |
| title_full | Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare context |
| title_fullStr | Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare context |
| title_full_unstemmed | Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare context |
| title_short | Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the finnish healthcare context |
| title_sort | validation of the lean healthcare implementation self assessment instrument lhisi in the finnish healthcare context |
| topic | Lean healthcare Lean management Lean implementation Self-assessment instrument Lean maturity assessment |
| url | https://doi.org/10.1186/s12913-021-07322-2 |
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