On SAGE Insight: Casting the lean spell: The promotion, dilution and erosion of lean management in the NHS

From Human Relations

Lean manufacturing (or ‘lean’) is one of the world’s most influential management ideas. Champions such as high-profile gurus argue that lean principles are appropriate to all kinds of organization in both the public and private sectors. This is a study of the introduction of lean in a large UK public sector NHS hospital. Based on a three-year ethnographic study of how employees make sense of lean ‘adoption’, auth0rs describe a process in which lean ideas were initially championed, later diluted and ultimately eroded. Authors suggest that the goal of some kind of lean revolution – of a wholesale lean ‘system-level’ adoption –is unrealistic for both the sellers and buyers of lean, and that there remains considerable value in revisiting the concept of the ‘fad life cycle’ in an effort to understand the contested reality of lean adoption in public sector settings.

Abstract

Lean thinking has recently re-emerged as a fashionable management philosophy, especially in public services. A prescriptive or mainstream literature suggests that lean is rapidly diffusing into public sector environments, providing a much-needed rethink of traditional ways of working and stimulating performance improvements. Our study of the introduction of lean in a large UK public sector hospital challenges this argument. Based on a three-year ethnographic study of how employees make sense of lean ‘adoption’, we describe a process in which lean ideas were initially championed, later diluted and ultimately eroded. While initially functioning as a ‘mechanism of hope’ around which legitimacy could be generated for tackling longstanding work problems, over time both ‘sellers’ and ‘buyers’ of the concept mobilized lean in ambiguous ways, to the extent that the notion was rendered somewhat meaningless. Ultimately, our analysis rejects current prescriptive or managerialist discourses on lean while offering support for prior positions that would explain such management fashions in terms of the ‘life cycle of a fad’.

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Article details

Leo McCann, John S Hassard, Edward Granter, and Paula J Hyde
Casting the lean spell: The promotion, dilution and erosion of lean management in the NHS
Human Relations October 2015 68: 1557-1577, first published on April 8, 2015 doi:10.1177/0018726714561697

 

 

     
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