How to increase value and reduce waste in research: initial experiences of applying Lean thinking and visual management in research leadership.

Waste in research has been well documented, but initiatives to reduce it are scarce. Here, we share our initial experiences of implementing Lean thinking and visual management into hospital research units in the Region of Southern Denmark. A Transformation Guiding Team (TGT) anchored in the top management was established with participation from leaders, researchers and patient representatives. The role of the TGT was to implement Lean methods, considering patients as primary end-users of the research results. This is in line with an explicit decision on setting patient values first in clinical settings at participating hospitals. The leaders of the research units were instructed in Lean thinking and Lean methods during a five-module course focusing on increasing value and reducing waste in research production. Initial experiences were that Lean tools could create a patient-centred vision that through visual management could identify waste in work processes. Concerns were lack of evidence for using Lean methods in research leadership and that the model itself could be a time consumer. Some lessons learnt were that adding Lean tools in research leadership should not just provide increased research productivity, but also improve other important key performance indicators such as quality of research and patient-relevant results. We intend to evaluate the value of the initiative by follow-up research and publish the outcome of key behavioural and key performance indicators.

[Waiting time for treatment shall be calculated correctly]. / Ventetid på behandling skal beregnes korrekt.

Every system is perfectly designed to achieve the results it gets and in the Danish health care system there is a significant waiting time for the patients. If we want this result to change, we have to change something in the system, but before we do that, we need to understand the system. With queuing theory as a frame of reference, the anatomy and physiology of waiting time is illuminated in order to bring additional knowledge into the design of systems in health care.