Lean principles can only take root in healthcare organizations characterized by an adaptive culture and highly engaged employees who are responsive to the changing needs of patients and other stakeholders. Building an organizational culture that is receptive to Lean thinking requires unwavering leadership commitment, respect for people, shared vision, effective communication, creating a sense of urgency, modeling of Lean principles, and positive reinforcement of desired behaviours. Lean thinking also involves taking ownership, robust planning and deployment processes, elimination of waste beyond departmental boundaries, continuous learning, active coaching, and innovation based on five basic Lean principles. These Lean principles, as defined by Womack and Jones (1996), are fully adaptable to hospitals, outpatient clinics, medical offices, and other healthcare organizations.
Organizational structure is one of the key enterprise environmental factors that can influence allocation of resources, coordination of tasks and overall approach to Lean implementation. There are many types of organizational structures including the traditional functional, divisional, matrix, composite, flat, and projectized structure. Each organizational structure comes with various advantages and disadvantages and may be appropriate in certain circumstances. However, matrix organization makes it easier to understand system interdependencies and interactions, focus improvement efforts on the entire value stream, resolve potentially conflicting priorities, and synchronize multiple functions and processes to achieve the goal of providing effective and efficient patient care.