An Investigation Into The Implementation Of Lean Strategies For Improving Health Care Operations In The United Arab States

Principles and strategies of Lean Management for healthcare

Title – An investigation into the implementation of Lean Strategies for improving Health Care Operations in The United Arab States. 

Academic aspect

The Lean Management method in healthcare consists of various principles and strategies to produce quality care to the patients in the hospitals. The main objective of this system is to focus on the needs and requirements of the patients by the involvement of employees and improve in a continuous manner. Health care operations consists of various functions of healthcare to provide quality services related to healthcare to all the patients. The principles of healthcare operations include providing patient-centered care and develop different strategies to reduce long duration of waiting and queues of patients to visit the health care professional. They also focus on creating innovative solutions with the help of other healthcare organizations to provide value services to the customer at affordable rates. The healthcare organizations always strive for perfection and foster to improve continuously. 

The Lean Management Techniques have been identified as one of the most effective approaches utilized in the industry in order to improve the healthcare systems in the UAE. There is an urgent need in the UAE to improve the quality and during the monitoring of costs involved in providing proper care to the patients. There are various reasons to improve the efficiency of healthcare services in the UAE such as increase in population and innovative treatment methods, improved education of patients that might lead to an increase in the expenses involved in healthcare. The challenges involved with lean management are a lack of proper evidence in other hospitals  and expert professionals to provide quality services to patients It also requires various attributes such as  patience , leadership, and perseverance to improve the quality of the healthcare services in the United Arab Emirates. 

 The research aims to find out the factors that are essential for the successful implementation of the Lean Management Model in Public Hospitals in the UAE. Conversely, there is not sufficient research on its sustainability in the healthcare sector. It is one of the reasons which has been a prime motivator in the selection of this topic. The research work will follow The Data Protection Act 1990 and the infringement of same will be abstained. Collected data will only be used for academic purpose and in no situation the data will shared with any other individual or organization.

• To highlight the issues and the challenges involved in lean implementation in the healthcare operations in the UAE.
• To evaluate the policies, initiatives and impact of lean management in the UAE about lean management
• To evaluate the applicability of the practice from the organizations that adopted lean management in other healthcare organizations

Feasibility of the dissertation

Challenges and factors involved in implementing Lean Management in healthcare

In order to carry out the research, Sheikh Khalifa Medical City (SKMC) in Abu Dhabi is selected as it has already implemented the lean management system. A written permission letter from the higher authorities was taken and the data was collected through 4 healthcare managers of Sheikh Khalifa Medical City (SKMC).The pros and the cons of the lean system and the challenges this hospital has faced will be used in the study. The consent from the present organization was taken for the research. The findings obtained will be used in the examination of other hospitals to observe whether the same benefits and challenges can be applied to these hospitals. (Dul and Hak 2012).Between two data collections methods (qualitative and quantitative), qualitative data collection method will be used in this research. Interviews will be conducted with the 4 managers of Sheikh Khalifa Medical City (SKMC).Through the interview descriptive data will be collected which will allow to understand the impact of globalization on diversity management strategies of the organization (Morgan 2012). The responses collected from the managers of through interview, will be analyzed separately. The analysis will be done with the help of literature. Between probability and non probability sampling method, only non probability sampling method will be used in this research.

There has been a significant growth in the healthcare industry in the UAE in the recent years due to competition to increase the operations of manufacturing on a global level. According to a study conducted by Mena Research Partners proposed that the health care industry will observe a growth of 60% over the next five years. According to a report, the current value of the industry is 17 billion dollars and is expected to reach up to 28 billion dollars by the year 2021 (Younies et al. 2016). The primary factors facilitating the surge are stipulated as “rising needs for preventive care, increase in specialist medical services and high growth potential within specific medical device and pharmaceutical sub-sectors” (Dulaimi and Ellahham 2016).  There is a need by the organizations to use all its resources that are available in an effective and efficient manner which is referred to as lean management. Lean Management is a method that involves improvement that is continuous in nature and involves achievement of small positive changes to achieve the ultimate objective in an organization. It also includes changes in the thinking of the organization which results in positive changes in the culture, performance of operations and the behavior of the organization (Maasouman and Demirli 2016). It involves various principles observation of the value from the customer point of view, identification of the important steps in the process of business and elimination of steps that are not important, making sure that these steps occur in a sequential order and finally repletion of the previous steps in a continuous manner to achieve the goal (Malik 2016). It also plays an important role to reduce the costs involved in the organization and increase their share of profit in the market worldwide. It has been reported that a large number of organizations have adopted lean management practice to prevent extra transportation costs, delays and excess movement and processing.

The importance of Lean Management in the healthcare industry

The lean management system is an effective process that leads to increase in value and reducing the wastes. According to research around 40-50% of the waste is reported in healthcare services (Hussain and Malik 2016). It is an essential requirement that each and every employee in the organization give best efforts so that the lean management system can be implemented in a successful manner. It is not a technical process but a culture that is rooted deeply in an organization to improve the operations effectively and efficiently. Since the year 2000, there has been a large number of projects that have applied lean management strategies for the improvement of services given by health care organizations. A dutch hospital in the UAE has also implemented this practice to reduce the duration of reports obtained from a pathology lab for the patients (Tenali, Ganti and Taranikanth 2015). There are various other settings related to healthcare in the UAE who have reported a successful implementation of lean management practice. There are various requirements for the lean system to give positive results such as proper financial resources, engagement of each and every employee, active participation of higher authorities and active communication between them are important to bring about positive changes in the organization. Hospitals that have implemented lean management system have observed satisfaction of the employees and safety of the patients.  According to the Toyota model, it majorly focuses on how the resources are used effectively and emphasizes on the value that is increased for the customers in the entire process. There has been a little documentation on the barriers involved in the implementation of lean management system (Upadhye, Deshmukh and Garg 2016). Initially used by renowned automobile company, Toyota, lean management is now being employed by healthcare organizations to maximize value for patients whilst reducing wastes and waiting times. The usage of lean principles can also be witnessed across United States, United Kingdom, Australia, Canada, as well as the UAE. The UAE provides several opportunities for innovation (Askary, Kukunuru and Pech 2014). One of the initiatives undertaken by the government is to heighten the involvement of the private sector in the healthcare division. However, due to a large dependence of the UAE on oil and gas resources, funding is a key area of concern (Younies et al. 2016). Additionally, the overuse of healthcare services and gaps in quality across specialties has led to maximized costs with minimized efficiency has necessitated the formulation of strategies that are economical and ensure the appropriate use of resources for the welfare of the nation.

Successful implementation of Lean Management in healthcare organizations

In the context of UAE, a study conducted by researchers showcases lean management as a basis for influencing healthcare innovation. The integration of lean along with novel practices would promote the achievement of healthcare objectives. The external and internal elements driving the use of lean management have also been identified in the study. Two case studies involving the application of this method for dealing with emergency cardiovascular cases along with an outpatient pharmacy project suggested the accomplishment of safety goals which exceeded international benchmarks (Hussain, Malik and Al Neyadi 2016).A research on the use of process advancement procedures in the public sector illustrated that 51% of sourced publications concentrated on lean and 35% of the above aimed at lean in healthcare services (Yu Demirli and Bhuiyan 2015).Tangible benefits such as minimal errors, cost-reduction, diminished waiting times, along with intangible benefits such as improved employee motivation and customer satisfaction have been recorded. This serves as another in conducting further research on this subject matter.

Figure 2 Furterer (2004) conceptual model. 

The adoption of lean methods has activated and delivered a change in the industry that has reinforced many modernizations in healthcare projects. Lean management model has led to increase in the saving of time and improvement in the satisfaction of patient only if every individual is actively participates for the smooth running of the operational processes in a healthcare organization. Further research can prove to be valuable for the development of successful lean frameworks.

Hypothesis

H0- Lean management can not improve the quality of healthcare services

H1- Lean management improves the quality of healthcare services 

• What are the positive and the negative effects of lean management in the healthcare industry in the UAE?
• What can be learnt from the evidence on lean management that exists presently and the various methods that can be used in the evaluation of the impact?
• What are the various differences involved in the implementation of lean management and how these differences can lead to different impacts?

References

Askary, S., Kukunuru, S. and Pech, R.,  2014. An assessment of employee commitment to work among UAE nationals. International Journal of Business  Excellence, 7(1), pp.1-15,30 Oct 2014.

Dul, J. and Hak, T. 2012. Case Study Methodology in Business Research, 3rd ed. Oxford: Elsevier

Dulaimi, M. and Ellahham, S., 2016.Using Lean management to leverage innovation in healthcare projects: case study of a public hospital in the UAE. BMJ Innovations,5 January, 2016.

Ellis, T. and Levy, Y. 2012. ‘Towards a guide for novice researchers on research methodology: Review and proposed methods’, Issues in Informing Science and Information Technology, 6, 11 Feb, 2012323-337.

Hussain, M. and Malik, M., 2016. Prioritizing lean management practices in public and private hospitals. Journal of health organization and management, 30(3), 10 August, 2014, pp.457-474.

Hussain, M., Malik, M. and Al Neyadi, H.S., 2016. AHP framework to assist lean deployment in Abu Dhabi public healthcare delivery system. Business Process Management Journal, 22(3), June 2016, pp.546-565.

Lancaster, G. 2012. Research Methods in Management, 4^th ed. Oxford: Elsevier

Maasouman, M.A. and Demirli, K., 2016. Development of a lean maturity model for operational level planning. The International Journal of Advanced Manufacturing Technology, 83(5-8), March 2016,pp.1171-1188.

Malik, M.H.M., 2016. Prioritizing Lean management practices in public and private hospitals. hospitals, 30(3), pp.457-474.

Morgan, D. L. 2012. “Paradigms lost and pragmatism regained: methodological implications of combining qualitative and quantitative methods”, Journal of Mixed Methods Research, 1(1),1 January, pp. 48-76

Upadhye, N., Deshmukh, S.G. and Garg, S., 2016. Lean manufacturing system implementation barriers: an interpretive structural modelling approach. International Journal of Lean Enterprise Research, 2(1), 15 April, pp.46-65.

Younies, H., Elzenaty, R.J., Gantasala, S. and Nwagwu, E., 2016. Healthcare Forecasting in the United Arab Emirates (UAE). Journal of Health and Human Services Administration, Summer,2016 39(1), p.3.

Yu, T., Demirli, K. and Bhuiyan, N., 2015, March. A general framework for lean transformation of hospitals. In Industrial Engineering and Operations Management (IEOM), 5,April, 2015 International Conference on (pp. 1-8). IEEE.

Tenali, S., Ganti, R.S. and Taranikanth, K., 2015, March. Implementing lean six sigma to improve the ratio of admissions to placements in an academic year: Statistical and psychological case study of a technical institute. In Industrial Engineering and Operations Management (IEOM),  10.11.2015 International Conference on (pp. 1-12). IEEE.