Role of lean leadership in the lean maturity—second-order problem-solving relationship

A mixed methods study

A. Bijl, K. Ahaus, P. Gemmel, B. Meijboom

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objectives:To investigate the relationship between lean adoption and problem-solving behaviour in nursing teams, and to explore the practices of lean leaders on nursing wards to reveal how they can stimulate second-order problem-solving within their teams.Design:A mixed-methods retrospective multiple case study using semistructured interviews. Interview data were used to assess the level of lean maturity (based on a customised validated instrument) and the level of second-order problem-solving (based on scenarios). Within-case and cross-case analyses were employed to identify lean leadership practices.Setting:14 nursing teams, with different levels of lean maturity, in a Dutch hospital.Participants:Three members of each nursing team were interviewed: the team leader, one nurse from the ward's core team for the lean-based quality improvement programme and one nurse outside the core team.Interventions:The nursing teams were in various phases of a lean-based quality improvement programme: 'The Productive Ward - Releasing Time to Care'.Results:A strongly significant positive relationship between lean maturity and second-order problem-solving was found: β=0.68, R2=0.46, p<0.001. Further, the results indicated a potential strengthening effect of lean leadership on this relationship. Seven lean leadership practices emerged from the data collected in a nursing ward setting: (1) convincing and setting an example; (2) unlocking individual and team potential; (3) solving problems systematically; (4) enthusing, actively participating and visualising; (5) developing self-managing teams; (6) sensing, as orchestrator, what is needed for change; and (7) listening, sharing information and appreciating. These practices have a strong link with transformational leadership.Conclusions:As lean matures, nursing teams reach a higher level of second-order problem-solving. In later stages, lean leaders increasingly relinquish responsibility by developing self-managing teams.
Original languageEnglish
Article number026737
Number of pages7
JournalBMJ Open
Volume9
Issue number6
DOIs
Publication statusPublished - 2019

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Team Nursing
Nurses
Interviews
Information Dissemination

Keywords

  • HEALTH-CARE
  • IMPROVEMENT
  • WORK

Cite this

@article{48ee5300bc25437ab446564492014fc3,
title = "Role of lean leadership in the lean maturity—second-order problem-solving relationship: A mixed methods study",
abstract = "Objectives:To investigate the relationship between lean adoption and problem-solving behaviour in nursing teams, and to explore the practices of lean leaders on nursing wards to reveal how they can stimulate second-order problem-solving within their teams.Design:A mixed-methods retrospective multiple case study using semistructured interviews. Interview data were used to assess the level of lean maturity (based on a customised validated instrument) and the level of second-order problem-solving (based on scenarios). Within-case and cross-case analyses were employed to identify lean leadership practices.Setting:14 nursing teams, with different levels of lean maturity, in a Dutch hospital.Participants:Three members of each nursing team were interviewed: the team leader, one nurse from the ward's core team for the lean-based quality improvement programme and one nurse outside the core team.Interventions:The nursing teams were in various phases of a lean-based quality improvement programme: 'The Productive Ward - Releasing Time to Care'.Results:A strongly significant positive relationship between lean maturity and second-order problem-solving was found: β=0.68, R2=0.46, p<0.001. Further, the results indicated a potential strengthening effect of lean leadership on this relationship. Seven lean leadership practices emerged from the data collected in a nursing ward setting: (1) convincing and setting an example; (2) unlocking individual and team potential; (3) solving problems systematically; (4) enthusing, actively participating and visualising; (5) developing self-managing teams; (6) sensing, as orchestrator, what is needed for change; and (7) listening, sharing information and appreciating. These practices have a strong link with transformational leadership.Conclusions:As lean matures, nursing teams reach a higher level of second-order problem-solving. In later stages, lean leaders increasingly relinquish responsibility by developing self-managing teams.",
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Role of lean leadership in the lean maturity—second-order problem-solving relationship : A mixed methods study. / Bijl, A.; Ahaus, K.; Gemmel, P.; Meijboom, B.

In: BMJ Open, Vol. 9, No. 6, 026737, 2019.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Role of lean leadership in the lean maturity—second-order problem-solving relationship

T2 - A mixed methods study

AU - Bijl, A.

AU - Ahaus, K.

AU - Gemmel, P.

AU - Meijboom, B.

PY - 2019

Y1 - 2019

N2 - Objectives:To investigate the relationship between lean adoption and problem-solving behaviour in nursing teams, and to explore the practices of lean leaders on nursing wards to reveal how they can stimulate second-order problem-solving within their teams.Design:A mixed-methods retrospective multiple case study using semistructured interviews. Interview data were used to assess the level of lean maturity (based on a customised validated instrument) and the level of second-order problem-solving (based on scenarios). Within-case and cross-case analyses were employed to identify lean leadership practices.Setting:14 nursing teams, with different levels of lean maturity, in a Dutch hospital.Participants:Three members of each nursing team were interviewed: the team leader, one nurse from the ward's core team for the lean-based quality improvement programme and one nurse outside the core team.Interventions:The nursing teams were in various phases of a lean-based quality improvement programme: 'The Productive Ward - Releasing Time to Care'.Results:A strongly significant positive relationship between lean maturity and second-order problem-solving was found: β=0.68, R2=0.46, p<0.001. Further, the results indicated a potential strengthening effect of lean leadership on this relationship. Seven lean leadership practices emerged from the data collected in a nursing ward setting: (1) convincing and setting an example; (2) unlocking individual and team potential; (3) solving problems systematically; (4) enthusing, actively participating and visualising; (5) developing self-managing teams; (6) sensing, as orchestrator, what is needed for change; and (7) listening, sharing information and appreciating. These practices have a strong link with transformational leadership.Conclusions:As lean matures, nursing teams reach a higher level of second-order problem-solving. In later stages, lean leaders increasingly relinquish responsibility by developing self-managing teams.

AB - Objectives:To investigate the relationship between lean adoption and problem-solving behaviour in nursing teams, and to explore the practices of lean leaders on nursing wards to reveal how they can stimulate second-order problem-solving within their teams.Design:A mixed-methods retrospective multiple case study using semistructured interviews. Interview data were used to assess the level of lean maturity (based on a customised validated instrument) and the level of second-order problem-solving (based on scenarios). Within-case and cross-case analyses were employed to identify lean leadership practices.Setting:14 nursing teams, with different levels of lean maturity, in a Dutch hospital.Participants:Three members of each nursing team were interviewed: the team leader, one nurse from the ward's core team for the lean-based quality improvement programme and one nurse outside the core team.Interventions:The nursing teams were in various phases of a lean-based quality improvement programme: 'The Productive Ward - Releasing Time to Care'.Results:A strongly significant positive relationship between lean maturity and second-order problem-solving was found: β=0.68, R2=0.46, p<0.001. Further, the results indicated a potential strengthening effect of lean leadership on this relationship. Seven lean leadership practices emerged from the data collected in a nursing ward setting: (1) convincing and setting an example; (2) unlocking individual and team potential; (3) solving problems systematically; (4) enthusing, actively participating and visualising; (5) developing self-managing teams; (6) sensing, as orchestrator, what is needed for change; and (7) listening, sharing information and appreciating. These practices have a strong link with transformational leadership.Conclusions:As lean matures, nursing teams reach a higher level of second-order problem-solving. In later stages, lean leaders increasingly relinquish responsibility by developing self-managing teams.

KW - HEALTH-CARE

KW - IMPROVEMENT

KW - WORK

U2 - 10.1136/bmjopen-2018-026737

DO - 10.1136/bmjopen-2018-026737

M3 - Article

VL - 9

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 6

M1 - 026737

ER -