A mixed model study evaluating lean in the transformation of an orthopaedic radiology service

Martin, A; Hogg, P; Mackay, S

Abstract

Objective: The purpose of the study was to explore the proposition that lean is an effective methodology
for service improvement within healthcare by using it to evaluate and implement change in a poor
service.
Design: A mixed model approach was used with data being collected before and after change.
Setting: The orthopaedic radiology out-patient pathway in a large district general hospital was receiving
increasing numbers of complaints with long waiting times and poor levels of satisfaction amongst
patients and staff.
Participants: Data were collected in the form of qualitative and quantitative data taken from questionnaires
completed by staff and patients, and quantitative data extracted from the Radiology Information
System. A proportionate stratified random sampling method was used to collect data from the patients
and a theoretical sample was used for the staff.
Intervention: The pre-implementation data was collected during a lean event in which a value stream
map of the pathway was created. From this information, changes were planned and implemented, before
collecting the post-implementation data using the same methods.
Main outcome measures: The aims of the study were to compare pre-implementation and postimplementation
data related to patient journey time, patient experience and staff and patient satisfaction.
The quantitative data were analysed using Levene’s test for equality of variance and a 2-sample ttest
to test for comparison of the means. Descriptive statistics were used to analyse data collected from
the polar and the selected response questions from the questionnaires, whilst thematic analysis was used
to analyse the qualitative data.
Results: Results demonstrated that the new service offered a better quality of patient experience with
higher levels of staff satisfaction whilst enabling an improvement in productivity.
Conclusions: The author proposes that these findings support the proposition that lean is an effective
methodology for service improvement within a healthcare setting.

Citation

Martin, A., Hogg, P., & Mackay, S. (2013). A mixed model study evaluating lean in the transformation of an orthopaedic radiology service. Radiography, 19(1), 2-6. https://doi.org/10.1016/j.radi.2012.09.005

• Journal Article Type: Article
• Publication Date: Feb 1, 2013
• Deposit Date: Oct 8, 2013
• Journal: Radiography
• Print ISSN: 1078-8174
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Issue: 1
• Pages: 2-6
• DOI: https://doi.org/10.1016/j.radi.2012.09.005
• Publisher URL: http://dx.doi.org/10.1016/j.radi.2012.09.005
• Related Public URLs: http://www.journals.elsevier.com/radiography/