Implementing lean methods in the emergency department: the role of professions and professional status

The purpose of this paper is to examine the implementation of lean methods in an Emergency Department (ED) and the role of the professions in this process. Qualitative, semi-structured interviews with ED staff in a UK NHS hospital. Lean was met with more engagement and enthusiasm by the professionals than is usually reported in the literature. The main reasons for this were a combination of a national policy, the unique clinical environment and the status of the professional project for doctors in emergency medicine. Single site, one-off study. The status and development of professionals involved may play a big part in the acceptability of initiatives like lean methods in health care. The longer-term sustainability of the organisational changes introduced remains open to question. This paper analyses the success of lean methods in health care with reference to the professional status and stage of development of the professions involved, using the sociology of professions. This approach has not been used elsewhere.