A fuzzy interpretive structural modeling approach for evaluating the factors affecting lean implementation in Indian healthcare industry

Lean concept is implemented in healthcare organizations, as it deals with improvement processes so that best services may be provided to the patients and competitive advantage may be achieved. The purpose of this paper is to evaluate the important factors which influence implementation of lean principles in the healthcare industry.

The factors influencing lean implementation in the healthcare industry have been determined through literature review and results of a survey where questionnaires were distributed among 325 healthcare professionals. Fuzzy Interpretive Structural Modeling (FISM) approach has been used to analyze the interrelationships among these factors. A FISM model has been developed to extract the key factors influencing lean implementation.

Results of the survey and model show that lean leadership, professional organizational culture and teamwork and interdepartmental cooperation are the top level factors. Clarity of organizational vision, communication of goals and results, follow up and evaluations are the factors with strong driving as well as strong dependence power. Even a slight action taken on these factors will have a significant impact on other factors.

The healthcare professionals and managers can acquire information from the drive power dependence matrix so that they can thoroughly understand the relative importance, interdependencies and relationships among these factors. The model will help in determining the hierarchy of various actions and activities which may be taken by the management for managing the factors that remarkably affect the lean management in hospitals.

In this paper, only 15 variables appropriate for the Indian healthcare industry have been identified. The model developed in the present research has not been validated statistically which can be done by structural equation modeling (SEM).

Though there are various studies which depict that lean principles have been implemented successfully in various industries, there are few studies specifying the application of lean principles in healthcare sector in India. This paper is an attempt to identify various factors which are important for application of Lean concept in the healthcare sector.