Lean implementation in healthcare: offsetting Physicians’ resistance to change
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Physicians’ resistance towards Lean is often viewed as an important barrier to its successful implementation in healthcare organisations. However, there exists a dearth of knowledge regarding what influences reactions from physicians towards Lean and what organisations can do about it. This study adopts a behavioural perspective and focuses on the triggers of physicians’ resistance towards Lean. Using longitudinal qualitative data from multiple case studies of Canadian hospitals, 15 behavioural triggers are identified. A cross-case analysis reveals that core-technical and efficiency-driven changes clash with medical professionalism and generate active resistance from physicians, while leadership and familiarity with Lean are linked to championing behaviours that mitigate it. This study provides a deeper understanding of physicians’ behaviours during Lean transformations and the factors that drive resistance. It also provides insight into how organisations can better engage their medical staff in their Lean efforts by focussing on the process of change to offset resistance.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it