Moving and resisting Lean: Saskatchewan’s contested implementation of Lean healthcare
Bibliographic record
Abstract
Abstract This article considers the complexities of how policy moves across jurisdictional and sectoral boundaries by examining how Lean Management was introduced into Saskatchewan’s healthcare system. In 2012, the government of Saskatchewan retained a management consulting firm to “transform” the province’s healthcare system using Lean Management. Over subsequent months and years, the consulting firm and provincial government worked to reconstitute the province’s healthcare system, which became the focal point of public debate in the province. This article explores the complexities of how Lean Management arrived in Saskatchewan, how it was translated to address “waste” in the province, and how resistance to its deployment shaped its mobilization in future settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.023 | 0.011 |
| Scholarly communication | 0.012 | 0.003 |
| Open science | 0.003 | 0.008 |
| Research integrity | 0.002 | 0.007 |
| Insufficient payload (model declined to judge) | 0.006 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".