Abstract
This thesis focuses on the use of Lean Thinking in the mental health and addictions sector. It considers the directions in which the sector is trying to improve and the suitability of Lean Thinking approaches to assist the sector to realise those aims.
With the sustained increase in demand for mental health and addiction services and a period of fiscal restraint, the sector has been challenged to improve towards the New Zealand Triple Aim of; improved experience of care, improved health outcomes and improved value for public resources. The Blueprint II strategy documents identified these three key aims for the sector, and also proposed Lean methods as a way for the sector to achieve these aims.
Using a qualitative research design this study involved interviewing 17 health care professionals and/or consumer advisors within one DHB geographical region. The qualitative software package QSR Nvivo 12 Pro was used to assist in coding the interview transcription data thematically.
This study demonstrated that Lean had been adopted in multiple formats within the sector to date, however implementation of Lean is primarily evident in manualised or project based approaches. There was minimal evidence that Lean Thinking informed longer term work plans or has been adopted at a systemic level, both of these being more comprehensive and sustained levels of Lean implementation.
Based on participant’s current exposure to Lean, even in its current form it is seen as a valuable method to improve the aims of the sector. Participants also acknowledge that Lean is currently not being used to its full potential. The barriers that were cited as impeding the further adoption of Lean in the sector included lack of a single Lean quality improvement approach, the sector being unclear of the final goals of services, limited resourcing of Lean efforts and a risk averse sector including reluctance of staff to participate in change processes.
While the Lean philosophy of determining value from the consumer’s perspective resonated with the aims of the mental health and addiction sector, the inclusion of direct consumer input in determining value was deemed to be lacking in Lean itself. The sector incorporated existing consumer consultation methods and also explored further co-design methods to enhance meaningful consumer engagement when defining value for their consumers.
This research has highlighted that Lean is perceived to be able to assist the sector progress towards the aims of Blueprint II. However, modifying current Lean approaches to be more suited to the high level of natural variability seen in the sector and enhancing direct consumer involvement in Lean efforts would make Lean more appropriate for the mental health and addiction sector.