Quality in the Emergency Department

Abstract: How are the quality outcomes of implementing change management theories in the emergency department measured? Lean and similar change management-theories such as TQM or Six Sigma have rendered a lot of at-tention in the Swedish healthcare business over the past ten years. According to an article in Läkar-tidningen, the Swedish medical association´s official journal, nine out of ten Swedish hospitals have implemented Lean or some other form of change management theory (Weimarsson 2011). Using change management theories seems to be a good way to enhance productivity. According to its proponents it’s also a good way to maintain, and perhaps even improve quality (Rognes & Svarts 2012). However, there have been questions raised whether this increase in productivity is possible without having to compromise on the quality of care and the working environment (Bertholds 2010). This questioning of Lean, and similar theories, from doctors and other healthcare personnel may in some way hinder them to be fully implemented in hospitals. One possible reason to why there is resistance towards the Lean-concept amongst healthcare workers is that quality occupies a special position in healthcare production, as delivering high quality care may be the difference between life and death (SBU 2010). Still, the most common way to measure the success of Lean today seems to be by measuring how much faster the production cycles are flowing, which first and foremost is a quan-titative measurement. Our intension is to gain understanding about what is perceived as quality when delivering health care, and to what extent the qualitative outcomes of using change management theories in emer-gency wards of Swedish hospitals is measured. We will then analyze if these performance measures may be improved in order to increase the focus on the qualitative outcomes of the use of change management theories in the emergency wards.