Lean Service Implementation in Hospital : A Case study conducted in “University Clinical Centre of Kosovo, Rheumatology department”

University essay from Umeå universitet/Handelshögskolan vid Umeå universitet; Umeå universitet/Handelshögskolan vid Umeå universitet

Author: Lura Rexhepi; Priti Shrestha; [2011]

Keywords: ;


The principle of Lean is to eliminate the waste from the system. The purpose of this study is to explore Lean implementation in service sector, especially in health care settings, by focusing on Lean tools and techniques, as well as critical success factors and challenges of Lean implementation.


Research literature for Lean was reviewed to gain understanding of its applicability in service sector. In service settings, non value added work that creates waste is more difficult to identify than in manufacturing. The categories of seven wastes are the same in service as in manufacturing, such as overproduction, defects, waiting, transport, inventory, over-processing and motion. There are several popular Lean tools and techniques, which will help to eliminate these seven wastes from the process. These were the tools identified within the hospital settings, such as value stream mapping, process mapping, five S’s, kanban, visual management and red tag techniques. Thorough analysis of literature was done to ensure the applicability and understanding of Lean in service setting, especially in health care settings.


Several literatures were reviewed to understand the critical success factors and challenges for implementing Lean in service sector. This research also covers the comparative study of secondary data of hospitals on Lean practices implementation and its benefits. Theoretical aspects of Lean tools and techniques findings from literature were compared and contrasted with the real investigation process in the University Clinical Center of Kosovo, rheumatology department.


The research design is a case study, which follows interpretivism and constructionism research philosophies. Qualitative study with the semi-structured interviews and observations were applied for data collection for the University Clinical Center of Kosovo, rheumatology department. Based on the interviews, current process for the rheumatology department was examined. Relevant and applicable Lean tools and techniques were recommended to improve the performance and reduce the waste.

The findings of the study validate that Lean applicability in rheumatology department is achievable. This is because the researchers identified various non value added activities in current processes, which should be eliminated. Then the study continues with discussion by suggesting simplified and standardized processes, which would increase patients’ satisfaction, and work efficiency in rheumatology department. After analyzing the data, researchers make some recommendations to implement Lean by highlighting some Lean tools and techniques, which are applicable to various hospitals, including rheumatology department in University Clinical Center of Kosovo.

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