Impact of lean interventions on time buffer reduction in a hospital setting

Oskar P. Roemeling*, Martin J. Land, Kees Ahaus, Jannes Slomp, Wouter van den Bijllaardt

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)
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This paper focuses on performance changes stemming from a series of lean interventions in a medical laboratory. This research is one of the first to link a series of lean interventions and performance over time. In a mixed-method case study, six years of patient-related throughput data, retrieved from a laboratory computer database, are analysed. Three distinct periods with significant differences in throughput time performance can be distinguished. Semi-structured interviews were held to investigate the lean interventions preceding the performance changes. Given the long-term nature of the study, the event history calendar method was applied to enhance the respondents' recall and reliability. A single lean intervention, among the hundreds that took place, was supposed to cause the main reduction in throughput times. It concentrated on improving process flow through the removal of batching, a source of artificial variability. A later major intervention, the introduction of flow-focused machinery, had mixed effects and initial performance gains were not sustained. The results show that ongoing series of interventions do not always lead to ongoing performance improvements in terms of throughput times but support theories emphasising the importance of variability reduction.

Original languageEnglish
Pages (from-to)4802-4815
Number of pages14
JournalInternational Journal of Production Research
Issue number16
Early online date13-Mar-2017
Publication statusPublished - 2017


  • lean manufacturing
  • Kaizen
  • leanness
  • performance analysis
  • Toyota production system
  • health care

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