Lean leadership: Towards continuous improvement capability in healthcare

Bianca van Elp, Oskar Roemeling*, Kjeld Aij

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


This research focuses on the role of leadership styles during Lean Management (LM) initiatives in healthcare environments. Specifically, this study examined the role of leadership styles in the development of Continuous Improvement (CI) capability of teams. The empirical evidence was collected by applying a multiple-case design, and consisted of interviews, observations, and documentation. These data sources were used to develop case studies, and to identify leadership behaviours supportive of LM. Through qualitative case analysis, the influence of leadership styles on CI capability was determined. The results show that a hybrid leadership style is associated with higher levels of CI capability, and that the duration of a LM program in itself does not dictate maturity. A mix of both transactional and transformational leadership styles seems a necessary condition for teams to reach higher levels of CI capability. Based on these findings, this paper provides a framework to structure thinking on LM and leadership styles, and concludes with supporting propositions. The current outcomes imply that leaders should be sensitive towards their adopted leadership style, and should adopt a leadership style that combines both transformational as well as transactional elements, when leading LM teams.
Original languageEnglish
JournalHealth Services Management Research
Publication statusE-pub ahead of print - 12-Mar-2021


  • continuous improvement
  • healthcare
  • Kaizen
  • leadership
  • lean management

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