"Leanyfying" high variability operations - Lessons from applying lean to oncology care

Sammanfattning: The increasing toll exerted by health care on society has called for the application of new management techniques that demand fewer resources. This demand has not gone unanswered and health care structures are starting to experiment with a set of tools borrowed from car manufacturing: Lean. As a relatively new phenomenon a definitive assessment of the efforts in this respect has yet to be made, but so far the results seem to be positive. And while the examples of successful Lean applications in hospitals increase the question rises as to whether these outcomes can be applied to every branch of health care. By taking the example of oncology care the author aims at showing what happens when variation in the operations is a desired quality, rather than a source of waste. By combining classical and newer perspectives on the application of Lean the author aims at providing a critical framework for defining the importance that should be given to variation in different scenarios. The cases studies, three oncology departments in Stockholm's main health structures, exemplify the dilemma between accommodating and reducing variation and how these choices affect the implementation of Lean. The result of this work is not to be seen only as proof of the versatility of Lean, but also as a moment of reflection as to what value is and being efficient is not always enough in delivering it.