title: "The largest Lean transformation in the world": the implementation and evaluation of lean in Saskatchewan healthcare.
abstract: The Saskatchewan Ministry of Health has committed to a multi-million dollar investment toward the implementation of Lean methodology across the province's healthcare system. Originating as a production line discipline (the Toyota Production System), Lean has evolved to encompass process improvements including inventory management, waste reduction and quality improvement techniques. With an initial focus on leadership, strategic alignment, training and the creation of a supportive infrastructure (Lean promotion offices), the goal in Saskatchewan is a whole health system transformation that produces "better health, better value, better care, and better teams." Given the scope and scale of the initiative and the commitment of resources, it is vital that a comprehensive, longitudinal evaluation plan be implemented to support ongoing decision-making and program design. The nature of the initiative also offers a unique opportunity to contribute to health quality improvement science by advancing our understanding of the implementation and evaluation of complex, large-scale healthcare interventions. The purpose of this article is to summarize the background to Lean in Saskatchewan and the proposed evaluation methods.
authors.affiliation: Member of the School of Rural Health, Monash University, in Victoria, Australia.
authors.forename: Leigh
authors.initials: L
authors.lastname: Kinsman
authors.affiliation: Member of the College of Pharmacy and Nutrition, University of Saskatchewan, in Saskatoon, Saskatchewan.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rotter
authors.affiliation: Member of the School of Physical Therapy, College of Medicine, University of Saskatchewan.
authors.forename: Katherine
authors.initials: K
authors.lastname: Stevenson
authors.affiliation: Member of the School of Physical Therapy, College of Medicine, University of Saskatchewan.
authors.forename: Brenna
authors.initials: B
authors.lastname: Bath
authors.affiliation: Member of the College of Nursing, University of Saskatchewan.
authors.forename: Donna
authors.initials: D
authors.lastname: Goodridge
authors.affiliation: Member of the School of Physical Therapy, College of Medicine, University of Saskatchewan.
authors.forename: Liz
authors.initials: L
authors.lastname: Harrison
authors.affiliation: Member of the College of Pharmacy and Nutrition, University of Saskatchewan.
authors.forename: Roy
authors.initials: R
authors.lastname: Dobson
authors.affiliation: Member of the Department of Economics, University of Saskatchewan.
authors.forename: Nazmi
authors.initials: N
authors.lastname: Sari
authors.affiliation: Member of the College of Nursing, University of Saskatchewan.
authors.forename: Cathy
authors.initials: C
authors.lastname: Jeffery
authors.affiliation: Member of the Department of Indigenous Education, Health and Social Work, First Nations University of Canada, in Regina, Saskatchewan.
authors.forename: Carrie
authors.initials: C
authors.lastname: Bourassa
authors.affiliation: Member of Community Matters, in Unley, South Australia.
authors.forename: Gill
authors.initials: G
authors.lastname: Westhorp
mesh_terms: D003695:Delivery of Health Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006801:Humans; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care / Q000458:organization & administration; D012525:Saskatchewan; D017749:Total Quality Management / Q000458:organization & administration