title: How Visual Management for Continuous Improvement Might Guide and Affect Hospital Staff: A Case Study.
abstract: Visual management (VM) tools such as whiteboards, often employed in Lean thinking applications, are intended to be helpful in improving work processes in different industries including health care. It remains unclear, however, how VM is actually applied in health care Lean interventions and how it might influence the clinical staff. We therefore examined how Lean-inspired VM using whiteboards for continuous improvement efforts related to the hospital staff's work and collaboration. Within a case study design, we combined semistructured interviews, nonparticipant observations, and photography on 2 cardiology wards. The fate of VM differed between the 2 wards; in one, it was well received by the staff and enhanced continuous improvement efforts, whereas in the other ward, it was not perceived to fit in the work flow or to make enough sense in order to be sustained. Visual management may enable the staff and managers to allow communication across time and facilitate teamwork by enabling the inclusion of team members who are not present simultaneously; however, its adoption and value seem contingent on finding a good fit with the local context. A combination of continuous improvement and VM may be helpful in keeping the staff engaged in the change process in the long run.
authors.affiliation: Medical Management Centre, Karolinska Institutet, Stockholm, Sweden (Drs Ulhassan, von Thiele Schwarz, Sandahl, and Thor); Department of Psychology (Dr von Thiele Schwarz) and Stress Research Institute (Dr Westerlund), Stockholm University, Stockholm, Sweden; and the Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden (Dr Thor).
authors.forename: Waqar
authors.initials: W
authors.lastname: Ulhassan
authors.forename: Ulrica
authors.initials: U
authors.lastname: von Thiele Schwarz
authors.forename: Hugo
authors.initials: H
authors.lastname: Westerlund
authors.forename: Christer
authors.initials: C
authors.lastname: Sandahl
authors.forename: Johan
authors.initials: J
authors.lastname: Thor
mesh_terms: D003142:Communication; D017598:Efficiency, Organizational; D006801:Humans; D010564:Personnel, Hospital; D058996:Quality Improvement