Addressing Lean and Safety Readiness Assessment in Territorial Ambulatory Healthcare

Abstract

Within the international healthcare landscape, it is incumbent upon all organisations to proactively address individual patient needs by offering a wide range of services. In this context, Territorial Ambulatory Healthcare (TAH) is critical to promote equal access to care as the primary point of contact between National Healthcare Systems and individuals. To achieve this goal, the adoption of Lean and Safety Management (L&SM), a managerial approach to proactively reduce clinical risk and process inefficiencies, can support organisations in pursuing high quality care objectives. Despite the positive benefits associated with the adoption of this approach, the feasibility of guaranteeing a sustainable care quality over time may encounter several challenges. Among these, key contributors to failure include the lack of tailored tools and practices suitable for the healthcare environment, insufficient readiness of the context for implementation, and the absence of a comprehensive system-wide performance strategy. Recent studies in literature address these issues presenting theoretical and practical models to assess readiness levels, highlighting opportunities for future developments of these topics. The current empirical study contributes to the existing knowledge by creating a framework to assess the level of readiness for L&SM implementations within TAH. While this context is essential for ensuring high-quality care and equitable access to care services, successfully implementing L&SM initiatives within TAH is challenging due to the organizational complexity and the involvement of multiple, fragmented stakeholders and care providers. Addressing weak Critical Readiness Factors (CRFs) before starting a project can significantly contribute to successfully implement L&SM and sustain improvement over time. This study will be conducted within the TAH setting of a healthcare organisation in Northern Italy and aims 1) to evaluate the specific care setting readiness for L&SM implementations and 2) to develop practical guidelines to support the organisation in increasing its actual readiness level. The theoretical framework will be grasped integrating prior research on Lean readiness assessment, along with specific literature on L&SM sustainability implementation factors within TAH. Once refined and tested with the purpose of developing a practical assessment tool, the framework will be applied within the selected setting, leading to the identification of practical guidelines to facilitate project success and improvements sustainability. Overall, this research will contribute to enrich the knowledge about L&SM implementation within TAH, supporting health organisations, managers, and clinical leadership to sustainably improve care quality, enhancing the role of territorial care to foster social well-being.