Relationships between leadership and culture, human resources and process improvement in lean healthcare

Abstract

Purpose: This research aims to examine the relationships among leadership and culture, human resources and process improvement in lean hospitals from the socio-technical perspective. Design/methodology/approach: The survey instrument was developed from literature reviews, verified by experts and confirmatory factor analysis. Multiple responses were used to collect data from 473 care providers in 220 outpatient departments of Thai hospitals to improve reliability of the obtained data. Path analysis of structural equation modeling was applied to analyze the hypotheses. Findings: It was found that human resources has a significant positive direct effect on process improvement. Leadership and culture not only has significant direct positive impacts on human resources and process improvement but also has a significant indirect positive impact on process improvement through human resources. Originality/value: This is one of the first examples of research to present insights into the links between soft and hard factors of lean hospitals at strategic and operational levels.