Kan lean bli hållbart i svensk sjukvård? Om betydelsen av delaktighet och tydlighet

Sammanfattning: Something is happening within healthcare. An increased pressure for change towards increased efficiency and effectiveness has made Swedish healthcare organizations focusing on organizational change strategies – where expressions such as continuous improvements and to do more with less are frequently used. Lean production (lean) is a commonly used organizational development strategy within Swedish healthcare. However, many organizations today fail when trying to implement lean as a means to change the organization.The purpose of this thesis is to increase the knowledge level about sustainable development work and working conditions within Swedish healthcare. Another purpose is to make this knowledge applicable to on-going development work of today.In this thesis, the approach has been interactive research, where a method triangulation has been used including a literature study, a qualitative study, and a quantitative study. The empirical data are from two Swedish hospitals.By using an interactive research approach, joint learning among the researcher and first-line management within Swedish psychiatric care has been reached. This joint learning concerns how to strengthen the sustainability of organizational development work within Swedish healthcare. Specifically, the findings show that participation, as a democratic principle and an important organizational development factor, needs to be promoted among first-line management in the development work. For the development work to be sustainable, all parties within the organization need to participate in the work.Finally, the findings show that clear organizational structures, i.e. objectives and responsibilities, correlate to participation in the organization. The prerequisites for sustainable development work within Swedish healthcare are believed to be strengthened due to the Scandinavian organizational tradition of participation.