Browsing by Person "Keown, Anne Marie"

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The contribution of leaders' and managers' attributes, values, principles, and behaviours to the sustainable implementation of Lean in healthcare: A realist review protocol
(Health Research Board, 2024-08-13) Keown, Anne Marie; Teeling, Seán Paul; McNamara, Martin
Background Global healthcare faces challenges such as rising costs, budget constraints, aging populations, chronic diseases, and increasing patient expectations. Healthcare organisations are deploying continuous improvement methodologies to address these challenges. Lean, derived from the Toyota Production System, focuses on eliminating non-value-adding activity and enhancing efficiency, making it a prominent quality improvement approach in healthcare. Effective implementation of Lean requires robust leadership to sustain improvements and foster a culture of continuous improvement. However, the attributes, values, principles, and behaviours of effective Lean leaders in healthcare remain underexplored. Methods This realist review protocol details methods to research how leaders' and managers' attributes, values, principles, and behaviours contribute to the sustainable implementation of Lean in healthcare. Following the RAMESES guidelines, a five-stage structured methodology will be used: defining the scope of the review and developing initial theories, developing the search strategy, reviewing primary studies and extracting data, synthesising evidence and developing conclusions, refining theory iteratively, and disseminating findings. An Expert Panel and reference groups of healthcare managers and leaders will refine candidate programme theories (CPTs) into initial programme theories (IPTs), guiding detailed evidence searches and data extraction. Conclusion This realist review will deepen our understanding of the specific mechanisms by which leadership impacts Lean implementation outcomes in the context of acute hospitals. By exploring how leadership attributes, values, principles and behaviours shape outcomes for diverse stakeholders, the review aims to provide critical insights into the dynamics driving the success of Lean in healthcare. The findings will inform policy and practice, enhancing leadership strategies to improve patient and staff experiences, patient outcomes, and organizational performance.
The contribution of a person-centred model of Lean Six Sigma to the development of a healthful culture of health systems improvement
(Frontiers Media, 2025-08-18) Teeling, Sean Paul; Baldie, Deborah; Daly, Ailish; Keown, Anne Marie; Igoe, Aileen; Dowling, Ciara; McNamara, Martin
Background: A failure to distinguish between person-centredness, person-centred care, and person-centred cultures can result in improvement initiatives focusing solely on improvement initiative metrics and outcomes, excluding the authentic experiences of patients and staff. Building on the foundational work of Dewing and McCormack, we have designed, piloted, and implemented the Person-centred Lean Six Sigma (PCLSS) model in public and private acute and community healthcare settings across Ireland. This model uses Lean Six Sigma, a widely adopted improvement methodology, through a person-centred lens with which improvement practitioners and healthcare staff can inspect their Lean Six Sigma practice and critically evaluate whether, to what extent, and how it is synergistic with person-centred approaches. Aim: This paper explores the deployment of the PCLSS model across four clinical study sites and examines its alignment with McCance and McCormack's conceptual work on healthful cultures, evaluating its contribution to creating cultures that support sustainable improvement, compassion, and respect. Methods: The PCLSS model was embedded within a university-accredited education programme for healthcare staff. The model was applied across four distinct healthcare settings in Ireland: a public acute teaching hospital, a private full-service acute hospital, an integrated ophthalmology service bridging hospital and community care, and a public rehabilitation hospital. A case study methodology was used to examine implementation and impact. Results: Across all four sites, the PCLSS model facilitated improvements in operational efficiency, staff and patient engagement, interprofessional collaboration, and reflective practice. The model supported leadership at all levels, fostered sustainable change, and successfully mapped onto key domains associated with healthful cultures, as articulated in the work of McCance and McCormack. Conclusion: The PCLSS model represents a sustainable, values-based approach to improvement that aligns operational excellence with person-centred principles. Its application contributes meaningfully to the development of healthful cultures in healthcare organisations.