İşletme Bilimi Dergisi

Öz

Lean
applications are based on a philosophy of eliminating the waste in the system
and consist of a production system aiming to reach the most productive way by
focusing on value concept. The lean management is a philosophy that can change
organization types of hospitals. Lean is a management system that allows
increasing the quality of patient care by reducing mistakes and waiting period.
In the long run, lean applications will make hospitals stronger by reducing
costs and risks and thereby increasing growth and expansion. For a lean
transformation to be successful, it is necessary to have a vision and an action
plan in an organizational manner. Therefore, before applying lean improvement
techniques, it is necessary to share the vision and the action plan of the
institution with all personnel. To start the change, first of all, we need to
change skills and thinking patterns of personnel. However, many employees are
resistant to change, although they complain about the situation. A literature
review for this study indicated that while there are some studies on the lean
manufacturing practices with health professionals their resistance to lean
applications are under researched. It is a well-known fact that health
professionals are resistant to lean improvement due to distrust to change,
falling in inadequate position, future anxiety, economic and social losses.
However, it is important to determine for what reasons and at what level these
resistances take place. Based on this idea, it was aimed that determination of
health professionals working in Duzce University Health Application and
Research Center how perceived lean health practices, their attitudes towards
lean health practices and resistance to lean health applications and their
resistance levels.
The research includes health professionals working at the Health
Application and Research Center of Duzce University. According to year 2016
data, there are 555 academic and executive, 138 company personnel, in total 693
health profesionals in this center. Although our intention was to include all
of this personnel in the research, we were only able to include 202 people due
to annual leave, compassionate leave, watch leave, and assignment of academic
and executive personnel to other institutions. In determining the research
method, it is thought that the quantitative research is the best choice
considering the aim, problem and the subject of the survey. In the survey, the
questionnaire technique was applied. Data were collected from 202 people which
gives a response rate of %29 (202/693). %29 response rate is considered good
comparing the other studies in social sciences. All the results of the
questionnaire were analyzed in SPSS 20 package program; factor analysis,
descriptive statistical analysis, deductional statistical analysis and
correlation analysis were utilized. A Cronbach Alpha value of 0.925 indicates a
general reliability of the questionnaire. It is known reality that health
professionals are resistant to lean improvement due to distrust to change,
falling in inadequate position, future anxiety, economic and social losses. It
is important to find out the real reasons and level of the resistance. In this
respect, “Is there a resistance of health proffesionals to lean improvement and
what level is it?” is the main question of this research. The following
hypotheses were formulated to address the research question:

•            H1: There is a significant
difference according to the gender of health professionals' resistance to lean
applications.

•            H2: There is a significant
difference according to age ranges of health professionals' resistance to lean
applications.

•            H3: There is a significant
difference according to the educational status of health professionals'
resistance to lean applications.

•            H4: There is a significant
difference according to the duties in their institutions of health
professionals' resistance to lean applications.

•            H5: There is a significant
difference according to the professional experience of health professionals'
resistance to lean applications.

•            H6: There is a relationship between
health professionals' perceptions of lean applications and resistance states.

In the
findings of the survey; it is seen that % 56,4 of the participants are women;
%45,5 is people at the age of 31-40; approximately %72 is at least university
graduate; %57 holds executive positions; % 45 of participants have a high level
of job experience. In the survey, it is seen that there is a positive and
meaningful relationship between the resistance of health professionals and the
results of the change. Besides, it is seen that there is no meaningful
difference between the resistance of health professionals to lean improvement
and their demographic characteristics (gender, age, education, jobs at
institutions, job experience). In addition, it is seen that health
professionals are happy with a change of the management but they are not
satisfied with the performance evaluation and reward system. On the other hand,
meaningful and high level of positive correlation is found between
“institutional policy in change”, “resistance to change”, “results of the
change” factors and “personal scale score”. Institutional belonging has a
meaningful but not very strong effect on the general resistance scale score and
other independent variables.

In
general, the results show that the resistance of health professionals to change
is at a moderate level. Health professionals who accept lean improvement as
positive change are resistant due to insufficient motivation and reward system.
Besides, the findings show that it is necessary to have the right cultural
background and common institutional targets to reduce the resistance. It is
seen that the level of institutional belonging is low and it is necessary to
provide on the job training to adopt to lean improvement. Low institutional
belonging makes health professionals reluctant in adopting lean improvement.
However, health professionals are happy with the attitude and policy of their
institutions, and it is considered that this will help in reducing the
resistance to change.