--- title: "Nurses' perspectives on Lean redesigns | Sutter Health" description: "We found that nurses experienced competing demands and tensions related to their time and professional roles and responsibilities as a result of Lean." url: "https://www.sutterhealth.org/research/publications/nurses-perspectives-on-lean-redesigns-1055312406" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Nurses' perspectives on Lean redesigns # Nurses' perspectives on Lean redesigns to patient flow and inpatient discharge process efficiency. Nicosia FM, Park LG, Gray CP, Yakir MJ, & Hung DY. _Glob Qual Nurs Res. 5:2333393618810658. doi: 10.1177/2333393618810658. eCollection 2018 Jan-Dec._ 2018-11-20 ## Abstract As hospitals around the world increasingly face pressure to improve efficiency, "Lean" process improvement has become a popular approach to improving patient flow. In this article, we examine nurses' perspectives on the implementation of Lean redesigns to the inpatient discharge process. We found that nurses experienced competing demands and tensions related to their time and professional roles and responsibilities as a result of Lean. Four main themes included (a) addressing the needs of individual patients, while still maintaining overall patient flow; (b) meeting discharge efficiency targets while also achieving high patient satisfaction scores; (c) "wasting time" to save time; and (d) the "real" work of providing clinical care versus the "Lean" work of process improvement. Our findings highlight the importance of soliciting hospital nurses' perspectives when implementing Lean process improvements to improve efficiency and patient flow. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/30480041) ## Research topics - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [A three-talk model for shared decision making: multistage consultation process.](https://www.sutterhealth.org/research/publications/shared-decison-making-three-talk-model-1055312442) Elwyn G, Durand MA, Song J, Aarts J, Barr PJ, Berger Z, Cochran N, Frosch D, Galasinski D, Gulbrandsen P, Han PKJ, Härter M, Kinnersley P, Lloyd A, Mishra M, Perestelo-Perez L, Scholl I, Tomori K, Trevena L, Witteman HO, Van der Weijden T. BMJ. 2017 Nov 6;359:j4891. doi: 10.1136/bmj.j4891. 2017 Nov 06 - Publication ### [Time is up: increasing shadow price of time in primary-care office visits.](https://www.sutterhealth.org/research/publications/increasing-shadow-price-of-time-in-pc-visits-1055312555) Tai-Seale M, McGuire T. Health Econ. 21(4):457-76. doi: 10.1002/hec.1726. Epub 2011 Mar 27. 2012 Apr 01 - Publication ### [The language of engagement: "aha!" moments from engaging patients and community partners in two pilot projects of the Patient-Centered Outcomes Research Institute.](https://www.sutterhealth.org/research/publications/engaging-pts-community-two-pcori-pilot-projects-1055312382) Tai-Seale M, Sullivan G, Cheney A, Thomas K, Frosch D. Perm J. 20(2). doi: 10.7812/TPP/15-123. \[Epub ahead of print\] 2016 Feb 22 - Publication ### [Acceptance of Lean redesigns in primary care: A contextual analysis.](https://www.sutterhealth.org/research/publications/accept-lean-redesign-prim-care-contextual-analysis-1055312514) Hung D, Gray C, Martinez M, Schmittdiel J, Harrison MI. Health Care Manage Rev. \[Epub ahead of print\] Send to: 2016 Mar 02 - Publication ### [Overcoming challenges to adoption of shared medical appointments.](https://www.sutterhealth.org/research/publications/challenges-to-adoption-of-shared-medical-appts-1055312762) McCuistion MH, Stults CD, Dohan D, Frosch DL, Hung DY, Tai-Seale M. Popul Health Manag. 17(2):100-5. doi: 10.1089/pop.2013.0035. Epub 2013 Oct 24. 2014 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/nurses-perspectives-on-lean-redesigns-1055312406#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Nurses' perspectives on Lean redesigns"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/nurses-perspectives-on-lean-redesigns-1055312406#medicalscholarlyarticle","name":"Nurses' perspectives on Lean redesigns to patient flow and inpatient discharge process efficiency.","headline":"Nurses' perspectives on Lean redesigns","abstract":"As hospitals around the world increasingly face pressure to improve efficiency, \"Lean\" process improvement has become a popular approach to improving patient flow. 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