Lean management is one of the fourth most common tools in organizing health care in Norway. Lean management is implemented as a systematic approach aimed to improve quality, streamline processes, reduce costs and waste and improve timely delivery of products and services. In early February 2008, the member organization Oslo Cancer Cluster engaged the Clinical Cancer Research Unit at the Norwegian Radium Hospital in a process improvement project based on Lean management strategy. The purpose was to examine and improve the process for managing clinical trials, to get an increase in the number of clinical trials, a reduction in time from idea to start up and to give the employees a more predictable work day and knowledge about the method of continuous improvement.
This thesis examines the Lean process in the time period from February 2008 to December 2010. The objective of the thesis is explanatory in regard to assess the outcome of a Lean process in a hospital unit. The process lead to several effects and the Lean project is analyzed using the theoretical perspectives; the rational-instrumental perspective expects the organization to be an instrument for goal achievement. It is to expect that an actual problem will initiate the process and the management will define a clear goal in the search for solution to the problem. All possible alternatives will be considered and every consequence will be estimated before the action best suited to solve the problem (reach the goal) will be chosen. The cultural perspective expects the organization to act according to the identity of the organization and internal pressure and external pressure influences the way the organization acts and makes decisions. Decisions made by the management will only be accepted and implemented if they fit the internal culture and values of the organizations. Decision making is associated with the “logic of appropriate behavior”. Goals are vague and functions more as values characterizing the organization. The myth perspective expects the organization to adjust to external demands by adopting myths to be regarded as legitimate and to survive. The organization can behave hypocritical by just adopting the myths in talk, and not in action. Talk, decisions and actions can be inconsistent, the goals are often vague and processes are not problem driven as solutions might as well be existing before the problems.