Discursive practice - lean thinking, nurses’ responsibilities and the cost to care

Harvey, Clare Lynette; Baret, Christophe; Rochefort, Christian M.; Meyer, Alannah; Ausserhofer, Dietmar; Ciutene, Ruta; Schubert, Maria

doi:10.1108/JHOM-12-2017-0316

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Discursive practice - lean thinking, nurses’ responsibilities and the cost to care
Authors:	Harvey, Clare Lynette Baret, Christophe Rochefort, Christian M. Meyer, Alannah Ausserhofer, Dietmar Ciutene, Ruta Schubert, Maria
DOI:	10.1108/JHOM-12-2017-0316
Published in:	Journal of Health Organization and Management
Volume(Issue):	32
Issue:	6
Page(s):	762
Pages to:	778
Issue Date:	2018
Publisher / Ed. Institution:	Emerald
ISSN:	1477-7266 1758-7247
Language:	English
Subjects:	Lean management; Missed nursing care; Nursing practice; Work intensification
Subject (DDC):	610.73: Nursing
Abstract:	Purpose: The purpose of this paper is to explore the literature regarding work intensification that is being experienced by nurses, to examine the effects this is having on their capacity to complete care. The authors contend that nurses’ inability to provide all the care patients require, has negative implications on their professional responsibility. Design/methodology/approach: The authors used institutional ethnography to review the discourse in the literature. This approach supports inquiry through the review of text in order to uncover activities that remain institutionally accepted but unquestioned and hidden. Findings: What the authors found was that the quality and risk management forms an important part of lean thinking, with the organisational culture influencing outcomes; however, the professional cost to nurses has not been fully explored. Research limitations/implications: The text uncovered inconsistency between what organisations accepted as successful cost savings, and what nurses were experiencing in their attempts to achieve the care in the face of reduced time and human resources. Nurses’ attempts at completing care were done at the risk of their own professional accountability. Practical implications: Nurses are working in lean and stressful environments and are struggling to complete care within reduced resource allocations. This leads to care rationing, which negatively impacts on nurses’ professional practice, and quality of care provision. Originality/value: This approach is a departure from the standard qualitative review because the focus is on the textual relationships between what is being advocated by organisations directing cost reduction and what is actioned by the nurses working at the coalface. The discordant standpoints between these two juxtapositions are identified.
URI:	https://digitalcollection.zhaw.ch/handle/11475/12544
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Nursing (IPF)
Appears in collections:	Publikationen Gesundheit

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Harvey, C. L., Baret, C., Rochefort, C. M., Meyer, A., Ausserhofer, D., Ciutene, R., & Schubert, M. (2018). Discursive practice - lean thinking, nurses’ responsibilities and the cost to care. Journal of Health Organization and Management, 32(6), 762–778. https://doi.org/10.1108/JHOM-12-2017-0316

Harvey, C.L. et al. (2018) ‘Discursive practice - lean thinking, nurses’ responsibilities and the cost to care’, Journal of Health Organization and Management, 32(6), pp. 762–778. Available at: https://doi.org/10.1108/JHOM-12-2017-0316.

C. L. Harvey et al., “Discursive practice - lean thinking, nurses’ responsibilities and the cost to care,” Journal of Health Organization and Management, vol. 32, no. 6, pp. 762–778, 2018, doi: 10.1108/JHOM-12-2017-0316.

HARVEY, Clare Lynette, Christophe BARET, Christian M. ROCHEFORT, Alannah MEYER, Dietmar AUSSERHOFER, Ruta CIUTENE und Maria SCHUBERT, 2018. Discursive practice - lean thinking, nurses’ responsibilities and the cost to care. Journal of Health Organization and Management. 2018. Bd. 32, Nr. 6, S. 762–778. DOI 10.1108/JHOM-12-2017-0316

Harvey, Clare Lynette, Christophe Baret, Christian M. Rochefort, Alannah Meyer, Dietmar Ausserhofer, Ruta Ciutene, and Maria Schubert. 2018. “Discursive Practice - Lean Thinking, Nurses’ Responsibilities and the Cost to Care.” Journal of Health Organization and Management 32 (6): 762–78. https://doi.org/10.1108/JHOM-12-2017-0316.

Harvey, Clare Lynette, et al. “Discursive Practice - Lean Thinking, Nurses’ Responsibilities and the Cost to Care.” Journal of Health Organization and Management, vol. 32, no. 6, 2018, pp. 762–78, https://doi.org/10.1108/JHOM-12-2017-0316.