Implementation of a Lean Daily Management Operating System in an Academic Hospital: A Mixed Methods Study

Restricted (Penn State Only)
- Author:
- Stewart, Wade
- Graduate Program:
- Lifelong Learning and Adult Education (DED)
- Degree:
- Doctor of Education
- Document Type:
- Dissertation
- Date of Defense:
- March 14, 2023
- Committee Members:
- Roderick Lee, Outside Unit Member
Sharilee Hrabovsky, General Studies & Outside Field Member
Karin Sprow Forte, Chair & Dissertation Advisor
Elizabeth Tisdell, Major Field Member
Susan Land, Program Head/Chair - Keywords:
- Daily Management Operating System
Psychological safety
Second-order problem solving
Academic Medical Center
Lean
Situated Cognition
Experiential Learning
Action Learning - Abstract:
- This mixed methods research study explored the impact of implementing a Lean Daily Management Operating System (DMOS) on psychological safety in structured problem solving and learning second-order problem solving skills in a 500-bed academic medical center. Participants were from the Emergency Department within an academic medical center that implemented a Lean DMOS training and deployment program prior to the study. The mixed methods study used a survey to collect quantitative data, followed by interviews of a subset of survey participants to obtain qualitative data. The integrated findings indicate that participants learned to engage in second-order problem-solving through sharing knowledge and multiple iterations of experimentation. Other findings suggest that characteristics of situated cognition, experiential learning, and action learning aligned with the critical components needed for successful Lean DMOS implementation and problem solving, such as a balance between flexibility, structure, collaboration, positive reinforcement and support from leadership, and a level of psychological safety to allow for risk-taking in the form of speaking up about issues. The study findings indicated that psychological safety is a key factor in learning second-order problem solving and Daily Management Operating System (DMOS) implementation in a healthcare setting. Recommendations for practice and future research are suggested.