ABSTRACT
Hospitals are faced with heavy pressure £l'om increasing demands from both patients and society, as well as a more constrained budget and still more medical opportunities. Lean has been suggested as a possible means to meet this challenge. However, lean derives from manufacturing industry, so the question is how to apply it in a hospital setting and what the consequences might be for employees. This question was studied in a cancer department in a university hospital. The psychosocial working environment was measured before and after lean implementation, and qualitative data was collected from the implementation process. The two groups most affected - lab technicians and nurses in the chemotherapy outpatient clinic _. showed quite different results. The lab technicians experienced an improvement in the working environment, whereas the opposite was the case for the nurses. One possible explanation is that lean gave a greater degree of control to lab technicians, whose work had originally been rather standardized, whereas nurses, with more complex and non-standardized work, experience lean as limiting their degree of control and as questioning their professional assessment with regard to the care of individual patients.
