ABSTRACT
This chapter places Lean management in the context of debates concerning the reordering and transformation of expertise during organisational change in health and social care organisations. The chapter starts from the notion that situatedness is characteristic of the knowledge and expertise created during the process of introducing organisations to Lean management. The chapter analyses the efforts of Lean consultants to facilitate Lean transformations in welfare service organisations from the perspective of participants’ different ‘ways of knowing’ and how these are recognised in the process. The chapter asks how situated knowledges are generated when Lean is introduced to welfare service organisations, and what kind of boundary work this involves. The findings suggest that improving work performance together as a shared initiative is a process that does not automatically take equal account of the different ways of knowing involved. Nor is it a process that necessarily supports professional values, despite the attractiveness of the value-for-patient rhetoric. To conclude, the boundary work involved in Lean implementation can reaffirm old hierarchies and create new ones among occupational groups.
