A RESEARCH FOR DETERMINING THE RESISTANCE OF HEALTH PROFESSIONALS TO LEAN APPLICATIONS

Yıl 2018, Cilt: 6 Sayı: 3, 239 - 272, 26.12.2018

Feryal Bulut Mehmet Selami Yıldız

https://doi.org/10.22139/jobs.439994

Cited By: 2

Öz

Lean
applications are based on a philosophy of eliminating the waste in the system
and consist of a production system aiming to reach the most productive way by
focusing on value concept. The lean management is a philosophy that can change
organization types of hospitals. Lean is a management system that allows
increasing the quality of patient care by reducing mistakes and waiting period.
In the long run, lean applications will make hospitals stronger by reducing
costs and risks and thereby increasing growth and expansion. For a lean
transformation to be successful, it is necessary to have a vision and an action
plan in an organizational manner. Therefore, before applying lean improvement
techniques, it is necessary to share the vision and the action plan of the
institution with all personnel. To start the change, first of all, we need to
change skills and thinking patterns of personnel. However, many employees are
resistant to change, although they complain about the situation. A literature
review for this study indicated that while there are some studies on the lean
manufacturing practices with health professionals their resistance to lean
applications are under researched. It is a well-known fact that health
professionals are resistant to lean improvement due to distrust to change,
falling in inadequate position, future anxiety, economic and social losses.
However, it is important to determine for what reasons and at what level these
resistances take place. Based on this idea, it was aimed that determination of
health professionals working in Duzce University Health Application and
Research Center how perceived lean health practices, their attitudes towards
lean health practices and resistance to lean health applications and their
resistance levels.
The research includes health professionals working at the Health
Application and Research Center of Duzce University. According to year 2016
data, there are 555 academic and executive, 138 company personnel, in total 693
health profesionals in this center. Although our intention was to include all
of this personnel in the research, we were only able to include 202 people due
to annual leave, compassionate leave, watch leave, and assignment of academic
and executive personnel to other institutions. In determining the research
method, it is thought that the quantitative research is the best choice
considering the aim, problem and the subject of the survey. In the survey, the
questionnaire technique was applied. Data were collected from 202 people which
gives a response rate of %29 (202/693). %29 response rate is considered good
comparing the other studies in social sciences. All the results of the
questionnaire were analyzed in SPSS 20 package program; factor analysis,
descriptive statistical analysis, deductional statistical analysis and
correlation analysis were utilized. A Cronbach Alpha value of 0.925 indicates a
general reliability of the questionnaire. It is known reality that health
professionals are resistant to lean improvement due to distrust to change,
falling in inadequate position, future anxiety, economic and social losses. It
is important to find out the real reasons and level of the resistance. In this
respect, “Is there a resistance of health proffesionals to lean improvement and
what level is it?” is the main question of this research. The following
hypotheses were formulated to address the research question:

•            H1: There is a significant
difference according to the gender of health professionals' resistance to lean
applications.

•            H2: There is a significant
difference according to age ranges of health professionals' resistance to lean
applications.

•            H3: There is a significant
difference according to the educational status of health professionals'
resistance to lean applications.

•            H4: There is a significant
difference according to the duties in their institutions of health
professionals' resistance to lean applications.

•            H5: There is a significant
difference according to the professional experience of health professionals'
resistance to lean applications.

•            H6: There is a relationship between
health professionals' perceptions of lean applications and resistance states.

In the
findings of the survey; it is seen that % 56,4 of the participants are women;
%45,5 is people at the age of 31-40; approximately %72 is at least university
graduate; %57 holds executive positions; % 45 of participants have a high level
of job experience. In the survey, it is seen that there is a positive and
meaningful relationship between the resistance of health professionals and the
results of the change. Besides, it is seen that there is no meaningful
difference between the resistance of health professionals to lean improvement
and their demographic characteristics (gender, age, education, jobs at
institutions, job experience). In addition, it is seen that health
professionals are happy with a change of the management but they are not
satisfied with the performance evaluation and reward system. On the other hand,
meaningful and high level of positive correlation is found between
“institutional policy in change”, “resistance to change”, “results of the
change” factors and “personal scale score”. Institutional belonging has a
meaningful but not very strong effect on the general resistance scale score and
other independent variables.

In
general, the results show that the resistance of health professionals to change
is at a moderate level. Health professionals who accept lean improvement as
positive change are resistant due to insufficient motivation and reward system.
Besides, the findings show that it is necessary to have the right cultural
background and common institutional targets to reduce the resistance. It is
seen that the level of institutional belonging is low and it is necessary to
provide on the job training to adopt to lean improvement. Low institutional
belonging makes health professionals reluctant in adopting lean improvement.
However, health professionals are happy with the attitude and policy of their
institutions, and it is considered that this will help in reducing the
resistance to change.

Anahtar Kelimeler

Lean İmprovement, Healthcare Professionals, Lean Health, Resistance

SAĞLIK PROFESYONELLERİNİN YALIN UYGULAMALARA DİRENCİNİ BELİRLEMEYE YÖNELİK BİR ARAŞTIRMA

Öz

Amaç: Bu çalışmada Düzce Üniversitesi
Sağlık Uygulama Araştırma Merkezinde görev yapan sağlık profesyonellerinin,
kurumda uygulanan yalın uygulamalara karşı direnç durumlarını belirlemek
amaçlanmaktadır.

Yöntem: Araştırmada nicel araştırma
yöntemi kullanılmıştır. Araştırmada anket tekniği uygulanmıştır. İki yüz iki
katılımcının doldurmuş olduğu anket değerlendirilmeye alınmıştır. Elde edilen
veriler SPSS 20 paket programında analiz edilmiştir ve verilere faktör analizi,
tanımlayıcı istatistiksel analiz, çıkarımsal istatistiksel analiz ve korelasyon
analizi uygulanmıştır.

Bulgular: Araştırmanın sonucunda; sağlık
profesyonellerinin yalın uygulamalara karşı direnç durumları ile değişimin
sonuçları arasında anlamlı ve pozitif yönde yüksek düzeyde ilişkiler tespit edilmiştir.
Bunun yanı sıra sağlık profesyonellerinin yalın uygulamalara karşı
gösterdikleri direnç durumları ile sosyo-demografik özellikleri arasında
anlamlı farklılıkların olmadığı görülmüştür. Bununla birlikte sağlık
profesyonellerin yalın uygulamalar ile sağlık merkezinde ortaya çıkan değişimin
yönetilmesi aşamasından memnun oldukları, ancak performans ve ödüllendirme
yönetiminden memnun olmadıkları tespit edilmiştir.

Sonuç: Yalın yolculukta sağlık
profesyonellerinin değişime direncini en aza indirebilmek için ortak kurum
hedeflerinin ve değişim için gerekli kültürel alt yapının sağlanması gerektiği
sonuçlarına ulaşılmıştır. Bununla birlikte kurum aidiyetinin düşük olduğu ve
yalın uygulamaları kurumda benimsetmek için hizmet içi eğitimlere ağırlık verilmesinin
gerektiği tespit edilmiştir.

Anahtar Kelimeler

Yalın Uygulamalar, Sağlık Pofesyonelleri, Yalın Sağlık, Direnç

Kaynakça

• Alakavuklar, O. N. (2012).Yönetsel Kontrole Direncin Ahlakı. Yayınlanmamış Doktora Tezi. Dokuz Eylül Üniversitesi Sosyal Bilimler Enstitüsü İşltme Anabilim Dalı. İzmir.
• Apillioğulları, L. (2016). Yalın Dönüşüm. (2.Basım). İstanbul: Ceylan Matbaası.
• Argon T. ve Özçelik N. (2008) İlkögretim Okulu Yöneticilerinin Değişimi Yönetme Yeterlilikleri. Mehmet Akif Ersoy Üniversitesi Egitim Fakultesi Dergisi 8: 70–89.
• Arthur, J. B,Boyles, T (2007). Validating the Human Resource System Structure: A Levels-Based Stratagic HRM Aproach. Human Resource Management. Review: 17,1 pp: 77-92.
• Barnas, K.ve Adams, E.(2016). Sağlık Sektörü İçin Yalın Yönetim Sistemi. (Çev. Prof. Dr. Mustafa Ayberk Kurt ve Ayşe Soydan). İstanbul. Tor Ofset Sn. Tic. Ltd. Şti.
• Brandoa de Souza, L.(2009). Trends and Approaches in Lean Healthcare, Leadesship in Health Services. 22(2), pp: 121.
• Bush, RW.(2007). Reducing Waste in US Health Care Systems. Journal of American Medical Association. Vol. 297, No. 8, pp. 871-874.
• Byrne,A.(2015).Yalın Dönüşüm.(Çev.Melis İnan). İstanbul: Tor Ofset Sn.Tic.Ltd.Şti.
• Dave,Y.,Sohani,N.(2012). Single Minute Exchange of Dies: Literature Review. International Journal of Lean Thinking. 3.2 ,pp: 27-37.
• Doğan, N.Ö.(2011)Sağlık Sektöründe Etkinliğin İyileştirilmesi: Bir Yalın Üretim Uygulaması. Yayımlanmamış Doktora Tezi. Erciyes Üniversitesi Sosyal Bilimler Enstitüsü İşletme Anabilim Dalı Üretim ve Pazarlama Bilim Dalı. Kayseri.
• Eğitim Fakultesi Dergisi, Cilt:32(1),SS:273-406.
• Ercan, Ü.(2014). Öğrenen Örgütler, Örgütsel Değişim ve Değişime Direnç: Bir Tipoloji Önerisi. İş ve İnsan Dergisi 1.1 (2014): 33-42.
• Erol, H.H.(2014).Identifying the Efects of Lean Construction Principles on Variaility of Project Duration. Diss. Middle East Technical University.Graban, M.(2011). Yalın Hastane. (Çev.Pınar Şengözer) İstanbul: Tor Ofset Sn.Tic.Ltd.Şti.
• Helvacı, M.A.(2011).Değişime Karşı Direniş Nedenlerini Belirleme Ölçeği.e-Journal of New World Sciences Academy.Volume:6 Number:3 Article Number:1CO425.
• Nunnally, Jum C (1979). This Week’s Citation Classic: Nunnally J C. Psychometric theory. New York: McGraw Hill, 1967, Department of Psychology Vanderbilt University. Nashville, TN 37240.
• Nursing Management. Review:17.5, pp:647-654.
• Ozen, F.E.(2015). Team Performance Management. An International Journal. Janset.
• Seren Şeyda, Ülkü BAYKAL (2007), Kalite Belgesi Alan Hastanelerde Örgüt Kültürü ve Değişime Karşı Tutumun İncelenmesi, Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi,; 10: 2, 1-11
• Seren, Ş.(2005).Değişime Karşı Tutum Ölçeğinin Geliştirirlmesi ve Kalite Belgesi Alan Hastanelerde Değişim ile Örgüt Kültürü Arasındaki İlişkinin İncelenmesi. Yayımlanmamış Doktora Tezi. İsatanbul Üniversitesi Sağlık Bilimleri Enstitüsü Hemşirelik Yönetim Anabilim Dalı. İstanbul.
• Sökmen, A.(2013). Örgütsel Davranış.(1.Basım). Ankara: Detay Yayıncılık.
• Terbaş, Ö. (2005). Joseph K.`nin direnci. İmago Dergisi.
• Tunçer, P.(2013).Değişim Yönetimi Sürecinde Değişime Direnme. Ondokuz Mayıs Üniversitesi
• Wilson, G.(2009).İmplemation of Relasing True to Care the Productive Ward. Journal of
• Womack, J.P.veJones, D.T.(2015).YalınDüşünce.(Çev: OygurYamak).(3.Basım) İstanbul: Tor Ofset Sn.Tic. Ltd.Şti.
• www.ihi.org (Erişim Tarihi: 10.02.2018)
• www.kalite.gov.tr (Erişim Tarihi: 12.05.2018)
• www.ulakbilim.gov.tr (Erişim Tarihi: 15.05.2018)
• www.yok.gov.tr (Erişim Tarihi: 10.06.2018)
• Yıldız, M.S. ve Yalman, F.(2015).Sağlık İşletmelerinde Yalın Uygulamalar Üzerine Genel Bir Literatür Taraması. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi. Cilt:1Sayı:1.
• Yüksel, H. (2012).Yalın Sağlık (1.Basım).Ankara: Nobel Akademik Yayıncılık Eğitim Danışmanlık Tic.Ltd. Şti.