LAUSR

PURPOSE The aim of this study is to document and analyze experiences with building a new hospital guided by lean-led hospital design (LLHD) (Grunden and Hagood, 2012) and to investigate key mechanisms enhancing healthcare professionals' participation and collaboration in implementing this innovative approach. DESIGN/METHODOLOGY/APPROACH An in-depth case study of the implementation of LLHD in a Dutch hospital was performed based on multiple data sources. The case hospital presented a unique opportunity since there was embedded access to the data by the first author. FINDINGS Three mechanisms supporting participation and collaboration of staff for implementing LLHD were identified. (1) Freedom in translating a concept enables managers to balance it with variations in practice at the organizational level. (2) A set of key principles governing the design process appeared an important anchor on a managerial level in a changing environment. (3) Creation of a supportive attitude toward lean and lean facility design, with co-creation as a key element of LLHD. PRACTICAL IMPLICATIONS By using the emerging mechanisms, managers/change agents can enlarge collaboration and participation of hospital staff when implementing organization-wide innovations. ORIGINALITY/VALUE This case study delivers a unique inside view on the dynamics evolving in the complex change processes at organizational, managerial and personal levels involved in implementing LLHD.