C for example one key difference appears to be

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c For example, one key difference appears to be whether the health care organization views Lean as a specific “tool” and set of techniques to “refine” or improve existing processes in smaller, discrete organizational areas, or whether it views Lean as a mechanism for fundamentally transforming care delivery processes and the entire organization, including potentially its culture. Other aspects of the Lean initiatives of importance at the organizational level are: scope and pace of Lean activity, locus of lean activity, and coordination of Lean activities and resources. A major decision that organizations must make is in how many areas and how quickly to try to implement Lean. Regardless of whether multiple areas of the inpatient or outpatient setting are being addressed or a single area and related value stream that is, whether the locus of lean activity is broad or narrow coordination of Lean activities is required. At both the organizational and Lean project levels, a variety of other factors are important. These include: leadership, education/training, communication about Lean, Lean team composition, resources, and routinization. For example, the composition and size of the Lean team itself may be shaped by several organization wide sub-domains (vision of and goals for Lean, locus of Lean activity, resources); team size and resources also reflect the content of the specific Lean project. These team features, in turn, have a significant impact on the teams’ overall effectiveness. A team is a type of formal g roup or collection of individuals who see themselves, and are seen by others, as a socially intact entity; share responsibility for tasks and outcomes; and operate within a broader organizational context, interacting with the larger organization or specific organizational subunits. 14 A health care organization’s ability to successfully implement, disseminate, and integrate Lean may also be affected by the content or nature of Lean, particularly the “fit” or “match” between the characteristics of the organi zation’s social structure and the nature of Lean. Work on the diffusion and dissemination of innovations, including organizational innovations like Lean, suggest that some innovations are a better “fit” or “match” with existing organizational structures and networks, and that successful dissemination and c Some may also consider the vision for, and goals of, Lean as part of the organizational process rather than a structural feature of the organization. However, in more rational organizational theories, visions of and goals for something like Lean are viewed as occurring first and shaping the organization of the Lean work. So, we include this sub-domain here and also consider how the vision for and goals of Lean may be reinforced, refined, or changed through the implementation process.
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7 integration is more likely when the degree of “fit” or “match” is greater. Aspects of Lean that
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