Lean Management in Public Social and Healthcare: Navigating Value Barriers

Abstract

Lean management has been widely adopted in public social and healthcare services, with a primary focus on value creation. However, value creation, destruction and co-destruction are interdependent processes shaped by the emotional and relational experiences of change. This study examines the factors that hinder value creation in Lean management within public social and healthcare organizations, and how these factors may lead to value destruction and co-destruction during transformation processes. Thematic interviews with 15 Lean-trained managers identified three key barriers: managerial change, managerial uncertainty and challenges related to information. These factors elicited negative emotions such as fear and shame, which in turn contributed to disengagement and diminished commitment. To address these challenges, we introduce the Lean Value Management (LVM) model, developed based on the Security–Inclusion–Success (SIS) framework. LVM extends the SIS model by explicitly incorporating value destruction and co-destruction as integral aspects of Lean management. Recognizing value destruction and co-destruction as part of value creation enables sustainable value generation, enhances employee well-being and improves service outcomes within complex public sector environments.