Publications

2024

Lean Leadership to Advance Strategic and Health Equity Goals - Legacy Health

Lean Action Research Learning Collaborative (LARLC)

Lean Leadership to Advance Strategic and Health Equity Goals - Zuckerberg SF General Hospital and Trauma Center 

Lean Action Research Learning Collaborative (LARLC)

Lean Leadership to Advance Strategic and Health Equity Goals - John Muir Health

Lean Action Research Learning Collaborative (LARLC)

Lean Leadership to Advance Strategic Goals - Indiana University Health

Lean Action Research Learning Collaborative (LARLC)

Associations Between Lean IT Management and Financial Performance in US Hospitals

Justin Lee, BA; Dorothy Hung, PhD, MA, MPH; Elina Reponen, MD, PhD; Thomas G. Rundall, PhD; Aaron A Tierney, BA; Pierre-Luc Fournier, PhD, MS; Stephen M. Shortell, PhD, MBA, MPH


2023

Sustainability of performance improvements after 26 Kaizen events in a large academic hospital system: a mixed methods study

Erik Haapatalo, Elina Reponen, MD, PhD; Paulus Torkki, PhD

Lean Performance Indicators and Facilitators of Outcomes in U.S. Public Hospitals

Tyler Roey, Dorothy Y. Hung, PhD, Thomas G. Rundall, PhD, Pierre-Luc Fournier, PhD, Athena Zhong, and Stephen M. Shortell, PhD

The Better Care Plan: a blueprint for improving America’s healthcare system
Stephen M. Shortell MBA, MPH Ph.D, John T. Toussaint MD, George C. Halvorson, Jon M. Kingsdale SPH, Richard M. Scheffler PhD, Allyson Y. Schwartz MS., Peter A. Wadsworth MBA, Gail Wilensky PhD.

Let’s talk about it: the impact of nurses’ implicit voice theories on individual agility and quality of care

Pierre-Luc Fournier, PhD, MS; Lionel Bahl, DBA, MBA, BAA; Desiree H. van Dun, PhD; Kevin J. Johnson, MS, PhD; Jean Cadieux, PhD;


2022

Transformational Performance Improvement: Why is Progress Slow?(PDF file)

Dorothy Y. Hung MA, Ph.D., MPH; Justin Lee; Thomas G. Rundall Ph.D.

Managing Through a Pandemic: A Daily Management System for COVID-19 Response and Recovery(PDF file)

Dorothy Y. Hung, Ph.D., ; Thomas G. Rundall, Ph.D., ; Justin Lee; Negeen Khandel; Stephen M. Shortell, Ph.D.;

Lean Practices for Resource Use, Timeliness, and Coordination of Care in Breast Cancer Navigation(PDF file)

Dorothy Y. Hung, Ph.D., MA, MPH, Paul Kim, MS, Martina Li, MPH, Qiwen Huang, MS, Cynthia Cantril, MPH, RN, OCN®, CBCN®, Natalia Colocci, MD, Ph.D., and Ellis C. Dillon, Ph.D.

Expert-Identified Practices for Achieving Measurable Performance Improvements With Lean Implementation(PDF file)

Elina Reponen, Thomas G. Rundall, Ph.D, Stephen M. Shortell, Ph.D., Janet C. Blodgett, Ritva Jokela, Markku Mäkijärvi, Paulus Torkki

Breast Cancer Navigation: Using physician and patient surveys to explore nurse navigator program experiences(PDF file)

Ellis C. Dillon, Ph.D., Paul Kim, MS, Martina Li, MPH, Qiwen Huang, MS, Natalia Colocci, MD, Ph.D., Cynthia Cantril, RN, MPH, OCN, CBCN, and Dorothy Y. Hung, Ph.D., MA, MPH

Seizing the opportunity: the emergence of shared leadership during the deployment of an integrated performance management system(PDF file)

Pierre‐Luc Fournier Ph.D., Line Moisan, and Denis Lagacé

Lean adoption, implementation, and outcomes in public hospitals: benchmarking the US and Italy health systems(PDF file)

Marta Marsilio Ph.D, Martina Pisarra M.S. , Karl Rubio M.S. and Stephen Shortell, Ph.D.


2021

Examining the Relationship Between the Lean Management System and Quality Improvement Care Management Processes

Aaron A. Tierney, BA; Stephen M. Shortell, PhD, MPH, MBA; Thomas G. Rundall, PhD; Janet C. Blodgett, MSc; Elina Reponen, MD, PhD

Assessing the relationship of the human resource, finance, and information technology functions on reported performance in hospitals using the Lean
management system

Stephen M. Shortell, MPH, PhD; Thomas G. Rundall, PhD; Janet C. Blodgett, MS

Road to Better Work-Life Balance? Lean Redesigns and Daily Work Time among Primary Care Physicians(PDF file)

Dorothy Y. Hung, Ph.D., Gabriela Mujal, M.H.A, Anqi Jin, Ph.D., and Su‐Ying Liang, Ph.D.

Validation of the Lean Healthcare Implementation Self-Assessment Instrument (LHISI) in the Finnish Healthcare Context(PDF file)

Elina Reponen MD, Ph.D., Ritva Jokela, Janet C. Blodgett M.S., Thomas G. Rundall Ph.D., Stephen M. Shortell Ph.D., Mikko Nuutinen Ph.D., Noora Skants M.D., Markku Mäkijärvi M.D., and Paulus Torkki Ph.D.

The cross-national applicability of lean implementation measures and hospital performance measures: a case study of Finland and the USA(PDF file)

Elina Reponen M.D., Ph.D., Thomas G. Rundall Ph.D., Stephen M. Shortell MPH, MBA, Ph.D, Janet C. Blodgett M.S.c, Ritva Jokela Ph.D., Markku Mäkijärvi M.D., and Paulus Torkki Ph.D.

Implementing Lean QI in PC: Impact on Efficiency in Performing Common Clinical Tasks (PDF file)

Pierre-Luc Fournier, Ph.D., Denis Chênevert M.S.c, Marie-Hélène Jobin MBA, Ph.D.

Lean implementation in healthcare: offsetting Physicians’ resistance to change(PDF file)

Pierre-Luc Fournier Ph.D., Marie-Hélène Jobin MBA, Ph.D., Liette Lapointe, Ph.D. M.S.c & Lionel Bahl, MBA

Lean, Shingo, and the Baldrige Framework: A Comprehensive Method to Achieve a Continuous-Improvement Management System(PDF file)

John S. Toussaint M.D., John R. Griffith, MBA, FACHE, Stephen M. Shortell, Ph.D., MPH, MBA

Lean Management and Hospital Performance: Adoption vs. Implementation(PDF file)

Stephen M. Shortell, Ph.D., MPH, MBA; Janet C. Blodgett, MSc; Thomas G. Rundall, Ph.D.; Rachel Mosher Henke, PhD; Elina Reponen, MD, PhD

2020 

Lean Management and Breakthrough Performance Improvement in Health Care

Christie Ahn, MPH; Thomas G. Rundall, PhD; Stephen M. Shortell, PhD, MPH, MBA; Janet C. Blodgett, MSc; Elina Reponen, MD, PhD

Patient experiences after implementing lean primary care redesigns

Dorothy Y. Hung PhD, MA, MPH; Gabriela Mujal MPH; Anqi Jin PhD; 
Su-Ying Liang PhD

“Better Care Plan”: A Public Option Choice(link is external)

George C. Halvorson, Stephen M. Shortell MBA, MPH, Ph.D., Laurence Kotlikoff Ph.D., Elizabeth Mitchell Ph.D, Richard M. Scheffler Ph.D., John Toussaint MD, Peter A. Wadsworth MBA, Gail R. Wilensky Ph.D.

COVID-19: A catalyst for innovative hybrid teledermatology workflows to increase access and improve patient care at a large group practice

Olga Afanasiev. MD, PhD, Dorothy Y. Hung PhD, MA, MPH, Sherry Yan PhD., Bryan K. Cho, MD, PhD, Susan Huang MD,.


2019

Lean Management and U.S. Public Hospital Performance: Results From a National Survey

Justine Po; Thomas G. Rundall, PhD; Stephen Shortell PhD; Janet C. Blodgett, MS

Contextual Conditions and Performance Improvement in Primary Care

Dorothy Y. Hung, PhD, MA, MPH; Michael I. Harrison, PhD; Su-Ying Liang, PhD; Quan A. Truong, MPH

Sustainment of Lean Redesigns for Primary Care Teams

Dorothy Y. Hung, PhD, MA, MPH; Caroline P. Gray, PhD; Quan A. Truong, MPH;
Michael I. Harrison, PhD


2018

Use of Lean and Related Transformational Performance Improvement Systems in Hospitals in the United States: Results From a National Survey

Stephen M. Shortell, PhD, MPH, MBA; Janet C. Blodgett, MS; Thomas G. Rundall, PhD; Peter Kralovec, PhD

Experiences of primary care physicians and staff following lean workflow redesign

Dorothy Y. Hung PhD, MA, MPH;Michael I. Harrison, PhD; Quan A. Truong, MPH and Xue Du

Nurses’ Perspectives on Lean Redesigns to Patient Flow and Inpatient Discharge Process Efficiency

Francesca M. Nicosia, PhD; Linda G. Park NP, PhD; Caroline P. Gray PhD, Maayan J. Yakir, MD; and Dorothy Y. Hung, MPH, MA, PhD;

Physician Engagement with Metrics in Lean Primary Care Transformation

Caroline P Gray PhD, MA; Maayan Yakir MD; Dorothy Hung PhD, MPH, MA;

Development and Use of a Comprehensive Contextual Framework for Evaluation of Process Redesign

Mahima Ashok PhD, MS; Dorothy Hung PhD, MPH, MA; Lucia Rojas-Smith DrPH; Michael Halpern MD, PhD MPH; Michael Harrison PhD;


2017

Scaling Lean in Primary Care: Impacts on System Performance

Dorothy Y. Hung, PhD; Michael I. Harrison, PhD; Meghan C. Martinez, MPH; and Harold S. Luft, PhD

Acceptance of lean redesigns in primary care: A contextual analysis

Dorothy Y. Hung, PhD; Michael I. Harrison, PhD; Caroline Gray, PhD; Meghan Martinez, MPH; Julie Schmittdiel, PhD;

Ready for Change? The Role of Physician and Staff Engagement, Burnout, and
Workplace Attributes

Dorothy Hung PhD, MPH, MA; Po-Han Chen, ScM


2016

Medical Assistants as Flow Managers in Primary Care: Challenges and Recommendations 

Caroline P Gray PhD, MA; Michael I Harrison PhD; Dorothy Hung PhD, MPH, MA;

Becoming Lean: What Will It Take to Sustain Lean Redesigns?

Dorothy Hung PhD, MPH, MA; Carrie Gray PhD, MBA; Michael Conroy MD; Terrigal Burn MD;

2015

Implementing a Lean Management System in Primary Care: Facilitators and Barriers from the Front Lines
Dorothy Hung, PhD, MA, MPH; Meghan Martinez, MPH; Maayan Yakir, BS; Caroline Gray, PhD, MA;