{"id":"https://openalex.org/W2131473259","doi":null,"title":"Lean Thinking in New Zealand Emergency Departments","display_name":"Lean Thinking in New Zealand Emergency Departments","publication_year":2011,"publication_date":"2011-01-01","ids":{"openalex":"https://openalex.org/W2131473259","mag":"2131473259"},"language":"en","primary_location":{"id":"pmh:oai:alma.64OTAGO_INST:11396598380001891","doi":null,"is_oa":true,"landing_page_url":"https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Lean-Thinking-in-New-Zealand-Emergency/9926478816601891","pdf_url":"https://ourarchive.otago.ac.nz/view/delivery/64OTAGO_INST/12396598370001891/13397209790001891","source":{"id":"https://openalex.org/S4306402094","display_name":"Otago University Research Archive (University of Otago)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I80281795","host_organization_name":"University of Otago","host_organization_lineage":["https://openalex.org/I80281795"],"host_organization_lineage_names":[],"type":"repository"},"license":"public-domain","license_id":"https://openalex.org/licenses/public-domain","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Masters Thesis"},"volume":null,"type":"dissertation","is_traditional":true,"indexed_in":[],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://ourarchive.otago.ac.nz/view/delivery/64OTAGO_INST/12396598370001891/13397209790001891","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5049058633","display_name":"Gareth H Rees","orcid":"https://orcid.org/0000-0002-8648-3626","observed_orcids":["https://orcid.org/0000-0002-8648-3626"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Gareth H. Rees","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0000-0002-8648-3626","affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5049058633"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":3,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.8417999744415283,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.8417999744415283,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11773","display_name":"Healthcare Operations and Scheduling Optimization","score":0.13600000739097595,"subfield":{"id":"https://openalex.org/subfields/1803","display_name":"Management Science and Operations Research"},"field":{"id":"https://openalex.org/fields/18","display_name":"Decision Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T10164","display_name":"Quality and Supply Management","score":0.01119999960064888,"subfield":{"id":"https://openalex.org/subfields/1404","display_name":"Management Information Systems"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/lean-thinking","display_name":"lean thinking","score":0.9100000262260437},{"id":"https://openalex.org/keywords/emergency-department","display_name":"emergency department","score":0.9520000219345093},{"id":"https://openalex.org/keywords/hospital-operations-management","display_name":"hospital operations management","score":0.6259999871253967},{"id":"https://openalex.org/keywords/toyota-production-system","display_name":"Toyota Production System","score":0.843999981880188},{"id":"https://openalex.org/keywords/waste-reduction","display_name":"waste reduction","score":0.8539999723434448},{"id":"https://openalex.org/keywords/patient-flow","display_name":"patient flow","score":0.9509999752044678},{"id":"https://openalex.org/keywords/process-redesign","display_name":"process redesign","score":0.9380000233650208},{"id":"https://openalex.org/keywords/waiting-time","display_name":"waiting time","score":0.6520000100135803},{"id":"https://openalex.org/keywords/organizational-commitment","display_name":"organizational commitment","score":0.7070000171661377},{"id":"https://openalex.org/keywords/continuous-quality-improvement","display_name":"continuous quality improvement","score":0.625},{"id":"https://openalex.org/keywords/implementation-readiness","display_name":"implementation readiness","score":0.5320000052452087},{"id":"https://openalex.org/keywords/new-zealand-healthcare-system","display_name":"New Zealand healthcare system","score":0.6650000214576721},{"id":"https://openalex.org/keywords/district-health-boards","display_name":"District Health Boards","score":0.7390000224113464}],"concepts":[{"id":"https://openalex.org/C137335462","wikidata":"https://www.wikidata.org/wiki/Q380772","display_name":"Lean manufacturing","level":2,"score":0.5755840539932251},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.38817697763442993},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.35577577352523804},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.3484219014644623},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.34794098138809204},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.3308722674846649}],"mesh":[],"locations_count":3,"locations":[{"id":"pmh:oai:alma.64OTAGO_INST:11396598380001891","doi":null,"is_oa":true,"landing_page_url":"https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Lean-Thinking-in-New-Zealand-Emergency/9926478816601891","pdf_url":"https://ourarchive.otago.ac.nz/view/delivery/64OTAGO_INST/12396598370001891/13397209790001891","source":{"id":"https://openalex.org/S4306402094","display_name":"Otago University Research Archive (University of Otago)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I80281795","host_organization_name":"University of Otago","host_organization_lineage":["https://openalex.org/I80281795"],"host_organization_lineage_names":[],"type":"repository"},"license":"public-domain","license_id":"https://openalex.org/licenses/public-domain","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Masters Thesis"},{"id":"pmh:oai:ourarchive.otago.ac.nz:10523/1673","doi":null,"is_oa":false,"landing_page_url":"http://hdl.handle.net/10523/1673","pdf_url":null,"source":{"id":"https://openalex.org/S4306402094","display_name":"Otago University Research Archive (University of Otago)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I80281795","host_organization_name":"University of Otago","host_organization_lineage":["https://openalex.org/I80281795"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"","raw_type":"Thesis or Dissertation"},{"id":"mag:2131473259","doi":null,"is_oa":false,"landing_page_url":"https://ourarchive.otago.ac.nz/bitstream/handle/10523/1673/ReesGarethH2011MCom.pdf?sequence=3&isAllowed=y","pdf_url":null,"source":null,"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":null}],"best_oa_location":{"id":"pmh:oai:alma.64OTAGO_INST:11396598380001891","doi":null,"is_oa":true,"landing_page_url":"https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Lean-Thinking-in-New-Zealand-Emergency/9926478816601891","pdf_url":"https://ourarchive.otago.ac.nz/view/delivery/64OTAGO_INST/12396598370001891/13397209790001891","source":{"id":"https://openalex.org/S4306402094","display_name":"Otago University Research Archive (University of Otago)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I80281795","host_organization_name":"University of Otago","host_organization_lineage":["https://openalex.org/I80281795"],"host_organization_lineage_names":[],"type":"repository"},"license":"public-domain","license_id":"https://openalex.org/licenses/public-domain","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Masters Thesis"},"sustainable_development_goals":[{"score":0.5683000087738037,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W2131473259.pdf","grobid_xml":"https://content.openalex.org/works/W2131473259.grobid-xml"},"referenced_works_count":145,"referenced_works":["https://openalex.org/W8317445","https://openalex.org/W11246522","https://openalex.org/W37333758","https://openalex.org/W81976031","https://openalex.org/W89006023","https://openalex.org/W99445820","https://openalex.org/W119335414","https://openalex.org/W122490179","https://openalex.org/W146116596","https://openalex.org/W146295182","https://openalex.org/W149670520","https://openalex.org/W155913291","https://openalex.org/W156695486","https://openalex.org/W158425375","https://openalex.org/W182673633","https://openalex.org/W588152175","https://openalex.org/W607215570","https://openalex.org/W619456796","https://openalex.org/W629174874","https://openalex.org/W642987987","https://openalex.org/W643357838","https://openalex.org/W1113029892","https://openalex.org/W1268823226","https://openalex.org/W1480564874","https://openalex.org/W1488999880","https://openalex.org/W1497880770","https://openalex.org/W1498661229","https://openalex.org/W1502208683","https://openalex.org/W1505713965","https://openalex.org/W1507254873","https://openalex.org/W1552064639","https://openalex.org/W1556808170","https://openalex.org/W1561082337","https://openalex.org/W1565676949","https://openalex.org/W1567853885","https://openalex.org/W1571608640","https://openalex.org/W1575538149","https://openalex.org/W1583309098","https://openalex.org/W1585558379","https://openalex.org/W1599912393","https://openalex.org/W1628652433","https://openalex.org/W1678912940","https://openalex.org/W1748126148","https://openalex.org/W1813152427","https://openalex.org/W1951650234","https://openalex.org/W1966468224","https://openalex.org/W1966502690","https://openalex.org/W1968374962","https://openalex.org/W1968832457","https://openalex.org/W1975302410","https://openalex.org/W1981801264","https://openalex.org/W1983604443","https://openalex.org/W1990515608","https://openalex.org/W1991625287","https://openalex.org/W1995620412","https://openalex.org/W1995770442","https://openalex.org/W1996708228","https://openalex.org/W2001136514","https://openalex.org/W2001863909","https://openalex.org/W2006586354","https://openalex.org/W2007318974","https://openalex.org/W2008412068","https://openalex.org/W2016938270","https://openalex.org/W2018719120","https://openalex.org/W2019213824","https://openalex.org/W2022186374","https://openalex.org/W2025457205","https://openalex.org/W2027644972","https://openalex.org/W2030819835","https://openalex.org/W2034908742","https://openalex.org/W2035619925","https://openalex.org/W2038745959","https://openalex.org/W2038914841","https://openalex.org/W2038944617","https://openalex.org/W2039326807","https://openalex.org/W2040460963","https://openalex.org/W2043409772","https://openalex.org/W2052032300","https://openalex.org/W2053035716","https://openalex.org/W2054355619","https://openalex.org/W2054689636","https://openalex.org/W2054966119","https://openalex.org/W2058437460","https://openalex.org/W2059670147","https://openalex.org/W2060785188","https://openalex.org/W2060832157","https://openalex.org/W2063838323","https://openalex.org/W2072183866","https://openalex.org/W2078084576","https://openalex.org/W2079713767","https://openalex.org/W2082994591","https://openalex.org/W2089364879","https://openalex.org/W2090884139","https://openalex.org/W2091355224","https://openalex.org/W2096477395","https://openalex.org/W2096524740","https://openalex.org/W2102765772","https://openalex.org/W2103362967","https://openalex.org/W2108291413","https://openalex.org/W2111482690","https://openalex.org/W2122132181","https://openalex.org/W2123587276","https://openalex.org/W2123901209","https://openalex.org/W2125031440","https://openalex.org/W2126840412","https://openalex.org/W2127160769","https://openalex.org/W2127815280","https://openalex.org/W2132214814","https://openalex.org/W2132377426","https://openalex.org/W2134648895","https://openalex.org/W2135005078","https://openalex.org/W2145075990","https://openalex.org/W2148952715","https://openalex.org/W2152428604","https://openalex.org/W2152515782","https://openalex.org/W2154876759","https://openalex.org/W2165736487","https://openalex.org/W2165753045","https://openalex.org/W2167695057","https://openalex.org/W2168133647","https://openalex.org/W2171985063","https://openalex.org/W2172157658","https://openalex.org/W2224915355","https://openalex.org/W2279253926","https://openalex.org/W2331205351","https://openalex.org/W2332433940","https://openalex.org/W2336196788","https://openalex.org/W2395302983","https://openalex.org/W2410659502","https://openalex.org/W2423315748","https://openalex.org/W2470227887","https://openalex.org/W2486787337","https://openalex.org/W2490322786","https://openalex.org/W2523503890","https://openalex.org/W2535419763","https://openalex.org/W2554845805","https://openalex.org/W2572143326","https://openalex.org/W2582377764","https://openalex.org/W2605895408","https://openalex.org/W2777803356","https://openalex.org/W2798911043","https://openalex.org/W2986921706","https://openalex.org/W2991813816","https://openalex.org/W2992277189","https://openalex.org/W3145636598"],"related_works":["https://openalex.org/W2138109499","https://openalex.org/W2766190576","https://openalex.org/W2071517960","https://openalex.org/W3044212705","https://openalex.org/W2761691812","https://openalex.org/W7119313651","https://openalex.org/W1748126148","https://openalex.org/W4386781640","https://openalex.org/W2060710073","https://openalex.org/W2170920092"],"abstract_inverted_index":{"Quality":[0],"and":[1,12,34,42,76,94,116,145,152,158,227,236,241,283,295,320,369,401,414,443],"costs":[2],"of":[3,28,30,45,52,106,141,169,181,199,207,232,299,326,336,342,346,355,380,435,463],"healthcare":[4,74,172,193,468],"have":[5,78,100],"become":[6],"a":[7,40,111,142,196,248,324,340,432,460,467],"focus":[8],"for":[9,65,412,445,459],"the":[10,18,23,49,53,70,104,107,121,131,179,224,230,238,256,281,297,300,305,311,316,332,337,424,439,446],"public":[11,19],"governments":[13,33],"alike.":[14],"Not":[15],"only":[16],"are":[17,36,126,162],"rightly":[20],"concerned":[21],"with":[22],"relative":[24],"risk":[25,379],"to":[26,56,80,88,138,149,177,212,220,293,398,455],"them":[27],"both":[29],"these":[31,156],"issues;":[32],"insurers":[35],"particularly":[37],"mindful":[38],"from":[39,262,276,291,438],"funding":[41],"efficacy":[43],"point":[44],"view.":[46],"This":[47,174,382],"explains":[48],"innate":[50],"attraction":[51],"health":[54],"system":[55,112,194,461],"interventions":[57],"that":[58,113,134,147,385,387,422],"enhance":[59,92],"quality":[60,115,151,392],"while":[61],"simultaneously":[62],"maintaining":[63],"value":[64],"money.":[66],"As":[67,202],"such,":[68],"over":[69],"last":[71],"ten":[72],"years":[73],"systems":[75],"institutions":[77],"begun":[79],"employ":[81],"operations":[82],"management":[83,143],"techniques":[84],"within":[85,466],"their":[86,457],"hospitals":[87,407],"better":[89],"organise":[90],"work,":[91],"flows":[93],"improve":[95,150],"productivity.":[96],"Modern":[97],"manufacturing":[98,157],"methods":[99],"been":[101,136],"led":[102],"by":[103,280,284,430,453],"globalisation":[105],"Toyota":[108],"Production":[109],"System;":[110],"integrates":[114],"waste":[117,371],"reduction":[118],"activities":[119,146],"into":[120],"production":[122],"tasks":[123],"as":[124,255],"they":[125],"performed.":[127],"Lean":[128,182,200,208,233,359,400,425,464],"Thinking":[129,183,209,234,360,465],"is":[130,195,210,378],"generic":[132],"label":[133],"has":[135],"given":[137],"this":[139,203],"combination":[140],"philosophy":[144],"aim":[148],"reduce":[153],"waste.":[154],"Moreover,":[155],"service":[159],"improvement":[160],"principles":[161],"being":[163],"used":[164,444],"in":[165,184,222,331,344,350,366,420],"an":[166,218,389],"increasing":[167],"number":[168],"sectors":[170],"including":[171],"services.":[173],"thesis":[175,428],"seeks":[176],"explore":[178],"implementation":[180,225,231,462],"New":[185,191,213,301],"Zealand":[186,214,302],"hospital":[187],"Emergency":[188],"Departments":[189],"(EDs).":[190],"Zealand\u2018s":[192],"recent":[197],"adopter":[198],"Thinking.":[201],"formal":[204],"roll":[205],"out":[206],"new":[211],"hospitals,":[215],"it":[216],"provides":[217],"opportunity":[219],"examine":[221],"detail":[223],"sites":[226,261,338],"discover":[228],"how":[229],"progressed":[235],"why":[237],"resulting":[239],"outputs":[240],"outcomes":[242],"were":[243,269,396,408],"achieved.":[244],"The":[245,427],"research":[246,258,383],"adopts":[247],"multiple":[249],"site":[250],"design":[251],"using":[252],"case":[253,312,318],"studies":[254],"primary":[257],"method.":[259],"Three":[260],"three":[263,286],"different":[264],"District":[265],"Health":[266],"Boards":[267],"(DHBs)":[268],"studied.":[270],"An":[271],"analysis":[272,306],"framework":[273,325],"was":[274,307],"developed":[275,437],"key":[277],"questions":[278],"posed":[279],"literature":[282],"crafting":[285],"best":[287,327,440],"practice":[288,328,441],"exemplar":[289,333],"cases":[290],"which":[292,449],"compare":[294],"contrast":[296],"progress":[298],"implementations.":[303],"Thus":[304],"conducted":[308],"firstly":[309],"at":[310,315],"level,":[313],"then":[314],"cross":[317],"level":[319],"finally,":[321],"reviewed":[322],"against":[323],"indicators":[329,436],"found":[330],"cases.":[334],"All":[335],"achieved":[339],"mixture":[341],"success":[343],"terms":[345],"improved":[347],"patient":[348],"flow;":[349],"effect":[351],"achieving":[352],"some":[353],"form":[354],"process":[356],"redesign.":[357],"Therefore,":[358],"can":[361],"provide":[362],"sought":[363],"after":[364],"improvements":[365],"waiting":[367],"times":[368],"operational":[370],"reductions":[372],"however,":[373],"without":[374],"organisational":[375],"commitment":[376],"there":[377],"sub-optimisation.":[381],"concludes":[384,429],"organisations":[386,454],"had":[388,416],"existing":[390],"continuous":[391],"culture":[393],"or":[394,418],"strategy":[395],"able":[397],"integrate":[399],"achieve":[402],"inter-department":[403],"admission":[404],"initiatives.":[405],"These":[406],"somewhat":[409],"more":[410],"prepared":[411],"change":[413],"already":[415],"structures":[417],"processes":[419],"place":[421],"facilitated":[423],"implementation.":[426],"offering":[431],"practical":[433],"range":[434],"exemplars":[442],"data":[447],"analysis,":[448],"could":[450],"be":[451],"employed":[452],"ascertain":[456],"readiness":[458],"environment.":[469]},"counts_by_year":[{"year":2019,"cited_by_count":1},{"year":2017,"cited_by_count":1},{"year":2016,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}