Abstract The purpose of this paper is to study physicians' reactions to Lean implementation in healthcare organizations. More precisely, we aim to answer the following question: what is the impact of pre-change and change antecedents on physicians' behavioral reactions to Lean implementation? To do so, we used a quantitative research methodology anchored in two significant frameworks from change management theory, while considering the unique characteristics of physicians as organizational actors. Using a survey of 176 physicians in healthcare organizations across the USA, the analysis revealed significant effects of pre-change and change antecedents on physicians’ behavioral support for Lean change, mediated by their commitment to organizational change. We concluded that process antecedents linked to change management practices were instrumental in engaging physicians toward Lean, whereas efficiency driven Lean implementation and traditional managerial techniques of rewards and incentives were counterproductive. This paper contributes to the developing literature on Lean implementation and, more broadly, on service operations management in healthcare, notably by focusing on its most influential group of actors.

中文翻译：

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医生对医疗精益的行为支持的前因：承诺对组织变革的中介作用

摘要 本文的目的是研究医生对医疗机构中实施精益的反应。更准确地说，我们旨在回答以下问题：变更前和变更前因对医生对精益实施的行为反应有何影响？为此，我们使用了基于变革管理理论的两个重要框架的定量研究方法，同时考虑了医生作为组织参与者的独特特征。通过对美国各地医疗机构的 176 名医生的调查，分析揭示了变革前和变革前因对医生对精益变革的行为支持的显着影响，通过他们对组织变革的承诺进行调解。我们得出的结论是，与变革管理实践相关的流程前提有助于医生参与精益，而效率驱动的精益实施和传统的奖励和激励管理技术则适得其反。本文为有关精益实施以及更广泛的医疗保健服务运营管理的发展文献做出了贡献，特别是通过关注其最有影响力的参与者群体。