The purpose of this paper is to present the supportive conditions that the first-line health-care managers claim that they need from their own managers and what they experience as their own roles and responsibilities in relation to their coworkers when applying Lean principles and practices.,A survey with a Web-based questionnaire was designed and used in a Swedish health-care organization two years after the initiation of Lean to investigate the managers’ views on their role, conditions and ability to create change according to Lean. The result from two of the questions will be presented where one focuses on the relationship to the first-line managers’ own manager and the second on the relationship to their coworkers.,The results show that to initiate improvement, work based on Lean first-line managers ask for own managers who are assured about Lean, include them in discussions and ask for follow-ups and results about Lean. Concerning first-line managers’ relation to their coworkers they experience themselves as responsible for leading toward creating a culture where problems and mistakes are viewed as possibilities to improve, for encouraging that new work procedures are tested and for creating commitment and inspiration in relation to their coworkers.,The questions can be used separately or as part of an entire questionnaire before and along the Lean process to highlight organizational issues such as shared responsibility and supportive relations when developing health care.

中文翻译：

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应用精益时，“停留在中间”一线医疗保健经理的职责和支持需求

本文的目的是介绍一线医疗保健经理声称他们需要他们自己的经理提供的支持条件，以及他们在应用精益原则和实践时相对于同事所经历的角色和责任。 Lean发起两年后，瑞典卫生保健组织设计并使用了基于Web问卷的调查，以调查经理对他们的作用，条件和创造变革的能力的看法。将提出两个问题的结果，其中一个集中在与一线经理自身经理的关系上，而另一个集中在与同事的关系上。结果表明，要开始改进，以精益一线经理为基础的工作，要求自己的经理对精益有放心，将他们纳入讨论范围，并要求有关精益的跟进和结果。关于一线经理与同事的关系，他们认为自己有责任领导建立一种文化，在这种文化中，问题和错误被视为可以改善的可能性，鼓励对新的工作程序进行测试以及相对于他们的工作创造承诺和启发在精益过程之前和沿着精益过程，这些问题可以单独使用，也可以作为整个问卷的一部分使用，以突出组织问题，例如在开发医疗保健时的共同责任和支持关系。