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“Lean Government” Initiative in Lithuania (2009 - to date) Dr Modestas Gelbūda ISM Research “Lean Government” Initiative in Lithuania (2009 - to date) Dr Modestas Gelbūda ISM Research Director & BILD Founder and board member Copyright © BILD

About me – academic, business, social and „public sector“ entrepreneur • • • Vilnius About me – academic, business, social and „public sector“ entrepreneur • • • Vilnius university, 1990 -1995 Aalborg university, 1994 – 1998, MSc Aalborg university, 1998 – 2004, Ph. D Stanford university, 2001 Uppsala university, 2002 Londono Business School, 2005 -2007 • Publications: - Journal of International Management - Management International Review - Journal of East-West Business • 3 company founder BILD ir 2 new venture firms Copyright © BILD

Worked closely with global firms Copyright © BILD Worked closely with global firms Copyright © BILD

Inspiration from Denmark from 1996 • A colleague and friend from 1996 • Conversations Inspiration from Denmark from 1996 • A colleague and friend from 1996 • Conversations in DK • Seminars in Lithuania • & • Direct experience with public sector in Denmark Dr Niels Gorm Rytter • Universities Aalborg University, Denmark • Municipalities Copyright © BILD

Inspiration from Denmark Randomly picked student project Lars Henrik Søfren & Aase Stegmann (2009) Inspiration from Denmark Randomly picked student project Lars Henrik Søfren & Aase Stegmann (2009) MSc thesis Lean processes in hospitals supported by health informatic Source: http: //projekter. aau. dk/projekter/en/studentthesis/sundhedsinformatisk-understoettelse-af-leanprocesser-isygehusvaesenet%28 c 7 f 09 ed 2 -9 f 88 -47 a 0 -926 b-23 b 3483 e 99 f 8%29. html Copyright © BILD

Data collection • Our empiric has been based on a literature search, • A Data collection • Our empiric has been based on a literature search, • A lean project at a hospital departments and qualitative interviews of key persons from both the lean concrete project, and other lean projects in Denmark • Supplemented with interviews of two providers of health IT solutions. • We have made a meaningful condensation of data, which are grouped in three divisions: Implementation of lean, monitoring and process support. Copyright © BILD

 • For analysis of the data we have chosen a theoretical framework combined • For analysis of the data we have chosen a theoretical framework combined with the use of change management (Kotter), Organization Culture (Schein), Socio-Technical approach (Marc Berg), STS - Symbolic interactionism (Herbert Blumer) and bound it together with Leavitts change diamond Results • The result of our investigation has shown that there have been only limited use of IT in the various lean projects, and where IT have been used, it has not been incorporated as a systematic part of the lean process but with few exceptions. Copyright © BILD

Msc thesis results • The result of our investigation has shown that there have Msc thesis results • The result of our investigation has shown that there have been only limited use of IT in the various lean projects, and where IT have been used, it has not been incorporated as a systematic part of the lean process - but with few exceptions. • We have also found that there are cultural considerations as well as some opposition to the use of IT in the clinical work in relation to lean processes. Existing IT solutions do not provide sufficient opportunities for full IT support for lean processes • We have found that only limited use of health informatics and IT in relation to lean projects is launched in Danish hospitals. This can be seen as unfortunate, and perhaps even a threat to these lean projects. • We have therefore outlined a number of options for the use of health informatics in lean processes. Copyright © BILD

Key words • • • Health informatic Process support Monitoring Lean IT system Value Key words • • • Health informatic Process support Monitoring Lean IT system Value stream analysis Copyright © BILD • • Patient flow Patient trajectories waste of time Workflow analysis

Community of volunteers – 5 people • Finance and corporate governance expert – interest Community of volunteers – 5 people • Finance and corporate governance expert – interest in transparency • Public sector leader with an understanding and interest in process excellence in Public sector • Lean consultant – in transformation and application of his competence in a new sector • Chairman of the National Young Researchers association – interest in transformation in PS • Academic entrepreneur – interest in societal change though new knowledge in Public sector Copyright © BILD

High Profile Forum at the President’s House Copyright © BILD High Profile Forum at the President’s House Copyright © BILD

High Profile Forum at the President’s House Copyright © BILD High Profile Forum at the President’s House Copyright © BILD

Attended by 70 participants, including ministers Copyright © BILD Attended by 70 participants, including ministers Copyright © BILD

Key policy makers from the Ministry of Internal Affairs Copyright © BILD Key policy makers from the Ministry of Internal Affairs Copyright © BILD

Keynote by Prof. Daniel Jones Copyright © BILD Keynote by Prof. Daniel Jones Copyright © BILD

Keynote by Prof. Daniel Jones Copyright © BILD Keynote by Prof. Daniel Jones Copyright © BILD

CEO of the YEAR Copyright © BILD CEO of the YEAR Copyright © BILD

CEO of the Most Efficient Company Copyright © BILD CEO of the Most Efficient Company Copyright © BILD

Project submitted to the idea contest • NGO and Public sector partnership funding scheme Project submitted to the idea contest • NGO and Public sector partnership funding scheme • Partner – Priminister’s Office • Lithuanian Young Researchers Association submitted an idea propoal in 2010 April • Assessment made in about year • Project start in June 2013 Copyright © BILD

Project activities • 2 experimental lean implementation initiatives in two public sector organizations • Project activities • 2 experimental lean implementation initiatives in two public sector organizations • Simultaneous research (to see how organization respond to lean implementation) • Roundtable discussion on Process Excellence and barriers in each ministry, a total of 14 • Roundtable discussions in municipalities (10) • Guidebook on “Lean Government” • 2 major conferences • Recommendations for new legislation Copyright © BILD

Progress • We are in the early stage and Lithuanian holds EU Presidency, so Progress • We are in the early stage and Lithuanian holds EU Presidency, so it is not easy to work with the government insitutions at the moment. • But we planned for it and activities are organized accordingly. Copyright © BILD

Questions & Comments Copyright © BILD Questions & Comments Copyright © BILD

Questions for Discussion • What are major shared and unique problems (inefficiencies) in the Questions for Discussion • What are major shared and unique problems (inefficiencies) in the Public Sector organizations in your countries? • How can “lean management” principles and implementation projects help solve these problems? • What are the major barriers to adapting lean in Public Sector? • How can public management institutes prepare, participate and support “lean transformatiob” initiatives in PS? Copyright © BILD

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