Lean beyond waste: Towards the reduction of variability and buffers in healthcare

Roemeling, O-P., 2016, [Groningen]: University of Groningen, SOM research school. 190 p.

Research output: ThesisThesis fully internal (DIV)

Copy link to clipboard


  • Title and contents

    Final publisher's version, 150 KB, PDF document

  • Chapter 1

    Final publisher's version, 257 KB, PDF document

  • Chapter 2

    Final publisher's version, 458 KB, PDF document

  • Chapter 3

    Final publisher's version, 357 KB, PDF document

  • Chapter 4

    Final publisher's version, 285 KB, PDF document

  • Chapter 5

    Final publisher's version, 203 KB, PDF document

  • Chapter 6

    Final publisher's version, 305 KB, PDF document

  • References

    Final publisher's version, 253 KB, PDF document

  • Samenvatting

    Final publisher's version, 160 KB, PDF document

  • Dankwoord

    Final publisher's version, 125 KB, PDF document

  • Appendices

    Final publisher's version, 134 KB, PDF document

  • Complete thesis

    Final publisher's version, 1.15 MB, PDF document

  • Propositions

    Final publisher's version, 72.4 KB, PDF document

Being Lean has become a popular approach towards process improvement in health care. The reduction of waste is considered central to a Lean approach. Next to the reduction of obvious waste, Lean initiatives are expected to reduce variability and consequential buffers. Variability can be classified as natural or artificial. The latter stems from one’s own actions and should be reduced. Where variability leads to buffering in general, time and capacity buffers are especially prevalent in health care. In addition to these well-established buffer types, this thesis also exposes the role of an unexplored buffering mechanism through adjustments of processing times.

Findings in this thesis contribute to the grounding of Lean theory, based on four research projects that investigated the roles of variability and buffers, mature Lean aspects, in a Lean context. Despite the large number of interventions investigated in the first project, only a few are shown to reduce variability and improve throughput time performance. Instead, the focus of interventions is skewed towards reducing specific types of obvious waste. Yet, knowledge on the roles of variability and buffers is shown to broaden the focus of interventions. This thesis shows several opportunities for improved lean applications in health care.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Ahaus, C, Supervisor
  • Slomp, Jannes, Supervisor
  • Land, Martin, Co-supervisor
  • Donk, van, Dirk Pieter, Assessment committee
  • Fredendall, L.D., Assessment committee, External person
  • Van Merode, Godefridus G., Assessment committee, External person
Award date9-Jun-2016
Place of Publication[Groningen]
Print ISBNs978-90-367-8751-2
Electronic ISBNs978-90-367-8750-5
Publication statusPublished - 2016

Download statistics

No data available

ID: 32501083