Problem Solving Nursing

Participants Three members of each nursing team were interviewed: the team leader, one nurse from the ward’s core team for the lean-based quality improvement programme and one nurse outside the core team.

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by acting as a coach.14 Transformational leadership is different from transactional leadership.

The latter is merely an exchange process to motivate follower compliance, where a leader clarifies performance criteria, states expectations and determines what followers receive in return.14 The link between transformational leadership theory and lean leadership is relatively under-researched.9 In healthcare, there are only a few empirical studies investigating lean leadership practices.9 10 ,3 we expect greater lean maturity to potentially lead to an elevated degree of second-order problem-solving in nursing teams.

Since then, lean has gained in popularity in the sector.1 The primary goals of lean in healthcare have been to increase the quality of care and to increase efficiency.2 To achieve these goals, most healthcare organisations have emphasised the application of lean tools to reduce direct waste, but neglected developing the problem-solving abilities of frontline employees.3 This approach may have created some process improvements, but long-term hospital-wide benefits have rarely been achieved.4 To realise more of lean’s potential, it is often suggested that structured problem-solving should be developed throughout the organisation to sustainably improve processes.3 This is inspired by Liker’s 4P model that identifies four aspects of lean: philosophy, process, people and problem-solving.3 One well-known and effective approach to this is 3 suggests that second-order problem-solving is more prevalent than first-order problem-solving in nursing teams with high levels of lean maturity.

However, evidence from a larger sample of wards is needed to confirm this.

Critical thinkingcan seem like such an abstract term that you don’t practically use. The truth is, that as nurses we can’t escape critical thinking .

Let me give you a few examples from my career in which critical thinking helped me take better care of my patient.

Interview data were used to assess the level of lean maturity (based on a customised validated instrument) and the level of second-order problem-solving (based on scenarios).

Within-case and cross-case analyses were employed to identify lean leadership practices.


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