Modeling Employees Behavior Intention with the Adoption of a Suggestion System for Lean Initiatives

The cost of healthcare in the United States is increasing at a significant rate. A substantial portion of the increased costs is associated to non-value-added activities in healthcare. For the past two decades, the healthcare industry has employed lean principles to increase quality and safety measures while reducing costs. Lean initiatives require extensive employee participation. Capturing employee suggestions is one way to engage employees in the improvement process. The purpose of this paper is to understand factors impacting employee behavioral intentions towards using an employee suggestion system (ESS) called KaiNexus, to facilitate process improvement in a healthcare organization. For this purpose, data were collected using a questionnaire-based survey distributed among the employees of Mary Greely Medical Center (MGMC). SmartPLS software was used to analyze the collected data. Results show that performance expectancy and social influence exerted a significant positive influence on employee behavioral intentions to use KaiNexus. The variables, effort expectancy and facilitating conditions, on the other hand, did not have a significant impact on employee behavioral intentions. Findings from this research will help organizations re-evaluate factors that increase employee participation in process improvement. An employee suggestion system offers a platform for employees and managers to work collaboratively on suggestions and reduce non-value-added activities in the daily operational process. INTRODUCTION The United States (US) is the highest spender on healthcare in the world; over 17% of the US gross domestic product (GDP) was devoted to healthcare in 2013. Notably, healthcare expenditure within the United States is 50% greater than the next-highest spender, France (11.6% of GDP), and two times more than healthcare spending in the United Kingdom (8.8% of GDP) (Squires & Anderson, 2015). One of the challenges faced by the American healthcare sector is finding methods to reduce medical errors while increasing quality and maintaining costs. Indeed, in 2010 the Patient Protection and Affordable Care Act increases pressure on healthcare providers to reduce costs related to healthcare services while improving quality. Consistency with which individual patients obtain desirable health outcomes with their existing professional knowledge helps measure healthcare quality (Sanfilippo, Bieber, Javitch, & Siegrist, 2015). Markedly, inefficiencies in the care system, not just the higher cost of medical care, contribute significantly to the overall healthcare cost. The past decade saw the implementation of lean practices beyond the realm of manufacturing. In the healthcare sector, lean methodology is aimed at providing quality care at low costs (Graban, 2011). Specifically, lean principles in healthcare focus on providing quality care, increasing systems efficiency, reducing errors in the process, and making healthcare affordable. Systems efficiency is enhanced when the people using the system are motivated to work collectively towards the common goal of process improvement. Thus, lean principles in healthcare increase employee responsibility towards continuous professional improvement (Simons et al., 2017) in terms of daily responsibilities. Currently, employees participate in resolving problems without considering waste reduction as a part of their work (Manos, Sattler, & Alukal, 2006). Unnecessary procedures or bottlenecks in service processes are opportunities to facilitate improvements (Mann, 2014). Because of their familiarity with organizational procedures, employees are in the best position to suggest improvements to job activities for organizational advancement (Lindberg & Rosenqvist, 2005). In the healthcare sector, employee involvement can be enhanced by utilizing the lean management system. The lean management system is a continuous process improvement methodology that consists of multiple process improvement systems (Graban, 2011). A suggestion management system helps improve Dr. Shweta Chopra is an assistant professor in Engineering Technology and Management Department at Ohio University (OU). Prior to this she was an Assistant professor at Iowa State University. She has Ph.D. in Industrial Technology from College of Technology, Purdue University, Masters of Material Science and Engineering from Rochester Institute of Technology and Bachelors in Polymer Engineering from Pune University. Her research areas are lean manufacturing for small and medium organization, healthcare; use of Information and communication technology for food distribution, examining racial discrimination in higher education, and measuring student learning outcome with industry engagement. She teach courses related to design, capstone and operation management.