Continuous improvement and dynamic actor associations: A study of lean thinking implementation in the UK National Health Service

Purpose– The purpose of this study is to explore the link between continuous improvement (CI) and dynamic actor associations through a case of lean thinking implementation in healthcare.Design/methodology/approach– The paper follows the qualitative case study strategy. Data were collected by interviewing (tape?recording) managers and staff, analysing relevant written project material, and conducting non?participant observations.Findings– The findings suggest that the implementation of CI depends on the emergence of a “favouring” network from the dynamic associations between heterogeneous entities. This network aims at facilitating change leadership, establishing behaviour/culture prone to CI, and constructing a behaviour non?resistant to CI needed for creating competencies for the continuous roll?outs of such changes. Continuous translation is the underlying mechanism for establishing the favouring network.Originality/value– The paper addresses the literature gap regarding the role of dynamic actor associations in shaping CI in a public sector context. It does not aim at generalising the results of the case study; it informs current theory by revealing that the success of CI deployment depends on the emergence of a CI?favouring network, which will continuously transform opposing views into accepting CI.