The antecedents of physicians' behavioral support for lean in healthcare: The mediating role of commitment to organizational change

The purpose of this paper is to study physicians' reactions to Lean implementation in healthcare organizations. More precisely, we aim to answer the following question: what is the impact of pre-change and change antecedents on physicians' behavioral reactions to Lean implementation? To do so, we used a quantitative research methodology anchored in two significant frameworks from change management theory, while considering the unique characteristics of physicians as organizational actors. Using a survey of 176 physicians in healthcare organizations across the USA, the analysis revealed significant effects of pre-change and change antecedents on physicians' behavioral support for Lean change, mediated by their commitment to organizational change. We concluded that process antecedents linked to change management practices were instrumental in engaging physicians toward Lean, whereas efficiency driven Lean implementation and traditional managerial techniques of rewards and incentives were counterproductive. This paper contributes to the developing literature on Lean implementation and, more broadly, on service operations management in healthcare, notably by focusing on its most influential group of actors.