Int. J Sup. Chain. Mgt Vol. 8, No. 4, August 2019 16 Lean Healthcare Practices and Operational Performance: Safety Climate as a Moderator Azyyati Anuar 1 , Rohaizah Saad 2 , Rushami Zein Yusoff 3 , Daing Maruak Sadek 4 1 Department of Business Studies, Faculty of Business and Management/ Universiti Teknologi MARA, Kedah, Malaysia 2,3 School of Technology Management and Logistics, College of Business/ University Utara, Malaysia 4 Academy of Contemporary Islamic Studies/ Universiti Teknologi MARA, Kedah, Malaysia 1 azyyati@kedah.uitm.edu.my 2 rohaizah@uum.edu.my 3 rzy278@uum.edu.my 4 daing729@kedah.uitm.edu.my Abstract : The main propose of this study was to examine the relationship between lean healthcare practices (LHP) (operational and sociotechnical aspects) and operational performance among Malaysia’s private hospitals. Specifically it aimed at investigating both the moderating role of safety climate on the relationship between operational aspects and sociotechnical aspects on operational performance. Quantitative method was applied for this study with the questionnaires were randomly distributed to 118 private hospitals in Malaysia as the sample. The data collected were analyzed by performing the PLS-SEM technique. The results indicate that operational aspects and sociotechnical aspects improved operational performance, showing that these are the important elements that should be seriously considered by practitioners. However, safety climate as a moderator failed to support the relationship between operational aspects and sociotechnical aspects on operational performance. These findings have contributed theoretically, practically and methodologically with imperative implications to academicians, policy-makers and private hospitals specifically. Keywords– Lean healthcare practices, operational performance, safety climate and private hospital 1. Introduction Lean healthcare is started with a basic concept of lean within an organization that seemed to be an efficient way to reduce waste, time, cost, as well as unnecessary travel while at the same time provide high quality services [1],[2],[3],[4]. Lean originated from Toyota Production System (TPS), a concept which was widely used in the manufacturing sector after World War II in 1940 [5]. Following that, lean service emerged in the 1990s, derived from lean manufacturing which has then expanded to non- manufacturing sectors such as insurance, banking, financial, and other service sectors including healthcare [6]. However, not all elements of lean practices have been deployed in the services sector, including in the healthcare industry. Womack and Jones introduced the idea of lean practices as lean thinking which include five main principles, namely specific value, value streams, value flow, pull value, and pursue perfection; however, it was within the manufacturing context [7]. As opposed to Womack and Jones, the principles of lean proposed by [8] have fourteen principles which included a people-focus that can be applied by organizations [8]. On the other hand, Dennis, in his book Lean Production Simplified, focused on the concept of the house of lean production by introducing six lean principles [9]. These three examples proved that lean principles described by scholars are inconsistent, but noted that the one introduced by Womack and Jones appears to be cited frequently [9]. Hence, [5] suggested that lean practices implementation in an organization is required to further strengthen the adopted lean principles, where they define lean production as the integration of sociotechnical system which is mainly adapted to eliminate waste and is associated with the social and technical practices to meet company’s objectives. There were also discussions whether lean thinking which has its background in the manufacturing sector will be suitable to be applied in healthcare firms [10]. Indeed, it is advisable to perceive lean thinking or lean healthcare into two different context by quantifying tools or operational aspects [11],[12] and the role of human factors or sociotechnical [13],[14]. Subsequently, past studies said that lean principles are capable to increase operational performance by reducing costs and lead times, and provide a high quality service, increased safety, and high morale [15]. Study by [16] discovered that JIT was a useful method to reduce costs and improved quality in the healthcare environment. This notion was further supported by [17] who said that lean provides some positive benefits such as improved quality of care and reduced costs in the healthcare sector. Consistently, social aspects of lean service also had a positive relationship on operational performance [18]. Besides, sociotechnical in the context of teamwork [19] and leadership [20],[21] are capable ______________________________________________________________ International Journal of Supply Chain Management IJSCM, ISSN: 2050-7399 (Online), 2051-3771 (Print) Copyright © ExcelingTech Pub, UK (http://excelingtech.co.uk/) brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by ExcelingTech Publishing Company (E-Journals)