1. “Lean Government” Initiative in Lithuania (2009 - to date) Dr Modestas Gelbūda ISM Research Director & BILD Founder and board member Copyright © BILD

2. About me – academic, business, social and „public sector“ entrepreneur Vilnius university, 1990 -1995 Aalborg university, 1994 – 1998, MSc Aalborg university, 1998 – 2004, PhD Stanford university, 2001 Uppsala university, 2002 Londono Business School, 2005-2007 Publications: - Journal of International Management - Management International Review - Journal of East-West Business 3 company founder BILD ir 2 new venture firms Copyright © BILD

3. Worked closely with global firms Copyright © BILD

4. Inspiration from Denmark from 1996 Dr Niels Gorm Rytter Aalborg University, Denmark A colleague and friend from 1996 Conversations in DK Seminars in Lithuania & Direct experience with public sector in Denmark Universities Municipalities Copyright © BILD

5. Inspiration from Denmark Randomly picked student project Lars Henrik Søfren & Aase Stegmann (2009) MSc thesis Lean processes in hospitals supported by health informatic Source: http://projekter.aau.dk/projekter/en/studentthesis/sundhedsinformatisk-understoettelse-af-leanprocesser-i- sygehusvaesenet%28c7f09ed2-9f88-47a0-926b-23b3483e99f8%29.html Copyright © BILD

6. Data collection Our empiric has been based on a literature search, A lean project at a hospital departments and qualitative interviews of key persons from both the lean concrete project, and other lean projects in Denmark Supplemented with interviews of two providers of health IT solutions. We have made a meaningful condensation of data, which are grouped in three divisions: Implementation of lean, monitoring and process support. Copyright © BILD

7. For analysis of the data we have chosen a theoretical framework combined with the use of change management (Kotter), Organization Culture (Schein), Socio-Technical approach (Marc Berg), STS - Symbolic interactionism (Herbert Blumer) and bound it together with Leavitts change diamond Results The result of our investigation has shown that there have been only limited use of IT in the various lean projects, and where IT have been used, it has not been incorporated as a systematic part of the lean process - but with few exceptions. Copyright © BILD

8. Msc thesis results The result of our investigation has shown that there have been only limited use of IT in the various lean projects, and where IT have been used, it has not been incorporated as a systematic part of the lean process - but with few exceptions. We have also found that there are cultural considerations as well as some opposition to the use of IT in the clinical work in relation to lean processes. Existing IT solutions do not provide sufficient opportunities for full IT support for lean processes We have found that only limited use of health informatics and IT in relation to lean projects is launched in Danish hospitals. This can be seen as unfortunate, and perhaps even a threat to these lean projects. We have therefore outlined a number of options for the use of health informatics in lean processes. Copyright © BILD

9. Key words Health informatic Process support Monitoring Lean IT system Value stream analysis Patient flow Patient trajectories waste of time Workflow analysis Copyright © BILD

10. Community of volunteers – 5 people Finance and corporate governance expert – interest in transparency Public sector leader with an understanding and interest in process excellence in Public sector Lean consultant – in transformation and application of his competence in a new sector Chairman of the National Young Researchers association – interest in transformation in PS Academic entrepreneur – interest in societal change though new knowledge in Public sector Copyright © BILD

11. High Profile Forum at the President’s House Copyright © BILD

12. High Profile Forum at the President’s House Copyright © BILD

13. Attended by 70 participants, including ministers Copyright © BILD

14. Key policy makers from the Ministry of Internal Affairs Copyright © BILD

15. Keynote by Prof. Daniel Jones Copyright © BILD

16. Keynote by Prof. Daniel Jones Copyright © BILD

17. CEO of the YEAR Copyright © BILD

18. CEO of the Most Efficient Company Copyright © BILD

19. Project submitted to the idea contest NGO and Public sector partnership funding scheme Partner – Priminister’s Office Lithuanian Young Researchers Association submitted an idea propoal in 2010 April Assessment made in about year Project start in June 2013 Copyright © BILD

20. Project activities 2 experimental lean implementation initiatives in two public sector organizations Simultaneous research (to see how organization respond to lean implementation) Roundtable discussion on Process Excellence and barriers in each ministry, a total of 14 Roundtable discussions in municipalities (10) Guidebook on “Lean Government” 2 major conferences Recommendations for new legislation Copyright © BILD

21. Progress We are in the early stage and Lithuanian holds EU Presidency, so it is not easy to work with the government insitutions at the moment. But we planned for it and activities are organized accordingly. Copyright © BILD

22. Questions & Comments Copyright © BILD

23. Questions for Discussion What are major shared and unique problems (inefficiencies) in the Public Sector organizations in your countries? How can “lean management” principles and implementation projects help solve these problems? What are the major barriers to adapting lean in Public Sector? How can public management institutes prepare, participate and support “lean transformatiob” initiatives in PS? Copyright © BILD

24. Group presentations Copyright © BILD