Table 2 Rating scale to score the Lean transformation constructs

0

No evidence of existence

There is little to no evidence that the construct is present at the site level, appears to have neutral effect (purely descriptive) or is only mentioned generically without evidence of positive or negative influence.

 • No interviewee describes this construct as existing at this time.

 • The construct is mentioned only in passing or at a high level without examples or evidence of actual, concrete descriptions of how that construct manifests.

 • There is insufficient information to make an inference about the generally positive or negative influence.

1

Limited evidence of existence

The construct is only inconsistently present as a positive influence at this site. Interviewees make general statements about the construct manifesting in a positive way but without several different examples.

 • One interviewee describes explicit examples of how this construct manifests itself in a positive way.

 • Other interviewees make general statements about the construct manifesting in a positive way but without concrete examples. There may be reports of mixed effects of the construct on implementation but with a general overall positive.

 • There is little information to indicate that this construct affects all areas of both value streams or multiple groups/units/departments within the site.

 • The interviewee is talking about wanting to do it, but it is not yet being implemented. At least they are aware of the issue.

2

Some of the time evident

The construct is stable but narrowly present as a positive influence within some areas or at a few levels of the site.

 • Two or more interviewees similarly describe this construct and how it is manifested. Are they on the same page or not?

 • Two or more interviewees describe explicit examples of how this construct manifests itself in a positive way.

 • Other interviewees make statements about the construct manifesting in a positive way with some concrete examples. There may be a few conflicting reports indicating mixed effects of the construct on implementation but most show an overall positive impact.

 • There is some information to indicate that this construct affects all areas of both value streams or multiple groups/units/departments within the site.

3

Much of the time evident

This construct is stable and present within many areas or at many levels of the site but there are still some pockets of the organization in which this construct is lacking.

 • Two or more interviewees from different organizational groups (leaders vs middle managers vs frontline) similarly describe this construct and how it is manifested. Are they on the same page or not?

 • The majority of interviewees describe explicit examples of how this construct manifests itself in a positive way.

 • Other interviewees make concrete statements about the construct manifesting in a positive way with various types of examples. There may be a few conflicting reports indicating mixed effects of the construct on implementation but in general there is a clear overall positive impact.

 • There is a lot of information to indicate that this construct affects all areas of both value streams or multiple groups/units/departments within the site.

4

Evidence exists firmly embedded in the organiza-tion

The construct is stable and broadly established at the site level.

 • Nearly all interviewees from different organizational groups (leaders vs middle managers vs frontline) similarly describe this construct and how it is manifested. Are they on the same page or not?

 • The majority of interviewees describe explicit examples of how this construct manifests itself in a positive way.

 • Other interviewees make concrete statements about the construct manifesting in a positive way with many examples. There may be a few conflicting reports indicating possible mixed effects of the construct on implementation but there is virtually a clear overall positive impact.

 • There is overwhelming information to indicate that this construct affects virtually all areas of both value streams or multiple groups/units/departments within the site.

Miss

Missing

Interviewee(s) were not asked about the presence or influence of the construct. Interviewee(s) lack of knowledge about a construct does not necessarily indicate missing data and may instead indicate the absence of the construct.