Background: Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of\nLean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent\nto which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and\nexhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job\nresources, as perceived by staff, have a moderated mediation effect.\nMethod: A longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care units\nresponded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings of\nLean maturity reflect participantsâ?? judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion and\njob demands and resources reflect participantsâ?? judgements regarding their own situation.\nResults: First, over time, increased Lean maturity was associated with increased staff satisfaction with their care-giving\nand increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associated\nwith decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that job\ndemands and job resources had a moderated mediation effect.\nConclusion: The results indicate that primary care staff may benefit from working in organizations characterized by high\nlevels of Lean maturity and that caregiving may also be improved as perceived by staff.
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