Continuous innovation through lean thinking in healthcare: the role of dynamic actor associations

This paper focuses on continuous innovation in healthcare examining the implementation of lean thinking in the English National Health Service (NHS). Using interviews and non-participant observations, this study focuses on the dynamics of actor associations as they are manifested in the efficiency innovations in specimen turnaround times in a pathology unit of an NHS hospital, under actor-network theory principles. We illustrate the emergence of continuous innovation as an actor-network, which is responsible for creating the necessary conditions and behavioural changes for continuous innovation. Furthermore, we explicate the mechanism of translation to represent the 'glue' that keeps the corresponding actors together, contributing to the success of lean in the hospital and subsequently continuous innovation.