Özet:

Lean applications are based on a philosophy of eliminating the waste in the system and consist of a production system aiming to reach the most productive way by focusing on value concept. The lean management is a philosophy that can change organization types of hospitals. Lean is a management system that allows increasing the quality of patient care by reducing mistakes and waiting period. In the long run, lean applications will make hospitals stronger by reducing costs and risks and thereby increasing growth and expansion. For a lean transformation to be successful, it is necessary to have a vision and an action plan in an organizational manner. Therefore, before applying lean improvement techniques, it is necessary to share the vision and the action plan of the institution with all personnel. To start the change, first of all, we need to change skills and thinking patterns of personnel. However, many employees are resistant to change, although they complain about the situation. A literature review for this study indicated that while there are some studies on the lean manufacturing practices with health professionals their resistance to lean applications are under researched. It is a well-known fact that health professionals are resistant to lean improvement due to distrust to change, falling in inadequate position, future anxiety, economic and social losses. However, it is important to determine for what reasons and at what level these resistances take place. Based on this idea, it was aimed that determination of health professionals working in Duzce University Health Application and Research Center how perceived lean health practices, their attitudes towards lean health practices and resistance to lean health applications and their resistance levels. The research includes health professionals working at the Health Application and Research Center of Duzce University. According to year 2016 data, there are 555 academic and executive, 138 company personnel, in total 693 health profesionals in this center. Although our intention was to include all of this personnel in the research, we were only able to include 202 people due to annual leave, compassionate leave, watch leave, and assignment of academic and executive personnel to other institutions. In determining the research method, it is thought that the quantitative research is the best choice considering the aim, problem and the subject of the survey. In the survey, the questionnaire technique was applied. Data were collected from 202 people which gives a response rate of %29 (202/693). %29 response rate is considered good comparing the other studies in social sciences. All the results of the questionnaire were analyzed in SPSS 20 package program; factor analysis, descriptive statistical analysis, deductional statistical analysis and correlation analysis were utilized. A Cronbach Alpha value of 0.925 indicates a general reliability of the questionnaire. It is known reality that health professionals are resistant to lean improvement due to distrust to change, falling in inadequate position, future anxiety, economic and social losses. It is important to find out the real reasons and level of the resistance. In this respect, “Is there a resistance of health proffesionals to lean improvement and what level is it?” is the main question of this research. The following hypotheses were formulated to address the research question: •            H1: There is a significant difference according to the gender of health professionals' resistance to lean applications. •            H2: There is a significant difference according to age ranges of health professionals' resistance to lean applications. •            H3: There is a significant difference according to the educational status of health professionals' resistance to lean applications. •            H4: There is a significant difference according to the duties in their institutions of health professionals' resistance to lean applications. •            H5: There is a significant difference according to the professional experience of health professionals' resistance to lean applications. •            H6: There is a relationship between health professionals' perceptions of lean applications and resistance states. In the findings of the survey; it is seen that % 56,4 of the participants are women; %45,5 is people at the age of 31-40; approximately %72 is at least university graduate; %57 holds executive positions; % 45 of participants have a high level of job experience. In the survey, it is seen that there is a positive and meaningful relationship between the resistance of health professionals and the results of the change. Besides, it is seen that there is no meaningful difference between the resistance of health professionals to lean improvement and their demographic characteristics (gender, age, education, jobs at institutions, job experience). In addition, it is seen that health professionals are happy with a change of the management but they are not satisfied with the performance evaluation and reward system. On the other hand, meaningful and high level of positive correlation is found between “institutional policy in change”, “resistance to change”, “results of the change” factors and “personal scale score”. Institutional belonging has a meaningful but not very strong effect on the general resistance scale score and other independent variables. In general, the results show that the resistance of health professionals to change is at a moderate level. Health professionals who accept lean improvement as positive change are resistant due to insufficient motivation and reward system. Besides, the findings show that it is necessary to have the right cultural background and common institutional targets to reduce the resistance. It is seen that the level of institutional belonging is low and it is necessary to provide on the job training to adopt to lean improvement. Low institutional belonging makes health professionals reluctant in adopting lean improvement. However, health professionals are happy with the attitude and policy of their institutions, and it is considered that this will help in reducing the resistance to change.

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