Purpose: NHS Trusts have begun to use Lean Management thinking to engage staff in redesigning organisational processes to reduce waste, improve quality and increase efficiency ensuring patients receive effective treatment. Lean is starting to be utilised within FM but despite evidence of process redesign and waste reduction there is no research on the impact on the people involved, or the support required for successful implementation. <p></p>\ud Theory: The study sought to understand the engagement with, and views of, lean approaches by facilities staff utilising these techniques in reorganisation projects. The understanding was applied to a case study of process redesign of the laundry service. <p></p>\ud \ud Findings: The study found that FM staff saw lean providing an opportunity to develop a better understanding between FM staff and their customers. This contributed to FM staff and customers engaging in joint process redesign, where the co-creative approach enabled the development of efficient and effective patient focused FM services. \ud It was observed that for many FM staff the lean journey can be frustrating, traumatic and in some cases life changing. Staff of all levels need the support of effective leaders as they experience changing approaches to decision making and process design.<p></p>\ud \ud Originality/Value: \ud The study provides further evidence to support the proposition that translational leadership and awareness of both ‘horizontal’ and ‘vertical’ discourses is a key enabler of effective facilitie
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