Making cars and making health care: a critical review.

The uncritical adoption of production-line manufacturing practices (such as "lean thinking") into work design processes in hospitals creates a fundamental tension between the production of health care and protection of the patient. There is scant evidence that re-engineering health care services in line with industrial models increases their efficiency. Indeed, reducing the richness of health care practice to impoverished snippets of work may add to the problems of hospital misadventure and inefficiency rather than solve them.