Saying what you do and doing what you say: The performative dynamics of lean management theory

Why are certain theories able to impose themselves and influence organizational practices in a significant way? Rooted at the intersection of inquiries into management fashions and into performativity, we investigate the case of the Québec public health care system, where a managerial theory – that of “lean management” – has recently emerged, gained saliency and become dominant in organizational practice. Adopting a longitudinal and multi-level research approach, we focus more precisely on the conditions that allow performativity to occur and increase, considering how this process unfolds over time. We therefore study the processes and the conditions through which lean management theory imposed itself, both in the global health care system and in two distinct health care organizations and the processes and the conditions through which this theory, while imposing itself, constructs a reality for these organizations, eventually reinforcing the theory itself. By unveiling the action of three performative dynamics in this particular case, our study provides a reflection on the catalysts and inhibitors of performativity, that goes beyond the specific case and that could be relevant to researchers interested by performativity.