ArticleInternational journal of health care quality assurance2023
A cross-organizational Lean deployment in an Italian regional healthcare system.
Article in International journal of health care quality assurance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A Lean-based Digital Twin model for planning and governance in secondary and tertiary hospital networks.BMC health services research · 2026Article
- Lean Adoption in Healthcare: Between Promise and Practice.Healthcare (Basel, Switzerland) · 2026Review
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Authors and funding
3 authors.
Funding
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Abstract
purposeThis study explores how Lean was deployed in several hospitals in the Apulia region in Italy over 3.5 years. DESIGN/METHODOLOGY/APPROACH: An exploratory qualitative design was drawn up based on semi-structured interviews.
findingsThe drivers of Lean in hospitals were to increase patient satisfaction and improve workplace well-being by eliminating non-value-add waste. The participants highlighted three key elements of the pivotal implementation stages of Lean: introduction, spontaneous and informal dissemination and strategic level implementation and highlighted critical success and failure factors that emerged for each of these stages. During the introduction, training and coaching from an external consultant were among the most impactful factors in the success of pilot projects, while time constraints and the adoption of process analysis tools were the main barriers to implementation. The experiences of the Lean teams strongly influence the process of spontaneous dissemination aided by the celebration of project results and the commitment of the departmental hospital heads. PRACTICAL IMPLICATIONS: Lean culture can spread to allow many projects be conducted spontaneously, but the Lean paradigm can struggle to be adopted strategically. Lean in healthcare can fail because of the lack of alignment of Lean with leadership in healthcare and with their strategic vision, a lack of employees' project management skills and crucially the absence of a Lean steering committee. ORIGINALITY/VALUE: The absence of managerial expertise and a will to support Lean implementation do not allow for systemic adoption of Lean. This is one of the first and largest long-term case studies on a Lean cross-regional multi-hospital application in healthcare.
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