Application of the Lean Healthcare method in hospitals. Global evidence and Peruvian perspective
Keywords:
Lean Healthcare, hospital modernization, quality of care, process improvement, public management, (UNESCO Thesaurus).
Abstract
The study analyzes the scientific production related to the application of the Lean Healthcare method for continuous quality improvement in hospitals. The objective of the research was to examine the potential of the Lean Healthcare method as a tool for modernizing the public hospital system in Peru. A bibliographic search was carried out with research works in databases of indexed journals that refer to advances in operational efficiency, user safety and hospital governance. Data was obtained from several countries that confirm the viability of the Lean Healthcare model. At the national level, several studies have shown satisfactory results in ambulatory management and in the perception of service quality. Evidence suggests that the model emerges as a strategic tool for institutional transformation in accordance with sustainable development goals and national guidelines aimed at optimizing public health management.
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References
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Fernández Gómez, V. J., Morales Salazar, P., & Yache Cuenca, E. J. (2025). Método Lean Healthcare en la mejora de calidad de consulta ambulatoria en un hospital público de la Región La Libertad [Tesis doctoral, Universidad César Vallejo]. Universidad César Vallejo.
Fournier, P. L., Jobin, M. H., Lapointe, L., & Bahl, L. (2021). Lean implementation in healthcare: offsetting Physicians’ resistance to change. Production Planning & Control, 34(6), 493–505. https://doi.org/10.1080/09537287.2021.1938730
Hagger, M. S., Polet, J., Lintunen, T., Ullrich-French, S., Hamilton, K., Rebar, A. L., Hein, V., Hagger, D., Hardcastle, S. J., & Chan, D. K. C. (2020). Predicting intention to participate in self-management behaviors in patients with familial hypercholesterolemia: A cross-national study. Social Science & Medicine, 242, 112591. https://doi.org/10.1016/j.socscimed.2019.112591
Kunnen, Y.S., Roemeling, O.P. & Smailhodzic, E. (2023) What are barriers and facilitators in sustaining lean management in healthcare? A qualitative literature review. BMC Health Serv Res, 23, 958. https://doi.org/10.1186/s12913-023-09978-4
Mahmoud, Z., Angelé-Halgand, N., Churruca, K., Ellis, L. A., & Braithwaite, J. (2021). The impact of lean management on frontline healthcare professionals: a scoping review of the literature. BMC health services research, 21, 383. https://doi.org/10.1186/s12913-021-06344-0
Marsilio, M., Berta, W., & Ramondetti, L. (2022). Lean adoption, implementation, and outcomes in public hospitals: An international benchmarking study comparing the US and Italy. BMC Health Services Research, 22, 122. https://doi.org/10.1186/s12913-022-07473-w
McDermott, O., Antony, J., Bhat, S., Jayaraman, R., Rosa, A., Marolla, G., & Parida, R. (2022). Lean Six Sigma in healthcare: A systematic literature review on motivations and benefits. Processes, 10(10), 1910. https://doi.org/10.3390/pr10101910
Mi, D., Li, Y., Zhang, K., Huang, C., Shan, W., & Zhang, J. (2023). Exploring intelligent hospital management mode based on artificial intelligence. Frontiers in public health, 11, 1182329. https://doi.org/10.3389/fpubh.2023.1182329
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Morales Olivares, F. J. (2022). Rediseño del proceso de gestión del área de logística y farmacia en la clínica RedSalud Providencia. [Trabajo de pregrado, Universidad de Chile]. Respositorio https://repositorio.uchile.cl/handle/2250/187623
Mukherjee, N. (2023). Quality Improvement in Critical Care Areas using the Lean Six Sigma approach. Indian Journal of Public Health Research & Development, 14(2), 90–96. https://acortar.link/xa7oYc
Ninavilca, Y. F. C., Rivera-Torcillas, W. F., & Silva-Sánchez, O. (2023). Application of Lean Office and Artificial Intelligence to optimize hospital management for improving efficiency and quality of services in Peru. Journal of Scientific and Technological Research Industrial, 6(2), 13-17. https://doi.org/10.47422/jstri.v6i2.64
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40. https://acortar.link/Db4mJV
Peimbert-García, R. E., Meave Gutiérrez-Mendoza, L., & García-Reyes, H. (2021). Applying Lean Healthcare to Improve the Discharge Process in a Mexican Academic Medical Center. Sustainability, 13(19), 10911. https://doi.org/10.3390/su131910911
Radnor, Z., Holweg, M., & Waring, J. (2012). Lean in healthcare: The unfilled promise? Social Science & Medicine, 242, 112591. https://doi.org/10.1016/j.socscimed.2011.02.011
Rathi, R., Vakharia, A., & Shadab, M. (2022). Lean six sigma in the healthcare sector: A systematic literature review. Materials today. Proceedings, 50, 773-781. https://doi.org/10.1016/j.matpr.2021.05.534
Rooslanda, E., & Ayuningtyas, D. (2023). Implementation of Lean Management for hospital service quality improvement: Literature review. Journal of Social Research, 2(8), 2488-2496. https://doi.org/10.55324/josr.v2i8.1232
Rosa, A., Marolla, G., Lega, F., & Manfredi, F. (2021). Lean adoption in hospitals: the role of contextual factors and introduction strategy. BMC health services research, 21(1), 889. https://doi.org/10.1186/s12913-021-06885-4
Schretlen, S., Hoefsmit, P., Kats, S., van Merode, G., Maessen, J., & Zandbergen, R. (2021). Reducing surgical cancellations: a successful application of Lean Six Sigma in healthcare. BMJ open quality, 10(3), e001342. https://doi.org/10.1136/bmjoq-2021-001342
Smith, I. M. (2023). Building lean improvement sckills at scale: an evaluation of a massive open online course in the English NHS. BMJ open quality, 12(4), e002357. https://doi.org/10.1136/bmjoq-2023-002357
Veres, C., Stoian, M., & Szabo, D.-A. (2025). The role of leadership in Lean Healthcare transformation: A mixed-methods study. Journal of the Knowledge Economy. https://doi.org/10.1007/s13132-025-02661-5
Wang, J., Lv, H., Chen, M., Liu, C., Ren, W., Jiang, H., & Zhang, L. (2025). A systematic review of Lean implementation in hospitals: Impact on efficiency, quality, cost, and satisfaction. International Journal of Health Policy and Management, 14(1), 1–17. https://doi.org/10.34172/ijhpm.8974
Womack, J. P., & Jones, D. T. (1997). Lean Thinking—Banish Waste and Create Wealth in your Corporation. Journal of the Operational Research Society, 48(11), 1148. https://doi.org/10.1057/palgrave.jors.2600967
Zevallos-Aquije, A., Salas-Castro, R., Carvallo-Munar, E., & Cardenas-Rengifo, L. (2021). Combined Model Based on Lean Healthcare and BPA to Reduce Waiting Times in Public Health Entities. En Y. Iano, O. Saotome, G. Kemper, A. Mendes, & G. Gomes (Eds.), Proceedings of the 6th Brazilian Technology Symposium (BTSym’20). (pp. 378-384). Springer International Publishing. https://doi.org/10.1007/978-3-030-75680-2_42
Zimmermann, G. D. S., & Bohomol, E. (2023). Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit. Revista brasileira de enfermagem, 76(3), e20220538. https://doi.org/10.1590/0034-7167-2022-0538
Zyl-Cillié, V., van Dun, D., & Meijer, H. (2024). Toward a roadmap for sustainable lean adoption in hospitals: A Delphi study. BMC Health Services Research, 24, 1088. https://doi.org/10.1186/s12913-024-11529-4
Åhlin, P., Almström, P., & Wänström, C. (2023). Solutions for improved hospital-wide patient flows: A qualitative interview study of leading healthcare providers. BMC Health Services Research, 23(1), 17. https://doi.org/10.1186/s12913-022-09015-w
Bellido-Boza, L., Villarreal-Zegarra, D., & Valdivia-Miranda, P. (2025). Human resources and healthcare infrastructure in Peru: A cross-sectional analysis from 2018 to 2024. Medrxiv, The preprint server for Health Sciences. https://doi.org/10.1101/2025.01.01.25319872
Burga Meza, M. (2023). Lean Healthcare y tiempo de espera en pacientes de emergencia de un Hospital Nacional, Perú-2023. [Tesis de licenciatura, Universidad Privada Norbert Wiener]. Repositorio de la Universidad Privada Norbert Wiener. https://hdl.handle.net/20.500.13053/10541
Cardoso, W. (2020). O mapeamento do fluxo de valor como ferramenta do Lean Healthcare para enxergar desperdícios e pontos de melhoria: o caso do pronto atendimento de um hospital universitário. Revista De Gestão Em Sistemas De Saúde, 9(2), 360–380. https://acortar.link/gm1gAD
Chen, M., Guan, Q., & Zhuang, J. (2024). Patient-centered Lean Healthcare management from a humanistic perspective. BMC Health Services Research, 24, 1261. https://doi.org/10.1186/s12913-024-11755-w
Donabedian, A. (1988). The quality of care—How can it be assessed? JAMA, 260(12), 1743–1748. https://doi.org/10.1001/jama.260.12.1743
Fernández Gómez, V. J., Morales Salazar, P., & Yache Cuenca, E. J. (2025). Método Lean Healthcare en la mejora de calidad de consulta ambulatoria en un hospital público de la Región La Libertad [Tesis doctoral, Universidad César Vallejo]. Universidad César Vallejo.
Fournier, P. L., Jobin, M. H., Lapointe, L., & Bahl, L. (2021). Lean implementation in healthcare: offsetting Physicians’ resistance to change. Production Planning & Control, 34(6), 493–505. https://doi.org/10.1080/09537287.2021.1938730
Hagger, M. S., Polet, J., Lintunen, T., Ullrich-French, S., Hamilton, K., Rebar, A. L., Hein, V., Hagger, D., Hardcastle, S. J., & Chan, D. K. C. (2020). Predicting intention to participate in self-management behaviors in patients with familial hypercholesterolemia: A cross-national study. Social Science & Medicine, 242, 112591. https://doi.org/10.1016/j.socscimed.2019.112591
Kunnen, Y.S., Roemeling, O.P. & Smailhodzic, E. (2023) What are barriers and facilitators in sustaining lean management in healthcare? A qualitative literature review. BMC Health Serv Res, 23, 958. https://doi.org/10.1186/s12913-023-09978-4
Mahmoud, Z., Angelé-Halgand, N., Churruca, K., Ellis, L. A., & Braithwaite, J. (2021). The impact of lean management on frontline healthcare professionals: a scoping review of the literature. BMC health services research, 21, 383. https://doi.org/10.1186/s12913-021-06344-0
Marsilio, M., Berta, W., & Ramondetti, L. (2022). Lean adoption, implementation, and outcomes in public hospitals: An international benchmarking study comparing the US and Italy. BMC Health Services Research, 22, 122. https://doi.org/10.1186/s12913-022-07473-w
McDermott, O., Antony, J., Bhat, S., Jayaraman, R., Rosa, A., Marolla, G., & Parida, R. (2022). Lean Six Sigma in healthcare: A systematic literature review on motivations and benefits. Processes, 10(10), 1910. https://doi.org/10.3390/pr10101910
Mi, D., Li, Y., Zhang, K., Huang, C., Shan, W., & Zhang, J. (2023). Exploring intelligent hospital management mode based on artificial intelligence. Frontiers in public health, 11, 1182329. https://doi.org/10.3389/fpubh.2023.1182329
Ministerio de Salud del Perú [MINSA]. (2022). Plan estratégico multisectorial al 2030 de la Política Nacional Multisectorial de Salud “Perú, país saludable”. https://acortar.link/bRItuV
Morales Olivares, F. J. (2022). Rediseño del proceso de gestión del área de logística y farmacia en la clínica RedSalud Providencia. [Trabajo de pregrado, Universidad de Chile]. Respositorio https://repositorio.uchile.cl/handle/2250/187623
Mukherjee, N. (2023). Quality Improvement in Critical Care Areas using the Lean Six Sigma approach. Indian Journal of Public Health Research & Development, 14(2), 90–96. https://acortar.link/xa7oYc
Ninavilca, Y. F. C., Rivera-Torcillas, W. F., & Silva-Sánchez, O. (2023). Application of Lean Office and Artificial Intelligence to optimize hospital management for improving efficiency and quality of services in Peru. Journal of Scientific and Technological Research Industrial, 6(2), 13-17. https://doi.org/10.47422/jstri.v6i2.64
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12–40. https://acortar.link/Db4mJV
Peimbert-García, R. E., Meave Gutiérrez-Mendoza, L., & García-Reyes, H. (2021). Applying Lean Healthcare to Improve the Discharge Process in a Mexican Academic Medical Center. Sustainability, 13(19), 10911. https://doi.org/10.3390/su131910911
Radnor, Z., Holweg, M., & Waring, J. (2012). Lean in healthcare: The unfilled promise? Social Science & Medicine, 242, 112591. https://doi.org/10.1016/j.socscimed.2011.02.011
Rathi, R., Vakharia, A., & Shadab, M. (2022). Lean six sigma in the healthcare sector: A systematic literature review. Materials today. Proceedings, 50, 773-781. https://doi.org/10.1016/j.matpr.2021.05.534
Rooslanda, E., & Ayuningtyas, D. (2023). Implementation of Lean Management for hospital service quality improvement: Literature review. Journal of Social Research, 2(8), 2488-2496. https://doi.org/10.55324/josr.v2i8.1232
Rosa, A., Marolla, G., Lega, F., & Manfredi, F. (2021). Lean adoption in hospitals: the role of contextual factors and introduction strategy. BMC health services research, 21(1), 889. https://doi.org/10.1186/s12913-021-06885-4
Schretlen, S., Hoefsmit, P., Kats, S., van Merode, G., Maessen, J., & Zandbergen, R. (2021). Reducing surgical cancellations: a successful application of Lean Six Sigma in healthcare. BMJ open quality, 10(3), e001342. https://doi.org/10.1136/bmjoq-2021-001342
Smith, I. M. (2023). Building lean improvement sckills at scale: an evaluation of a massive open online course in the English NHS. BMJ open quality, 12(4), e002357. https://doi.org/10.1136/bmjoq-2023-002357
Veres, C., Stoian, M., & Szabo, D.-A. (2025). The role of leadership in Lean Healthcare transformation: A mixed-methods study. Journal of the Knowledge Economy. https://doi.org/10.1007/s13132-025-02661-5
Wang, J., Lv, H., Chen, M., Liu, C., Ren, W., Jiang, H., & Zhang, L. (2025). A systematic review of Lean implementation in hospitals: Impact on efficiency, quality, cost, and satisfaction. International Journal of Health Policy and Management, 14(1), 1–17. https://doi.org/10.34172/ijhpm.8974
Womack, J. P., & Jones, D. T. (1997). Lean Thinking—Banish Waste and Create Wealth in your Corporation. Journal of the Operational Research Society, 48(11), 1148. https://doi.org/10.1057/palgrave.jors.2600967
Zevallos-Aquije, A., Salas-Castro, R., Carvallo-Munar, E., & Cardenas-Rengifo, L. (2021). Combined Model Based on Lean Healthcare and BPA to Reduce Waiting Times in Public Health Entities. En Y. Iano, O. Saotome, G. Kemper, A. Mendes, & G. Gomes (Eds.), Proceedings of the 6th Brazilian Technology Symposium (BTSym’20). (pp. 378-384). Springer International Publishing. https://doi.org/10.1007/978-3-030-75680-2_42
Zimmermann, G. D. S., & Bohomol, E. (2023). Lean Six Sigma methodology to improve the discharge process in a Brazilian intensive care unit. Revista brasileira de enfermagem, 76(3), e20220538. https://doi.org/10.1590/0034-7167-2022-0538
Zyl-Cillié, V., van Dun, D., & Meijer, H. (2024). Toward a roadmap for sustainable lean adoption in hospitals: A Delphi study. BMC Health Services Research, 24, 1088. https://doi.org/10.1186/s12913-024-11529-4
Published
2025-10-19
How to Cite
Fernández-Gómez, V. J. (2025). Application of the Lean Healthcare method in hospitals. Global evidence and Peruvian perspective. Gestio Et Productio. Revista Electrónica De Ciencias Gerenciales , 7(13), 352-368. https://doi.org/10.35381/gep.v6i11.471
Section
De Investigación
Copyright (c) 2025 Víctor Javier Fernández-Gómez
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