Health lean management implementation in local health networks : a systematic literature review

Purpose The aim of the paper is to discuss the current knowledge about Health Lean Management (LM) implementations extending the focus toward the unexplored setting of Local Health Networks (HNs). In particular, the study analyses the fundamental variables of LM implementations: context, project characteristics, the process of implementation, outcomes, and enablers. Methodology A systematic literature review has been conducted according to the PRISMA statement, selecting 70 relevant papers for the descriptive and content analysis. Findings The conducted analysis allowed to formulate a theoretical framework. It points out the hallmarks of HLM projects in LHNs, structuring the existing knowledge and highlighting the gaps. Originality This paper offers the first systematic overview of LM implementations in HNs. Addressing this gap, the study provides meaningful insights about LM projects in a new complex context, suggesting future research opportunities. New synergies between LM and care integration strategies have been investigated, with the purpose of improving the quality of care. From a managerial perspective, the formulated theoretical framework could support health providers with a synthesis of the best managerial practices for further implementations.