Lean in the hospital setting: Analysis of the literature from a business process improvement perspective

As reimbursements fall and costs for services climb, organizations are forced to follow the painful motto of doing more with less. A solution could be the adaptation of industrial business process improvement methods such as Lean to the healthcare setting. Many publications have described the numerous benefits that hospitals could obtain by adopting a Lean approach. However the Lean approaches related in the literature don't seem to be structured nor reproducible. In order to evidence, we elaborate an analytical framework based on the theory on Business Process Improvement to study the structuring of the Lean approaches reported in the literature. Our literature analysis of the Lean approach in the hospital setting shows that there is a lack of methodological support in the literature for undertaking a Lean approach in the hospital setting. Given this, we suggest the elaborating a robust Lean method for the hospital setting and test this method in the pharmacy of a French university hospital.