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How Do Spanish Hospitals Use Lean? Insights from a Multiple-Case Study
Aneta Pawłowska-Hulbój1, Bartosz Grucza1, Michał Kozieł1
1National Medical Institute of the Ministry of the Interior and Administration, 137 Wołoska Street, 02-507 Warsaw, Poland.
Healthcare (Basel, Switzerland)
|December 11, 2025
Summary
Lean Healthcare Management improves emergency departments by reducing procedure cancellations and hospital stays. Its effectiveness depends on tailoring strategies to each hospital's unique needs and patient population.
Area of Science:
- Healthcare Management
- Operations Research
- Public Health
Background:
- Emergency department visits increased by 30% in a decade, straining resources.
- Lean Healthcare Management offers a promising solution for optimizing emergency department operations.
- Growing demand necessitates efficient healthcare delivery models.
Purpose of the Study:
- To analyze specific Lean Healthcare Management interventions in three major Barcelona hospitals.
- To evaluate the impact of Lean Healthcare Management on emergency department efficiency.
- To identify commonalities and variations in Lean implementation across different healthcare settings.
Main Methods:
- Analysis of Lean Healthcare Management tools and hospital staff observations.
- Focus groups with nurses, physicians, and administrators.
- Cumulative SWOT analysis for synthesizing findings.
Main Results:
- High adherence to Lean solutions (85-89%) across hospitals.
- Reduced surgical cancellations (20%) and patient hospitalization times (8h to 70 min).
- Increased patient satisfaction and common use of Value Stream Mapping.
Conclusions:
- Lean Healthcare Management effectiveness is context-dependent.
- Successful implementation requires alignment with hospital mission, constraints, and patient population.
- Tailored Lean strategies lead to varied but positive outcomes.
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