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Lean Adoption in Healthcare: Between Promise and Practice
Jarosław Garski1, Dariusz Walkowiak1
1Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poznań 61-701, Poland.
Healthcare (Basel, Switzerland)
|August 13, 2026
Summary
Lean Management (LM) in healthcare faces adoption challenges due to interconnected barriers. This study identifies a measurement-accountability gap, tools-philosophy disconnect, and complexity-resistance cycle hindering sustainable implementation.
Area of Science:
- Healthcare Management
- Operations Research
- Organizational Behavior
Background:
- Lean Management (LM) offers significant potential for healthcare efficiency and quality improvement.
- Widespread, sustainable adoption of LM in healthcare is limited, with many initiatives failing long-term.
- Systemic barriers to LM integration in healthcare settings are not fully understood.
Purpose of the Study:
- To examine systemic barriers hindering long-term Lean Management integration in healthcare.
- To understand the gap between LM's theoretical potential and practical reality in healthcare settings.
- To develop an explanatory model of LM adoption barriers.
Main Methods:
- Systematic literature review following PRISMA 2020 guidelines.
- Searched Scopus, Emerald Insight, PubMed/MEDLINE, and Google Scholar (2015-2025).
- Focused on LM adoption, implementation, and sustainability in healthcare; synthesized data on barriers.
Main Results:
- Identified three interconnected thematic clusters of barriers: Measurement-Accountability Gap, Tools-Philosophy Disconnect, and Complexity-Resistance Cycle.
- These barriers function as mutually reinforcing loops, not independent factors.
- Evidence from ten studies synthesized into a conceptual model.
Conclusions:
- The study synthesizes reported barriers into an integrated conceptual model.
- The model highlights mutually reinforcing mechanisms hindering sustained LM adoption in healthcare.
- Provides healthcare leaders a structured perspective for interpreting limited sustained adoption patterns.
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