Healthcare Lean Readiness Assessment in a Territorial Outpatient System

Abstract

Healthcare organisations are increasingly compelled to adopt innovative managerial approaches to meet the high standards of care quality demanded by demographic changes, particularly the ageing population and the rising diffusion of chronic diseases. In this context, strengthening territorial care is essential to guarantee universal healthcare coverage. Providing care in outpatient and primary care settings enables more effective responses to population health needs, supports the prevention of chronic disease progression, and helps to reduce costly hospital admissions and clinical risks. However, implementing managerial innovation in territorial settings presents significant challenges due to the involvement of multiple care providers who must effectively coordinate and communicate to ensure continuity and integration of care. In this context, Healthcare Lean Management (HLM) emerges as a managerial approach that can reduce wastes while enhancing process performance and care quality. Nonetheless, many HLM initiatives fail due to insufficient organisational readiness to implement such a complex approach. To overcome this challenge, HLM readiness assessments are essential for identifying all those managerial, organisational, and cultural factors that must be strengthened before launching an HLM initiative. To this purpose, the current study aims to conduct an HLM readiness assessment within an outpatient territorial healthcare system in Italy, to identify critical areas for improvement and support the organisation in preparing for future HLM implementation. The evaluation was conducted using a previously developed model. A questionnaire was administered to employees and managers within the targeted setting, enabling the mapping of the readiness level and the identification of the weakest factors to be improved. Preliminary findings indicate key weaknesses in the diffusion of a culture that promote change acceptance and continuous improvement. In fact, despite strong support from top and middle management, there is a limited presence of HLM experts and leaders responsible for guiding and facilitating HLM and quality improvement projects. Results will be shared with participants to identify root causes and discuss possible countermeasures. This study represents an initial example of HLM readiness assessment in a non-hospital setting, providing valuable insights for initiating sustainable and effective improvement processes in this underexplored context. It advances knowledge in this field by proposing a model applicable in a territorial healthcare setting, without requiring prior expertise in HLM, and by integrating data analysis results with health staff insights. The contribution, both academic and managerial, also supports social sustainability and promotes patient well-being.