Evaluating Lean in healthcare

Nicola Burgess (Warwick Business School, University of Warwick, Coventry, UK)
Zoe Radnor (Cardiff Business School, Cardiff University, Cardiff, UK, and School of Business and Economics, Loughborough University, Loughborough, UK)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Publication date: 15 March 2013



The purpose of this paper is to present findings relating to how Lean is implemented in English hospitals.


Lean implementation snapshots in English hospitals were conducted by content analysing all annual reports and web sites over two time periods, giving a thorough analysis of Lean's status in English healthcare.


The article identifies divergent approaches to Lean implementation in English hospitals. These approaches are classified into a typology to facilitate an evaluation of how Lean is implemented. The findings suggest that implementation tends to be isolated rather than system‐wide. A second dataset conveys Lean implementation trajectory across the time period. These data signal Lean's increasing use by English hospitals and shows progression towards an increasingly systemic approach.

Practical implications

Data were collected using content analysis methods, which relies on how “Lean” methods were articulated within the annual report and/or on the organisation's web site, which indicates approaches taken by hospital staff implementing Lean.


This research is the first to examine more closely “how” Lean is implemented in English hospitals. The emergent typology could prove relevant to other public sector organizations and service organisations more generally. The research also presents a first step to understanding Lean thinking in the English NHS. This article empirically analyses Lean implementation in English hospitals. It identifies divergent approaches that allow inferences about how far Lean is implemented in an organisation. Data represent a baseline for further analysis so that Lean implementation can be tracked.



Burgess, N. and Radnor, Z. (2013), "Evaluating Lean in healthcare", International Journal of Health Care Quality Assurance, Vol. 26 No. 3, pp. 220-235. https://doi.org/10.1108/09526861311311418

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