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First evidences from “lean & safety” projects

Maria Crema (Department of Management and Engineering, University of Padova, Vicenza, Italy)
Chiara Verbano (Department of Management and Engineering, University of Padova, Vicenza, Italy)
Maria Laura Chiozza (Department for Quality and Accreditation, University Hospital of Padova, Padova, Italy)

International Journal of Quality and Service Sciences

ISSN: 1756-669X

Article publication date: 15 June 2015




The purpose of this paper is to investigate the significant features that characterize these projects: organizational aspects, phases and activities, tools, techniques, practices and key factors for successful implementation. No studies in the academic literature have yet focused on the relation between healthcare lean management (HLM) and clinical risk management (CRM) to enhance multiple aspects of performance, although the possibility of implementing “lean & safety” projects has been highlighted.


Two significant projects have been selected from the same Italian hospital in two different fields of application. Within- and cross-case analyses have been performed to obtain useful findings.


The results suggest that HLM can provide support for CRM, and an integrated methodology should be considered. The first indications concerning how this new synergistic methodology may be developed are provided and these should stimulate future research, testing and exploiting the methodology in other contexts.


From the results of this paper, guidelines for the implementation of a “lean & safety” project could be developed to improve the management of clinical processes pursuing multiple objectives. This study could contribute to the development of safer and more sustainable health care systems for the benefit of the entire community.



The research project is supported by the “Fondazione Studi Universitari” of Vicenza. For data collection and results measuring, the authors acknowledge the contribution of the graduating student Ettore Manfrotto and the availability of the staff of “Azienda Ospedaliera di Padova”.


Crema, M., Verbano, C. and Chiozza, M.L. (2015), "First evidences from “lean & safety” projects", International Journal of Quality and Service Sciences, Vol. 7 No. 2/3, pp. 245-259.



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Copyright © 2015, Emerald Group Publishing Limited

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