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The purpose of this paper is to review original research on lean management (LM) in health care to identify potential research gaps and present recommendations for future research. The paper also discusses the current state of implementing LM practices in health care. In addition, it presents and highlights “lean bundles” imported from manufacturing, namely, total quality management (TQM), human resource management, just-in-time and total productive maintenance, as a potential implementation strategy of LM in hospitals to optimize overall health care performance.

The scoping review was conducted based on the guidelines specified by Arksey and O’Malley (2005). Relevant included studies were retrieved by searching various electronic databases. The PRISMA guidelines were applied to identify and select eligible studies.

The majority of previous studies used selected practices to measure LM in health care. In most cases, these practices reflected a narrow and biased view of LM. Lean bundles which comprehensively view LM and reflect all its aspects have rarely been discussed in the health care literature. Evidence about the contribution of lean bundles to hospital performance needs to be addressed in future studies.

This paper demonstrates the implementation of the four lean bundles in hospitals. It argues that, instead of adopting one dimension or selected practices of LM, hospitals viewing LM as a comprehensive multi-dimensional approach through the adoption of the four lean bundles are expected to maximize their performances.

This is one of the first works to comprehensively review and discuss lean bundles in the context of health care. It argues that the adoption of the four lean bundles by hospitals will enable them to yield the maximum LM performance benefits. In addition, a proposed survey questionnaire based on the literature review is provided to assist researchers in conducting future empirical studies.

Total productive maintenance and total quality management are two lean manufacturing initiatives that are used by manufacturing plant managers to improve operations capabilities. The purpose of this paper is to investigate the effects of standalone lean practices and lean bundles on manufacturing business performance.

A quantitative approach was used. The survey data were drawn from 160 manufacturing organizations in India. The respondent companies were grouped on the basis of the duration of lean production in operation and then classified based on the profile of their operations strategy. The approach, based on comparative assessment between standalone lean practices and lean bundles, has been directed toward justification of lean bundles for its support to competitive manufacturing in the context of the Indian manufacturing sector.

The paper establishes the long-term effects of lean bundles in significantly improving manufacturing business performance as compared to standalone lean practices. Further findings of the study revealed the significance of the duration of lean production in operation in achieving higher levels of manufacturing business performance.

The study is cross-sectional in nature. It would be interesting to test the analytical framework adopted for this study for more industries and in different countries. The use of subjective measures in survey questionnaire is also another limitation of the study.

This study offers clear implications for practitioners, proving that they should give higher emphasis on the implementation of lean bundles using total productive maintenance and total quality management practices together, to prioritize their product, production and business strategies, to achieve sustainable competitive advantage.

This paper empirically examines and evaluates the effect of lean practices and bundles in the context of medium- and large-sized manufacturing industries in India. Besides, there are very few studies that comparatively assess the differences in performance contribution of various lean operational strategies considering duration of implementation of lean. Also, the theoretical contribution of the study establishes the essence of integrating total productive management and total quality management for attaining world class manufacturing is of high value.

The purpose of this paper is to examine whether there are different configurations of lean bundles leading to successful (bad) financial performance and to explore how the complementarities and substitutions between lean bundles shape these configurations.

A fuzzy-set qualitative comparative analysis (fsQCA) was performed on 19 manufacturing firms. Data on financial performance (return-on-asset and growth rate) were retrieved from the AIDA database and data on the lean bundles of just-in-time, total quality management, total preventive maintenance and human resource management were collected via surveys conducted in all the plants belonging to the sampled firms.

None of the lean bundles is able to explain alone the firm’s successful financial performance. Lean bundles always have to be complemented by other lean bundles. There are different, equifinal configurations of lean bundles leading to successful (bad) financial performance. Configurations characterized by low implementation of lean bundles are related to bad financial performance.

By finding different configurations of lean bundles associated with successful and bad financial performance, this study informs operations managers on the most effective investments concerning the implementation of lean manufacturing.

This study extends literature on complementarities in lean manufacturing literature. It also bridges together apparently contradictory research on the relationship between lean manufacturing and financial performance. Finally, the study demonstrates that lean bundles have different roles in reaching successful and bad financial performance.

The purpose of this paper is to contribute to the ongoing debate about the effectiveness of lean practices in the service sector.

This paper examines the impact of lean service on firm operational and financial performance. Exploratory factor analysis is used to reduce the data and identify the underlying dimensions of lean service, and partial least squares structural equation modelling is used to test the developed model.

The results indicate that the social bundles of lean service had an independent positive impact on firm operational and financial performance. Furthermore, while the technical bundles had an independent positive effect on only the operational performance, they interacted with the social bundles to improve both the operational and financial performance. The findings suggest that service managers must follow a systematic approach when implementing lean service practices without focusing on one side of the system at the expense of the other.

The paper highlights the importance of implementing lean service as a socio-technical system (STS) if service firms are to achieve the best possible benefits from their implementation. The motivation factor (social side) and the customer value factor (technical side) are capable of improving all operational performance dimensions and profit margin even if implemented alone. Therefore, service managers with limited resources are encouraged to start lean service implementation with practices within these factors. However, they can also expect improved operational and financial performance from implementing other factors as they positively interact to further improve performance.

Viewing lean service as a STS, this paper incorporates a larger set of lean practices than previous studies and demonstrates empirically their capability of improving service firms’ operational and financial performance. It contributes significantly to the emerging literature on lean service by empirically testing the mechanism through which lean service affects firm performance.

The purpose of this paper is to study the effect of the implementation of Lean bundles on hospital performance in private hospitals in Jordan and evaluate how much the size of organization can affect the relationship between Lean bundles implementation and hospital performance.

The research is considered as quantitative method (descriptive and hypothesis testing). Three statistical techniques were adopted to analyse the data. Structural equation modeling techniques and multi-group analysis were used to examine the research’s hypothesis, and to perform the required statistical analysis of the data from the survey. Reliability analysis and confirmatory factor analysis were used to test the construct validity, reliability and measurement loadings that were performed.

Lean bundles have been identified as an effective approach that can dramatically improve the organizational performance of private hospitals in Jordan. Main Lean bundles – just in time, human resource management, and total quality management are applicable to large, small and medium hospitals without significant differences in advantages that depend on size.

According to the researchers’ best knowledge, this is the first research that studies the impact of Lean bundles implementation in healthcare sector in Jordan. This research also makes a significant contribution for decision makers in healthcare to increase their awareness of Lean bundles.

The purpose of this paper is to examine the impact of lean management (LM) on operational performance (OP) in the context of health care in Jordanian private hospitals. LM is measured using four bundles: total quality management (TQM), human resource management (HRM), just-in-time system (JIT) and total productive maintenance (TPM). The study also investigates the effects of OP dimensions on hospitals’ business performance (BP).

The study is based on survey data collected from 260 respondents from 25 private hospitals in Jordan. Validity and reliability analyses were performed using SPSS and Amos, and the study hypotheses were tested using structural equation modeling.

The study found that the TQM bundle affects quality performance positively, but does not affect efficiency and accessibility performances, while the HRM bundle positively affects all OP dimensions. Furthermore, the JIT bundle positively contributes to both efficiency and accessibility performances, while the TPM bundle positively influences quality and accessibility performances. Moreover, the results have demonstrated that OP dimensions of quality and accessibility significantly and positively affect hospitals’ BP.

This study is one of the first to adapt the four lean bundles popularized in the manufacturing sector and apply them in a health-care context. It examines the effects of the four lean bundles on hospitals’ OP in terms of efficiency, quality and accessibility. In addition, the study demonstrates the role of OP dimensions in improving private hospitals’ BP.

The paper aims to test and validate the complementarity effects on operational performance of two of the main lean manufacturing bundles, just‐in‐time (JIT) and total quality management (TQM). The paper also explores the role played by the human resource management (HRM) bundle as an enhancer of the complementarity between JIT and TQM.

The paper is based on statistical analysis on the high performance manufacturing round III database, a survey that involves 266 plants in nine countries across three different industries (electronics, machinery and transportation components).

The paper proves the existence of complementarity between JIT and TQM and shows the enabling role of HRM on such complementarity.

The paper provides analytical and empirical argumentations showing that JIT and TQM mutually reinforce each other's marginal returns on operational performance. The study also indicates that only those plants characterized by a significant implementation of HRM practices enjoy the complementarity effects of TQM and JIT on operational performance.

The research suggests a pattern of improvements where JIT and TQM have to be implemented hand‐in‐hand to take full advantage of their complementarity. HRM, the soft part of lean initiatives, provides the ground over which complementarity originates, spreading its benefits throughout the organization.

The study represents one of the few attempts trying to operationalize and empirically validate the concept of complementarity. The study also provides original suggestions to practitioners on how to make the most out of lean initiatives.

The purpose of this paper is to investigate synergy/trade-off relationship between lean and operational resilience paradigms upon disruption. Lean and resilience are operationalised with practice bundles and core functions, respectively.

The study uses the Bayesian inference approach to analyse systematically encoded data from firms that faced disruptions in their supply chain. The data were collected from publicly available sources, and encoded using predefined constructs prior to analysis.

Findings show that the synergetic relations between operational resilience and lean in mitigating performance losses outweigh the trade-off. Just-in-time/flow and total productive maintenance lean practices appear to be major sources for the trade-off; there is limited-synergy leveraged on the anticipative (sense) capability of operational resilience.

The dependence on secondary data and small sample size are possible limitations. Future research may employ large-scale studies with the same encoding approach by combining both primary and secondary sources.

This study implies that companies need not abandon their lean implementation in order to be resilient against unanticipated disruptive circumstances. Most lean practices can be used to leverage agility to mitigate disruptions.

This is a first study to empirically compare synergy/trade-off between operational resilience and lean with reference to changes in operations performance upon disruption. It is also a first study to investigate sources of synergy/trade-off at lean practice bundles and resilience core functions level. This is a much more practical level compared to how previous studies have addressed the issue.

This article presents an empirically induced “high-performance” “human resources (HR) bundle”, comprising six HR practices, for supporting lean service operations.

This was a multiple case study. A qualitative data set, including transcripts from 27 semistructured in-depth interviews with lean practitioners from across five service organizations that have adopted lean practices, was thematically analyzed to establish key HR practices on the road to lean maturity.

A “high-performance” HR bundle of three work practices and three employment practices emerged from the analysis. These practices typically mature implicitly rather than systematically to support organizations in successfully implementing lean service operations by resourcing the most suitable people for carefully defined roles, providing workers with extensive lean training opportunities, appraising workers' performances such that lean behaviours are recognized and rewarded and encouraging a participative teamworking culture.

This article uses cross-sectional data from five case studies to induce a “high-performance” “HR bundle” theoretical model and process. A larger number of case studies and/or longitudinal data would add credence.

Lean service managers should regard HR practices as integral to the lean maturation process and might usefully conceive of them as processes allowing for greater management control to achieve incremental improvements to lean service provision.

The article provides deeper understanding of the importance of HR practice for lean service organizations and offers practical suggestions for managing HR practices in this context.

The purpose of this paper is to study the effects of lean in a longitudinal context. Lean is currently experiencing its second coming. In spite of this, the current body of research on lean is especially lacking in longitudinal studies.

The methodology used in this study is a longitudinal case study. The authors combined elements of multiple-case study and survey research by analyzing interview data on the same 23 Finnish manufacturing firms at three distinct points in time (1993, 2004 and 2010) with a methodology called qualitative comparative analysis (QCA) that is novel to the field.

The “thick” results of our exploratory contingency theoretic analysis suggest that the holistic and adaptive use of lean bundles is effective. It seems that especially the firm status of ownership and the phase of the business cycle exert an impact on successful lean bundle use. There is also evidence that a certain maturation effect takes place within lean bundle use: lean is increasingly being used as a complete management philosophy.

The authors hope that this research encourages researchers to use more QCA in their research, especially with small samples.

This is a unique longitudinal study on the same 23 manufacturing firms and their development. Furthermore, this study opens new avenues for lean theory development, introduces a new methodology to the field and helps decision makers to gain a better understanding of the long-term dynamics of lean.