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The purpose of this paper is to understand the barriers and enablers to lean implementation as part of an imaging quality improvement programme from a socio-cultural perspective.

An in-depth 33 month ethnographic study, using observation and qualitative interviews, examined the process of lean implementation as part of an improvement programme.

Implementation of lean was more successful compared with other reports of lean in healthcare settings. Key enablers of lean were high levels of multidisciplinary staff involvement and engagement; the professional credibility of facilitators and clinicians as early adopters, all within a wider culture of relatively strong inter-professional relationships in the imaging department. These enablers combined with the more routinised and standardised nature of imaging pathways compared to some other acute specialties suggest that imaging is fertile ground for lean, linked to the manufacturing origins of lean.

When introducing lean within healthcare settings, special attention needs to be paid to the specific healthcare context and the existing cultures of inter-professional relationships. Fostering an improvement culture and engagement with training, together with adequate financial resource, are a key to contributing to the level of acceptability of an improvement tool such as lean.

This ethnographic study, bringing together rich multi-source data, has provided a detailed insight into the cultural workings of the process of lean implementation within a complex healthcare system.

The manufacturing sector has been observing various benefits by the implementation of lean manufacturing practices. However, the manufacturing sector has neglected the significance of health and safety management system implementation. The purpose of this research is to propose and validate an occupational health and safety management systems (OHSMS) framework based on critical success factors and their relationships in the lean manufacturing organizations.

A critical literature review was conducted to identify the success factors of OHSMS. Subsequently, a questionnaire survey and semi-structured interviews were conducted with experts from process industries to consolidate the critical success factors. After consolidating the critical success factors, relationships among critical success factors were established with the help of interpretive structural modelling using a team of 12 experts from industry and academia. These established relationships helped in proposing the hierarchical implementation framework. Finally, the validation of the proposed implementation framework was carried out using structural equation modelling (SEM).

This study has identified nine broader critical success factors for implementation of OHSMS in lean manufacturing organizations, especially the process industry. Subsequently, this study has proposed an OHSMS framework with nine broader critical success factors to implement in lean manufacturing organizations. Finally, the proposed framework has been validated using SEM with an appropriate sample size.

This study is helpful to the organizations to implement OHSMS without losing the essence of lean manufacturing strategy. This study has proposed a framework for implementation of OHSMS in the lean manufacturing organizations, especially process industry sector. This study also provided confidence to the organization through the validation of proposed framework in the process industry.

To the best of the authors’ knowledge, this study is first of its kind in this field of OHSMS in lean manufacturing organizations, especially the process industry. This study has involved both academicians and industry experts to bring more robust outcomes. This study proposed a unique framework to implement OHSMS in lean manufacturing organizations. This study has considered a comprehensive literature to develop a framework for OHSMS in lean manufacturing organizations. An implementation framework was proposed by considering both the academicians’ and industry professionals’ opinions. The proposed framework was statistically validated. This will be helpful in effective implementation of OHSMS strategy in lean manufacturing organizations, especially process industry sector.