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Following the Agenda 2030 for Sustainable Development, the main challenge for the agrofood sector is to innovate food production, offering sustainable, smart and safe solutions. The future of food production will be oriented more and more towards sustainable industries with high technological content to guarantee food safety and food security. It implies that a change not only in the way food is conceived, but also in the way it is produced, processed and consumed is needed. The aim of the present study is to investigate the role of innovation, sustainability, smartness and health within the agrofood industry.

A literature review was conducted using 596 academic documents written in English language and published in peer-reviewed scientific journals as well as in conference proceedings. The relevant articles were analyzed using both a bibliometric and a systematic approach.

The results confirm the role of innovation and sustainability as key drivers in the food industry. The main findings concern the benefits deriving from the adoption of digital technologies, the ever-increasing involvement of consumers in health and environmental issues and the introduction of the open innovation concept in the agrofood industry.

This study jointly considers the dimensions of innovation, sustainability, smartness and health in the agrofood sector, demonstrating how they are strongly interdependent.

The goal was to improve the quality of the hospitalization process and the management of patients, allowing the reduction of costs and the minimization of the preoperative Length of Hospital Stay (LOS).

The methodology used to improve the quality of the hospitalization process and patient management was Lean Thinking. Therefore, the Lean tools (Value stream map and Ishikawa diagram) were used to identify waste and inefficiencies, improving the process with the implementation of corrective actions. The data was collected through personal observations, patient interviews, brainstorming and from printed medical records of 151 patients undergoing oral cancer surgery in the period from 2006 to 2018.

The authors identified, through Value Stream Map, waste and inefficiencies during preoperative activities, consequently influencing preoperative LOS, considered the best performance indicator. The main causes were identified through the Ishikawa diagram, allowing reflection on possible solutions. The main corrective action was the introduction of the pre-hospitalization service. A comparative statistical analysis showed the significance of the solutions implemented. The average preoperative LOS decreased from 4.90 to 3.80 days (−22.40%) with a p-value of 0.001.

The methodology allowed to highlight the improvement of the patient hospitalization process with the introduction of the pre-hospitalization service. Therefore, by adopting the culture of continuous improvement, the flow of hospitalization was redrawn. The benefits of the solutions implemented are addressed to the patient in terms of lower LOS and greater service satisfaction and to the hospital for lower patient management costs and improved process quality. This article will be useful for those who need examples on how to apply Lean tools in healthcare.