Abstract

Purpose: This paper aims to provide a historical overview of how lean thinking has transferred and spread from Toyota manufacturing to the healthcare sector. It aims to explain the origin of lean: how it is defined, the main tools, concepts, and principles behind it, provide some lean healthcare examples, and explore the differences between the manufacturing and healthcare systems.

Design/methodology/approach: The article reviews current literature for lean application in healthcare from five databases. More than 60 articles and books were considered according to a taxonomy suggested.

Findings: Lean originated from Toyota in the 1940s due to the need to increase production efficiency, specifically by reducing waste. Since then, lean has expanded to other industries and organisations, gradually advancing to services and, since the beginning of the twenty-first century, have also been used in the healthcare sector. While the philosophy was introduced to the world by Toyota, the term ‘lean’ was only introduced by Jon Krafcik in the late 1980s. Lean initially lacked an agreed-upon definition within the literature; any agreement reached was on the potential of lean thinking in the healthcare sector. Several lean tools and techniques were used by different organisations, mostly to reduce or eliminate waste. Some of the leading examples of lean healthcare include the United States of America’s (USA) Virginia Mason Medical Centre, Theda Care in Wisconsin (USA), Bolton Hospital in England, and the Saskatchewan health care system in Canada. Even with the encouraging success stories from adopting lean as a management approach, several challenges still remain. The healthcare sector differs greatly from the motor industry as hospitals are not factories, so the transition between the two is not straight forward.

Originality/Practical implications: This literature review is helpful for journal editors and reviewers, researchers in healthcare organisations and healthcare practitioners as it offers a comprehensive, historical overview of how lean thinking has transformed and spread from Toyota manufacturers to the healthcare sector.

Keywords: Lean; Toyota production system; Just in Time; Health services; Hospital; Patients