Lean and clinical risk management: an integrated implementation framework

Purpose – This study explores how the integration of lean management (LM) and clinical risk management (CRM) approaches enhances patient safety and operational efficiency by providing an integrated implementation framework. Design/methodology/approach – An empirical case study was conducted in a large academic hospital in Northern Italy, focussing on the hospital dietary process. A multiple–data-sources approach was employed for data collection, including participatory observations, surveys, structured interviews and secondary data. Findings – The integrated lean-clinical risk management approach increased incident reporting from 7 cases in 2020 to 30 in 2023, reflecting enhanced staff awareness and adverse event reduction. Diet prescriptions documented within 24 h rose from 71% to 99%, while kitchen order variations dropped from 52% to 2%. Patient satisfaction ratings increased by 11 percentage points. Operator time for diet management decreased significantly, from 750 to 47 h monthly. Practical implications – The study provides an integrated framework to support healthcare managers in integrating risk management and lean methodologies to boost clinical safety and process efficiency. Originality/value – The study fills a literature gap by providing empirical evidence of LM and CRM integration, offering actionable insights for sustainable healthcare quality improvement.