In the quest to improve the quality of health services and ensure more excellent patient safety, healthcare institutions look for alternatives that could help them achieve this goal. The Lean methodology has been a solution found by these organizations. This study has explored through Lean healthcare literature i) main barriers and facilitators to implementing the Lean approach into healthcare service organizations, and ii) practices and tools of Lean used to improve them continuously. One hundred two documents retrieved from Scopus and Web of Science databases were analyzed to reach the search goals. Through content analysis, the main barriers to Lean program implementation within healthcare institutions are related to resistance to change, low level of staff involvement, firm commitment to a cultural change, departments working in a silo approach, and misunderstanding of Lean concepts and its benefits. On the other hand, the main facilitators are support and engagement by leadership, training, and development of workers, and crossfunctional collaboration. This study also contributes to labeling the most frequent Lean practices and tools -value stream mapping, fishbone diagram, and SIPOC. The findings of this research provide practical implications since the barriers and facilitators raised from the literature will support healthcare professionals in their Lean healthcare journey in their organizations and consequently improve their competitiveness through a high level of efficiency, quality of care, and practitioner satisfaction.
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