The application of Lean Philosophy in a healthcare environment is still a relatively new field of research, but there already exists a considerable amount of literature on the topic. This article structures, analyzes and interprets the data of articles on Lean Healthcare from 2002 through 2015 bibliometrically. The databases used in order to realize the analysis are the main sources for citation data available: Elsevier's Scopus and Thomson Reuters' Web of Science. The scientific contribution of this article lies in structuring the literature on Lean Healthcare and summarizing future research proposals. Thereby it encourages the review and consolidation of existing directions in this field of research and the exploration of new ones. With respect to the article's applied contribution it helps hospitals and professionals which want to apply Lean Healthcare to deal with uncertainties and challenges before or during its implementation by granting easy access to the literature. It also allows adapting suitable findings of major publications for the practical implementation with the goal to improve the patient experience. As results of this bibliometric analysis it was found that J.E. Bassham and D.I. Ben-Tovim share the first place as most cited authors in Lean Healthcare and the Linköpings Universitet is the most cited institution. With respect to countries, the United States take the first rank. The most cited article is Trends and approaches in lean healthcare by L. Brandão de Souza which was published in the most cited journal, namely Leadership in Health Services. Four main tendencies for future research possibilities in Lean Healthcare were identified: Evaluate the implementation; Amplify basic knowledge; Investigate challenges and success stories; Expand the focus.

Purpose Lean Six Sigma (LSS) is a continuous improvement methodology used to increase the efficiency and effectiveness of processes. Although there are several articles published, only two have analyzed the literature from a bibliometrics perspective. The purpose of this paper is to analyze the LSS literature by bibliometrics, identifying its state of the art, scientific gaps and research trends. Design/methodology/approach Articles published up to 2016 in the database Scopus were investigated to identify the most significant articles, authors, journals, institutions and countries based on citation counting as well as the most frequent keywords and subject areas on LSS. Articles published in 2014, 2015 and 2016 were analyzed to point out scientific gaps and to identify eight main research trends on LSS. Findings The research trends are: “LSS implementation”, “Healthcare”, “LSS tools”, “Human factors”, “Expansion of results”, “SME”, “LSS combined with other methodologies” and “Education”. The research outcomes also point out the most significant articles, authors, journals, institutions and countries in LSS literature. Practical implications This research contributes to develop the state of the art of LSS and helps professionals as well as researchers to identify which issues new studies should address. Originality/value The performance of the literature is measured based on the number of citations and not on the number of published papers, and the bibliometric analysis covers the highest number of articles so far (319 articles). Besides, the identification of the main research trends on LSS is exclusively based on the most recent studies.