Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

Lean Healthcare (LHC) is a widely accepted approach to improve the quality of care around the world. This research compares two studies, which evaluated the adoption/implementation of LHC in Finland and Mexico, to understand how cultural similarities/differences influence LHC implementations. Data were gathered from previous questionnaire-based studies administered to healthcare professionals in both countries. Statistics (X2, p, and Wilcoxon tests) are used to compare both studies across topics related to adoption, introduction, integration, success, and barriers of LHC projects, and results are linked to cultural dimensions. Driven by economic savings, LHC has been more adopted in Finland than in Mexico (75/13%). Upon introduction, similarities are found in the way LHC projects are conducted, high project success rate, poor level of integration, and enabling/disabling factors. Conversely, differences were mainly found in the objectives of implementing LHC. These similarities/differences are linked to national factors involving culture, social structure, uncertainty management, time orientation, and indulgence level. In particular, uncertainty avoidance, equal rights’ structure, and a feminine culture are positive for implementing Lean. These findings can be a benchmark to evaluate cultural practices. Thus, this study provides insight into how national cultures relate to LHC and determined distinctive sociotechnical aspects that influence its adoption/implementation.