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.