Purpose This paper aims to propose a framework for analysing the influence of process improvement (PI) on the relationships between lean and resilience principles. Design/methodology/approach An exploratory case study of PI at the sterile unit of a hospital was conducted. Data collection for devising PI solutions involved interviews, observations and document analysis. Drawing on data from these sources as well as expert judgment, each solution was scored for their potential of using 14 lean and 7 resilience principles. Then, scores for the potential of combining pairs of lean and resilience principles were established. Findings 25 PI solutions were devised. For these, the highest joint use potential involved the lean principle of waste reduction through standardization and the resilience principle of standardization fit for purpose, followed by the relationship between the lean principle of long-term thinking and the resilience principle of providing slack resources. These and other relationships provide exploratory insight supportive of the view that the compatibility between lean and resilience is contingent upon the PI nature. Inductive reasoning generalized the method that produced these results, giving rise to a framework for the analysis of PI from the lean and resilience viewpoints. Research limitations/implications Scoring the solutions potential for using lean and resilience principles relied on the researchers’ assessment. Owing to this, the contributions of this article are more conceptual than empirical and the framework should be regarded as a basis for future empirical validation of lean-resilience relationships using more rigorous scoring methods. Originality/value Although prior studies recognized that lean implementation is context-dependent, this perspective in the realm of the relationships between lean and resilience is underexplored. Framing PI as a contextual factor that influences these relationships is also a new perspective.
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Saurin et al. (2026) studied this question.
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