Lean and Agile Management and Work Engagement Among Healthcare Employees: A Systematic Literature Review

Healthcare organizations face increasing pressure to improve operational efficiency while maintaining employee well-being and work engagement. Lean and Agile Management have been increasingly applied to address these challenges, yet evidence concerning their relationship with work engagement among healthcare employees remains fragmented. This systematic literature review synthesizes the existing evidence on Lean and Agile Management and work engagement in healthcare settings. Following the PRISMA 2020 guidelines, a systematic search of Scopus-indexed literature published between 2015 and 2025 identified 26 records. After removal of five duplicate and application of the eligibility criteria, 21 studies were included in the review. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT), and thematic analysis was conducted to synthesize the evidence. Three themes emerged: patient-centered care, healthcare efficiency, and impact on work engagement. The findings indicate that Lean Management was commonly associated with improved process flow, waste reduction, teamwork, and operational efficiency, although its relationship with work engagement varied across contexts, with some studies reporting increased workload, time pressure, and job strain. Studies examining Agile Management generally reported associations with adaptability, collaboration, autonomy, and employee motivation; however, differences in study designs and contexts limit direct causal interpretation. Leadership support, communication, employee involvement, and collaborative problem-solving emerged as important conditions influencing the implementation and outcomes of both approaches. The review highlights the importance of balancing efficiency-oriented management practices with employee well-being and identifies the need for longitudinal research and integrated Lean and Agile Management models across diverse healthcare contexts.