Health Lean Management and Clinical Risk Management: a systematic literature review

Nowadays healthcare context needs to afford increasing costs due to aging population, more advanced technologies, inefficiencies and medical errors. These costs cannot be afford any more by the government, considering the international crisis and the pressure to the spending review, that have caused a reduction of the public health care resources. On the other hand, quality must be guaranteed, not only because patients are even more exigent and they claim high quality, but also because of quality accreditation standards required and basic ethical principles. A central problem is to assure high efficiency and high quality level at the same time, and therefore it is crucial to control and reduce wastes and errors in healthcare environment, as they increase costs and decrease health quality. In medicine, errors management is still in developing and managerial tools and practices are needed to identify, analyze, treat and monitor clinical risks. The intention of this paper is to conduct a systematic literature review in order to investigate connections and overlaps between health lean management, focused on performance improvement through waste reduction, and clinical risk management, to understand if and how these two approaches can be combined together to pursue efficiency and quality simultaneously. Results highlight an emerging research stream, highly understudied, with many useful theoretical and practical implications also for the whole society.