Synergies between Healthcare Lean Management and Clinical Risk Management: A Case from Spain

Purpose-The purpose of the paper is to study "lean & safety" projects, which are those ones that combine Health Lean Management (HLM) and Clinical Risk Management (CRM). Thus, the research objective is to understand how "lean and safety" projects can be implemented, investigating the significant features that characterize them: organizational aspects, phases and activities, tools, techniques and practices and key factors. Methodology-As it is a new subject, case study methodology has been adopted; the selected project is one of the first cases where HLM is required firstly to reduce incidents and secondly to obtain efficiency improvements and HLM is fostered by who are in charge of patient safety. After creating an interview protocol based on literature, data has been collected conducting semi-structured interviews with the key informants involved in the implemented project. To guarantee triangulation, also relevant archival documentation has been collected and observations have been executed. Data were finally analysed to obtain a framework that answers the defined research objective. Originality/value-The connection between HLM and CRM is not studied in literature yet. To this extent, organizational aspects, phases followed, tools and practices adopted and key factors for a successful "lean & safety" project implementation is described in this paper. This is one of the first researches that investigate characteristics of a HLM project adopted to solve CRM issues. The results suggest HLM and CRM should be considered in a new synergic methodology. First indications about how developing it are provided boosting future research, also in other contexts and contributing to the development of more safe and sustainable health care systems. Practical implications-The outcomes of this research is valuable for hospital units or health organizations that need to achieve efficiency enhancement, improving quality and patient safety at the same time. For an improved management of clinical processes, hospital managers could consider the results of this research to solve their CRM problems. The indications about phases to follow for the implementation of a "lean & safety" project could be cogitated as guidelines during the application of this emerging methodology. In addition, they could grasp from this research the characteristics for a successful implementation of projects that pursue multiple objectives in a challenging environment.