Lean management and operational performance in health care Implications for business performance in private hospitals

Purpose The purpose of this paper is to examine the impact of lean management (LM) on operational performance (OP) in the context of health care in Jordanian private hospitals. LM is measured using four bundles: total quality management (TQM), human resource management (HRM), just-in-time system (JIT) and total productive maintenance (TPM). The study also investigates the effects of OP dimensions on hospitals' business performance (BP). Design/methodology/approach The study is based on survey data collected from 260 respondents from 25 private hospitals in Jordan. Validity and reliability analyses were performed using SPSS and Amos, and the study hypotheses were tested using structural equation modeling. Findings The study found that the TQM bundle affects quality performance positively, but does not affect efficiency and accessibility performances, while the HRM bundle positively affects all OP dimensions. Furthermore, the JIT bundle positively contributes to both efficiency and accessibility performances, while the TPM bundle positively influences quality and accessibility performances. Moreover, the results have demonstrated that OP dimensions of quality and accessibility significantly and positively affect hospitals' BP. Originality/value This study is one of the first to adapt the four lean bundles popularized in the manufacturing sector and apply them in a health-care context. It examines the effects of the four lean bundles on hospitals' OP in terms of efficiency, quality and accessibility. In addition, the study demonstrates the role of OP dimensions in improving private hospitals' BP.