The project regards the adoption of LH in primary care, and particularly in chronic pathways, with the final aim of building a model based on best practices to improve the efficiency, efficacy, safety and continuity of care for frail patients. The project will follow a multiple case study approach, analysing and comparing different practices and models, with the purpose of identifying guidelines to create an integrated healthcare system based on a "lean and safety" perspective. From an academic perspective, the project enriches the current scientific literature, introducing a structured methodology to proactively manage risks and wastes in the new setting of chronic pathways in primary care. From a managerial perspective, the project contributes to identify guidelines to improve their coordination and integration, guaranteeing the sustainability, equity and accessibility of health services.