The adoption of Health Lean Management pursuing Choosing Wisely objectives

A new approach for facing the resources overuse in hospital was introduced in very recent years. It is labelled “Choosing wisely” (CW), referring to the need of choosing the most appropriate care based on patient needs and on a responsible use of hospital resources. Working in team, several organizations have participated in drafting lists of treatments to be avoided favoring others. However, ethical issues have been raised and the lack of a rigorous method in the generation and further implementation of the top lists have questioned the applicability of this approach. In literature, no particular emphasis has been attributed to the right approach supporting the definition and the selection of the appropriate care process, eliminating the unnecessary activities and the improper use of scant resources. In industrial sector, Lean management has permitted to streamline and standardize processes achieving interesting results mostly in terms of efficiency improvements. In healthcare, this managerial approach (Health Lean Management - HLM) is spreading over the world. Focusing on customer needs and on waste elimination, HLM could support the adoption of CW approach. Through a systematic literature review, this research investigates whether and how HLM could be implemented pursuing CW objectives. The extracted database demonstrates the originality of the topic, but also its enforceability. Results highlight the potentialities of HLM pursuing appropriateness in healthcare paving the way for outlining interesting future developments.