Lean healthcare aims to manage and improve the processes in the healthcare sector by eliminating everything that adds no value by improving quality of services, ensuring patient safety and facilitating health professionals’ work to achieve a flexible and reliable organization. Value Stream Mapping (VSM) is considered the starting point of any lean implementation. Some papers report applications of VSM in healthcare services, but there has been less attention paid to their contribution on sustainability indicators. The purpose of this work is to analyze the role of VSM in this context. To do so, a scoping review of works from recent years (2015 to 2019) was done. The results show that most applications of VSM reported are in the tertiary level of care, and the United States of America (USA) is the country which leads most of the applications published. In relation with the development of VSM, a heterogeneity in the maps and the sustainability indicators is remarkable. Moreover, only operational and social sustainability indicators are commonly included. We can conclude that more standardization is required in the development of the VSM in the healthcare sector, also including the environmental indicators.

Purpose: The purpose of this paper is to introduce a new methodology called overall greenness performance for value stream mapping (OGP-VSM). Using value-added concepts, this approach has the potential to integrate, measure, control and improve productive and environmental performance in accordance with a company’s context.Design/methodology/approach: The OGP-VSM approach was developed by reviewing and integrating the environmental aspects of existing lean thinking tools and approaches.Findings: This research revealed the lack of practical integration between productive and environmental performance. Using OGP-VSM, managers can see that environmental practices have a direct impact on productivity. OGP-VSM allows a balance to be found between lean and green practices in order to achieve the simultaneous improvement of productivity and environmental performance.Practical implications: The proposed approach is applied to a case study in an automotive company in Spain and lays the groundwork for moving toward functional environmental sustainability in manufacturers.Originality/value: Companies are increasingly implementing environmentally focused practices. Pursuing environmentally friendly (green) performance poses several challenges, but it also affords opportunities to create new methodologies for generating a competitive advantage for manufacturing companies. There are a limited number of approaches to drawing together the elements and attributes that are essential for a holistic, practical and long-lasting improvement of environmental performance in the manufacturing sector.

Companies operate in a competitive and changing environment requiring increasingly effective and efficient management strategies. Lean is a proven philosophy in the industrial sector having helped companies to adapt to rapid market changes; to economic, technical, and social complexities; and to customer needs. For this reason, companies in the service sector are adopting Lean to improve their service management and to achieve economic, social, and environmental sustainability. This paper presents a model which uses Lean tools to facilitate the introduction of Lean in the management of primary care centers. The results show the implementation of Lean improved primary care center management, achieved stated objectives, and demonstrated faster adaptation to environmental needs and changes. The Lean philosophy developed and applied in the primary care center proved useful at a professional level facilitating developmental changes and prompting lasting improvements by developing a sustainable work culture.

Kaizen, or continuous improvement, is a management tool that allows the identification of activities that have no value in the processes examined. This identification leads to the improvement of these processes within any organization and promotes economic and social sustainability, and to a lesser extent environmental sustainability. Kaizen, already widely and successfully employed in the industrial sector, is now being applied in the health sector. However, the health sector tends to publish only the results of how processes have been improved in finely focused areas and the resulting benefits. The majority of the benefits focus on time and cost reduction. In this study, the authors carried out a bibliometric analysis using the Scimat program, which maps the thematic evolution of Kaizen in the health sector and its relationship with sustainability, in order to promote the interest of the health sector for this type of process improvement. The findings confirm that the implementation of Kaizen is recent and constantly evolves and grows, and that it can help economic and social sustainability, and to a lesser extent environmental sustainability.