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.