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. 2022 Jan 29;22:122. doi: 10.1186/s12913-022-07473-w

Table 4.

The strategic implementation approach

US Italy
N % Mean SD N % Mean SD
Approach at the beginning of Lean implementation 142 34
 Some elements hospital-wide 52 37 3 9
 Some elements in a small number of departments 52 37 22 65
 Some elements in a single department 13 9 9 26
 Comprehensive DMS hospital-wide 11 8 0 0
 Comprehensive DMS in a small number of departments 9 6 0 0
 Comprehensive DMS in a single department 5 4 0 0
Initiated Lean with a model cell 143 35
 Yes 84 59 24 69
 No 59 41 11 31
Have a True North vision 139 35
 Yes 68 49 19 54
 No 71 51 16 46
Overall Lean leadership commitment index (range: 0–8) 139 4.7 2.48 35 4.6 2.18
Have a central improvement team 139 35
 Yes 87 63 20 57
 No 52 37 15 43
Ever used an outside consultant 138 35
 Yes 100 72 2 6
 No 38 28 33 94