Table 1 Surveys’ dimensions and variables

Adoption maturity

• Number of years doing Lean

• Lean Maturity Assessment

• Number of units doing Lean

Strategic implementation approach

• Approach for Lean adoption

• Lean leadership commitment index

• Central improvement team

• External consultant

Operational implementation approach

• Daily management system index

• Index support by HR, IT and Finance units

• Reward and Recognition

• Lean team composition and leadership

• Main tools used

• Education and training index

• Staff Involvement index

Performance

• Self-reported index

• Self-reported impact on patients (Improved patient satisfaction scores, Reduced medical errors, Reduced one or more types of hospital-acquired infections, Reduced hospital readmissions within 30 days of discharge, Reduced risk adjusted 30-day mortality, Reduced ambulatory care sensitive admissions)

• Self-reported impact on employed and affiliated staff (Improved employee engagement in their work, Reduced employee turnover)

• Self-reported impacts on costs (Reduced expenditures in two or more departments, eliminated waste in two or more processes or departments, Reduced average length of stay)

• Self-reported impacts on service provision (Increased throughput in the emergency department, Increased throughput in the operating rooms, Increased throughput in the cardiac care unit, Increased throughput in med/surg nursing units)