Lida Gholizadeh - Department of Health Services Administration, Science and Research Branch, Islamic Azad University,
Iravan Masoudi Asl - Departmant of Health Services Managment, School of Health Management and Information Sciences, Iran University of Medical Sciences,
Kamran Hajinabi - Department of Health Services Administration, Science and Research Branch, Islamic Azad University,
Pouran Raeeisi Dehkordi - School of Management and Medical Information Services, Iran University of Medical Sciences, Tehran, Iran

Aim: Lean is a set of operating philosophies and methods that help create maximum value for patients by reducing waste and waits. It emphasizes the consideration of the customer’s needs, employee involvement, and continuous improvement. The aim of this study was of factors affecting lean management in public hospitals in Kohgiluyeh and Boyerahmad and Bushehr provinces. Materials and Methods: This research was descriptive correlation study. The questionnaire was used to collect the data. Factor analysis and multiple regression analysis were conducted to understand the relationship between these factors and lean implementation success. With using 60 questions questionnaire, the content validity of the method developed by the researchers and expert judgment and Cronbach’s alpha and test–retest reliability of the method was investigated, and the opinions of 500 primary health‑care practitioners were collected. Then, a two‑stage exploratory and confirmatory factor analysis and structural equation modeling with the use of statistical software SPSS for Window 17.0 software (SPSS Inc.,lllinois,USA) (Leland Stanford Junior University) and AMOS 20 carried out to review and modify the conceptual model. Results: Exploratory factor analysis identified five factors of human, technology, management, processes, and relational that explains 58.5% of the total variance. Confirmatory factor analysis also showed that among identified factors, technology factor with 0.953 coefficient has greatest impact and management factor with 0.615 coefficient has the lowest impact on the pattern of lean management in public hospitals to improve the quality of services. Conclusions: The factors affecting the deployment of lean management in public hospitals and appropriate strategy for using the lean management to improve the delivery of primary health care and reduce waste. The results represent guidelines for using effective implementation of lean management to increase efficiency and ability to compete in the global market offers.

Lean management, public hospitals, quality improvement