The Lean-DEA approach: Enhancing hospital’s processes using ideal DMUs

Purpose This paper proposes a novel framework that integrates Lean Healthcare (LH) practices with Data Envelopment Analysis (DEA) to realistically measure and enhance hospital operational efficiency.Design/methodology/approach The proposed Lean-DEA approach is structured into a comprehensive multi-stage framework: scope and variable selection, empirical efficiency assessment, and the proposition of realistic adjustment thresholds. By utilizing a Slacks-Based Measure (SBM) model to project inefficient hospitals toward an Ideal Decision-Making Unit (DMU), the framework breaks down absolute mathematical efficiency gaps into gradual, manageable, and Kaizen-driven improvement pathways.Findings The development of the Ideal Lean-DEA Adjustment successfully translates rigid mathematical efficiency targets into bounded, managerially actionable goals. The findings demonstrate that utilizing an Ideal DMU (IDMU) – representing the systemic ‘state-of-the-art’ rather than a single isolated institution – allows resource-constrained hospitals to benchmark their performance realistically, prioritize specific Lean interventions (such as Kanban, 5S, and Poka-Yoke), and improve workflow without organizational disruption.Originality This paper pioneers the integration of IDMU projections within a Lean-DEA framework specifically tailored for healthcare. It transcends traditional static and binary benchmarking (efficient vs. inefficient) by offering a flexible, two-dimensional diagnostic perspective that aligns rigorous mathematical efficiency targets with the practical, human-centric reality of continuous hospital transformation.