Redefining value creation innovation in healthcare organizations: the catalytic role of Lean Management, Six Sigma and Patient Safety

Purpose In light of the increasing interest from both public and private healthcare organizations (HOs) in assessing the impact of Lean Management (LM), Six Sigma (SS) and Patient Safety (PS) initiatives on value creation innovation (VCI), this study seeks to examine how these initiatives enhance healthcare business models. Furthermore, it investigates the differing tendencies of Italian public and private HOs in adopting these initiatives. Design/methodology/approach A self-administered survey developed with Google Form was submitted to 441 professionals from public and private HOs in Italy. Multiple regression analysis was employed to test the hypotheses on the relationships between LM, SS, PS initiatives, and VCI within business model innovation (BMI). Additional regression analyses were conducted to examine the relationships between these initiatives and regressor variables specific to HOs. Findings LM, SS and PS each exert a significant positive effect on VCI within HOs, indicating that their influence goes beyond operational improvements to shape broader strategic outcomes. Moreover, these initiatives appear more frequently adopted in public HOs than in private ones, while none of the control variables emerged as significant predictors across the tested models. Originality/value This study extends both healthcare and BMI literature by illustrating how LM, SS and PS – originally viewed as efficiency-focused frameworks – can drive innovative value-creating strategies in public and private healthcare contexts. In doing so, it provides new empirical evidence on the transformative role of process improvement methodologies as catalysts for deeper organizational shifts in the design and delivery of healthcare services.