From waste to wellness: unlocking pharmacy efficiency through Lean management and staff satisfaction

PURPOSE: This study aims to examine the impact of Lean management awareness and implementation (LMAI) on operational efficiency (efficiency improvements from Lean practices [EILP]) within hospital pharmacy services by exploring the mediating role of staff satisfaction with Lean management (SSLM) and the influence of challenges in adapting to Lean processes (CALP). The study intends to provide empirical insights into the interrelationships among Lean practices, employee perceptions and organizational performance, grounded in socio-technical systems (STS) theory and total quality management (TQM). DESIGN/METHODOLOGY/APPROACH: A quantitative research design was adopted for this study, utilizing a structured questionnaire. Data were collected from 170 pharmacy professionals working in various hospitals in Thrissur, Kerala, selected through purposive sampling. The collected data were analyzed using SPSS and SmartPLS 4.0. The analysis included descriptive statistics, reliability and validity assessments, and structural equation modeling (SEM) to examine direct, mediating and moderating relationships among the variables. FINDINGS: The results demonstrate that operational efficiency and staff satisfaction significantly improve with higher Lean awareness and implementation. SSLM partially mediates the relationship between LMAI and EILP, indicating that social engagement reinforces the technical benefits of Lean. However, CALP did not significantly moderate this relationship. The findings confirm that sustainable efficiency and medication safety are achieved through alignment of Lean technical tools and social-cultural factors. RESEARCH LIMITATIONS/IMPLICATIONS: Although the study was conducted across multiple hospitals, the findings are limited to a single geographic region, which may affect their generalizability. PRACTICAL IMPLICATIONS: Hospital administrators should prioritize structured Lean awareness programs, continuous staff training and participative decision-making to enhance pharmacy efficiency. Embedding Lean performance indicators into governance systems and linking them to staff appraisal can sustain improvements. Strengthening leadership support and employee engagement ensures long-term operational efficiency and improved patient safety outcomes. SOCIAL IMPLICATIONS: The study highlights that strengthening Lean awareness and staff satisfaction in hospital pharmacies enhances service reliability, reduces medication errors and promotes patient safety, thereby improving overall healthcare quality and community trust. ORIGINALITY/VALUE: This study extends Lean healthcare research by empirically integrating awareness, staff satisfaction and adaptation challenges within a socio-technical framework in Indian hospital pharmacies, offering a behavioral explanation for operational efficiency beyond traditional process-based analyses.