Bojana Novićević Čečević – Faculty of Economics, University of Nis, Trg Kralja Aleksandra Ujedinitelja 11, Niš, Serbia

Jelena Daraboš – Faculty of Economics, University of Nis, Trg Kralja Aleksandra Ujedinitelja 11, Niš, Serbia


6th International Conference – ERAZ 2020 – KNOWLEDGE BASED SUSTAINABLE DEVELOPMENT,  Online/virtual, May 21, 2020, CONFERENCE PROCEEDINGS

Published by: Association of Economists and Managers of the Balkans – Belgrade, Serbia

Conference partners: Faculty of Economics and Business, Mediterranean University, Montenegro; University of National and World Economy – Sofia, Bulgaria; Faculty of Commercial and Business Studies – Celje, Slovenia; Faculty of Applied Management, Economics and Finance – Belgrade, Serbia

ISSN 2683-5568, ISBN 978-86-80194-33-2, DOI:



Lean, as relatively new management concept, surpasses the traditional mass production and
creating stockpiles of goods which have to be placed on the market, without analyzing the customers’
needs. The focus of lean is on creating the value that customers demand and forming the value streams
which contain only processes and activities that generate that value and eliminating all types of wastes
and non-value adding activities. Lean concept was founded in Toyota company i.e. in manufacturing
system called Toyota production system. Nowadays, this concept has been implemented by many worlds
known organizations as the crucial part of their production system, but also other supportive processes
in the company. Application of the lean concept can significantly improve process efficiency, lead
to drastic cost-reduction, improved quality of the products/services provided, but also can be a main
factor of increased employees productivity and resource saving. Profitable and unprofitable health
care organizations have determined business strategy and adjusted mission and vision of their path
thus, they strive for resource optimization in the process of providing satisfactional level of service.
Accordingly, the examination of possibilities in implementing lean concept in Health Care organizations,
as well as analyzing executed techniques and performed activities in leading companies is more
than justified. Health Care organizations can be characterized as complex systems with numerous participants
and the need for strict coordination of activities in order to provide demanded value for the
customers. Monitoring and measuring the performances on various levels and areas of accountability
is highly valuable for the Health Care organizations. Regarding that, the subject of this paper will be
indicating specifics of measuring the performances in Health Care organizations and possibilities of
their improvement.

Key words

Customers, Lean techniques, Process, Value-adding activities, Non-value adding activities,
Implementation, Patient, Organization, Value, Value stream, Performance, Employees, Management,
Measurement, Waste, Reducing, Continuous, Waiting time


Antić, L.j, & Stevanović, T., Novićević Čečević, B. (2019). Koncepti obračuna i upravljanja
troškovima u lean poslovnom okruženju, Monografija. Niš: Ekonomski fakultet Niš.
Cookson, D., Read, C., Mukherjee, P., & Cooke, M. (2011). Improving the quality of emergency
Department care by removing waste using Lean Value Stream mapping, Research paper.
The International Journal of Clinical Leadership 2011, Radcliffe Publishing, p. 26.
Čečević, Novičević B. (2016). Upravljačko-računovodstvena podrška menadžmentu preduzeća
u lean poslovnom okruženju, Doktorska disertacija. Niš: Ekonomski fakultet.
Farid, D., Nejti , M., & Mirfakhredini , H. (2008). Balanced Scorecard application in university
and higher education institutes: Implementation guide in an Iranian context. Annals of
University of Bucharest, Economic and Administrative series, No2, 31-45.
Foley, R. (2006). NHS Lean Implementation Handbook Draft.
Huntzinger , J. (2007). Lean Cost Management, Accounting for lean by establishing flow. Fort
Lauderdale FL: J. Ross publishing.
James P. Womack, A. P. (2005). Going Lean in Health Care. Institute for Healthcare Improvement
(innovation series 2005), 2.
Joosten, T., Bongers , I., & Jansen, R. (2009). Application of lean thinking to health care: issues
and observations. International Journal for Quality in Health Care Volume 21, Number 5,
Advance Access Publication 19 August, p. 343.
Marković, N., Petković, D., Trbojević, S., & Bokonjić, D. (2013). Balanced scorecard u strateškom
planiranju razvoja visokoškolske institucije. 8. Naučni skup sa međunarodnim učešćem
„Kvalitet” 2013, (pp. pp. 439-446). Zenica, Bosna i Hercegovina.
Maskell, B. (2018). Where Lean Accounting came from and Why. Cost Management March/
April, 28-34.
Melton, T. (2005). The Benefits of Lean Manufacturing, What Lean Thinking has to Offer the
process Industries. Chemical Engineering Research and Design 83 (A6) 662-673, 666.
Ng, D., Vail, G., Thomas, S., & Schmidt, N. (2010). Applying the Lean principles of the Toyota
Production System to reduce wait times in the emergency department. Original research,
ED Administration, p. 53.
Olesen P., P. D. (2015). Using Lean Principles to Drive Operational Improvement in Intermodal
Container Facilities, a Conceptual Framework. Journal of Facilities Management Vol. 13
No. 3, 266-281 p. 269.
Radnor, N. B. (2011). Evaluating Lean in healthcare. International Journal of Health Care
Quality Assurance Vol. 26 Issue 3, 222.

Schimann, W., & Brewton, J. (2009). Functional Lean: A New Approach for Optimizing Internal
Service Function Value. Cost Management (July/ August), 5-13. p. 10.
Shazali, N., Habidin, N., Khaidir, N., Jamaludin, N., & Ali*, N. (2013). Lean Healthcare Practice
and Healthcare performance in Malaysian Healthcare industry. International Journal of
Scientific and Research Publications, Volume 3, Issue 1, 1-5.
Womack J., J. D. (2003). Lean thinking, banish waste and create wealth in your corporation p.
16. UK: Simon & Schuster.
Young T., M. S. (2008). A critical look at Lean Thinking in healthcare. Quality and Safety in
Health Care, Vol. 17, pp. 382-6.