Abstract
Recent healthcare literature has upheld lean as a methodology for improving operational efficiency and quality of care. However, the uncertainty of implementing lean successfully is still of concern as implementation failures have been recorded. Insufficient preparedness and lack of readiness assessment among other factors have been highlighted as a reason for failure. This paper develops an instrument for assessing the capabilities, quality management practices, and general preparedness of healthcare institutions for a lean implementation journey. The study identifies, through a comprehensive review of lean healthcare literature and the South African healthcare quality improvement literature to find current best quality management practices, and resource requirements needed to create a healthcare system that is supportive of lean. Application of this framework may provide an opportunity for hospital managers to benchmark with emerging lean success stories within the same operating context for organizational learning.