Continual pressures on healthcare budgets coupled with increasing demands and evidence of poor performance have led national and local healthcare organizations to look for methods to improve quality, safety and value in health service delivery. Increasingly this search for solutions has extended beyond the boundaries of healthcare practice to investigate successfully employed methods from other industries. Lean Systems Thinking and continuous improvement activities have come to the attention of healthcare administrators looking for ways to improve organizational performance. Originating in the work of Deming and refined in Japan, lean techniques and lean management principles have been developing in manufacturing settings since the 1950s. After becoming prominent in the early 1980s, lean practices have more recently been introduced into service industries.

The papers in this issue reflect once again the impact lean, LST and associated approaches can have on a healthcare system. The papers indicate the importance of not only the tools and techniques but the organisational factors that are important to implement and sustain the lean approach.