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Cases were classified according to lean deployment taxonomy in healthcare settings, showing some differences in lean journey stages in 15 countries.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p>There is an alignment between SCM thinking in healthcare and lean thinking that places a SCM decision as outsourcing as a lean practice serving not only strategic intent but solving operational efficiency. There is a match between different outsourcing drivers (transactional, strategic and transformational) and lean maturity levels. The main constraint to deployment of both lean and outsourcing practices are cultural differences.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Practical implications<\/jats:title><jats:p>Understanding lean and outsourcing different deployment maturity levels under the national cultural umbrella can open new perspectives to study lean sustainability factors and better outsourcing relationships in healthcare organisations.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>This paper presents a merger between the state\u2010of\u2010the art of both lean and outsourcing practices in healthcare settings and suggests an outsourcing and lean evolving pathway.<\/jats:p><\/jats:sec>","DOI":"10.1108\/so-11-2011-0035","type":"journal-article","created":{"date-parts":[[2013,8,29]],"date-time":"2013-08-29T09:48:59Z","timestamp":1377769739000},"page":"138-166","source":"Crossref","is-referenced-by-count":25,"title":["Strategic outsourcing: a lean tool of healthcare supply chain management"],"prefix":"10.1108","volume":"6","author":[{"given":"Cristina","family":"Machado Guimar\u00e3es","sequence":"first","affiliation":[]},{"given":"Jos\u00e9","family":"Crespo de Carvalho","sequence":"additional","affiliation":[]}],"member":"140","reference":[{"key":"key2022030720352765400_b1","doi-asserted-by":"crossref","unstructured":"Abramson, W.B. 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