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Additionally, a culture of continuous improvement search is created in the organization, a culture focused on the client (patient) that creates value for the client. This implies a change of the paradigm that prevails in some countries where the doctor is viewed as the \u2018client\u2019. The action research described in this article promoted lean principles in an operating room and support warehouses. The results were as follows: stocks management improved, warehouse spaces reduced by 20 to 25 per cent, operating room areas were better organized, equipment and obsolete surgical material were eliminated, equipment management was improved and operating times were reduced. Furthermore, it was necessary to create productivity indicators for the operating room to improve visual management and train staff for adopting a lean behaviour and attitude. This action research describes a trend in health care that implies an organizational change of culture and paradigm.<\/jats:p>","DOI":"10.1177\/0972063416637716","type":"journal-article","created":{"date-parts":[[2016,5,20]],"date-time":"2016-05-20T05:47:48Z","timestamp":1463723268000},"page":"239-257","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Lean Principles in an Operating Room Environment"],"prefix":"10.1177","volume":"18","author":[{"given":"Ivo Alexandre","family":"Matos","sequence":"first","affiliation":[{"name":"Industrial Engineer, Rua da Vilarinha, Porto, Portugal"}]},{"given":"Anabela Carvalho","family":"Alves","sequence":"additional","affiliation":[{"name":"ALGORITMI Center, Department of Production and Systems, University of Minho, School of Engineering CGIT Research Center, Campus of Azur\u00e9m, Guimar\u00e3es, Portugal"}]},{"given":"Anabela Pereira","family":"Tereso","sequence":"additional","affiliation":[{"name":"ALGORITMI Center, Department of Production and Systems, University of Minho, School of Engineering CGIT Research Center, Campus of Azur\u00e9m, Guimar\u00e3es, Portugal"}]}],"member":"179","published-online":{"date-parts":[[2016,5,19]]},"reference":[{"key":"bibr1-0972063416637716","doi-asserted-by":"publisher","DOI":"10.1108\/09696471211219930"},{"key":"bibr2-0972063416637716","volume-title":"The lean toolbox for service systems","author":"Bicheno J.","year":"2008"},{"key":"bibr3-0972063416637716","doi-asserted-by":"publisher","DOI":"10.1063\/1.3478637"},{"key":"bibr4-0972063416637716","volume-title":"APICS Series on Resource Management","author":"Feld W. 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