Adapting and validating the EPLIT for assessing lean healthcare maturity in Brazilian hospitals

Purpose This paper aims to evaluate the measurement properties of the Employee Perception to Assess the Lean Implementation Tool (EPLIT) in the Brazilian hospital context. Design/methodology/approach A cross-sectional study was conducted in two Brazilian hospitals, adhering to COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Exploratory factor analysis (EFA) and Cronbach's alpha were used for construct validity and reliability. Findings The adapted tool comprises 27 items across five domains, explaining 63.3% of the variance. Cronbach's alpha ranged from 0.78 to 0.86, indicating satisfactory reliability. Research limitations/implications Limitations include convenience sampling and exclusive use of EFA for validation. Future studies may employ Confirmatory Factor Analysis for further validation. Practical implications The tool aids healthcare managers in Brazil to systematically evaluate Lean implementation, contributing to process optimization and quality improvement. Social implications Effective Lean implementation using the validated tool could lead to improved healthcare delivery and patient outcomes. Originality/value This is the first study to adapt and validate EPLIT for the Brazilian healthcare sector, offering a robust tool for managers and researchers.