title: Lean thinking in health and nursing: an integrative literature review.
abstract: to demonstrate the scientific knowledge developed on lean thinking in health, highlighting the impact and contributions in health care and nursing.
  
  
  
  an integrative literature review in the PubMed, CINAHL, Scopus, Web of Science, Emerald, LILACS and SciELO electronic library databases, from 2006 to 2014, with syntax keywords for each data base, in which 47 articles were selected for analysis.
  
  
  
  the categories were developed from the quality triad proposed by Donabedian: structure, process and outcome. Lean thinking is on the rise in health surveys, particularly internationally, especially in the USA and UK, improving the structure, process and outcome of care and management actions. However, it is an emerging theme in nursing.
  
  
  
  this study showed that the use of lean thinking in the context of health has a transforming effect on care and organizational aspects, promoting advantages in terms of quality, safety and efficiency of health care and nursing focused on the patient.
authors: PhD, Adjunct Professor, Departamento de Enfermagem, Universidade do Estado de Santa Catarina, Chapecó, SC, Brazil.
authors: Aline Lima Pestana
authors: AL
authors: Magalhães
authors: PhD, Full Professor, Departamento de Enfermagem, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
authors: Alacoque Lorenzini
authors: AL
authors: Erdmann
authors: PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Federal do Maranhão, Florianópolis, SC, Brazil.
authors: Elza Lima da
authors: EL
authors: Silva
authors: PhD, Adjunct Professor, Departamento de Enfermagem, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
authors: José Luís Guedes Dos
authors: JL
authors: Santos
mesh_terms: D003695:Delivery of Health Care; D017598:Efficiency, Organizational; D006801:Humans; D009729:Nursing