The aim of the study is to examine the tri-dimensional relationship between Lean, perceived service quality, and patient satisfaction in public Lean hospitals, in Malaysia. This study employs quantitative approach to collect feedback from 48 public Lean hospitals in Malaysia. Partial Least Square-Structural Equation Modeling was employed to investigate the proposed measurement model and structural model. The findings showed that overall synergic effects of Lean practices particularly in the Strategy and alignment, Behaviour and engagement, and Process management have significant and positive relationship with perceived service quality. Additionally, perceived service quality has been found to have significant and positive relationship with patient satisfaction. However, none of the Lean practices has a significant impact on patient satisfaction. Such weak direct relationship between Lean and patient satisfaction is due to the lack of mediating effect contribution. Hence, med.....

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