The purpose of this paper is to examine the role of sustainable Lean patient value in relation to a long-term health condition in a healthcare context. A pragmatist research philosophy is used to conduct exploratory research utilising open data sources, semi-structured interviews, focus group meetings and participant workshops, where the quantitative data covered a 60-month period and the qualitative data collection and analysis covered a 36-month period. The findings show that Lean healthcare is overly focused on healthcare providers rather than patients leading to unmet value across the patient Value Stream. To conceptualise the findings and present the constructs and their relationships, a Lean patient healthcare framework is inductively developed. A number of propositions are advanced based on the relationships in the framework which provide a basis for further exploring improved Lean healthcare interventions in long-term conditions. The findings will assist healthcare academics, professionals and patient groupings in developing and improving Lean patient Value understanding and decision making. This will assist in effective Lean patient value creation and development for healthcare reforms and changes and in effective resource utilisation for improved and sustainable patient outcomes.

本文的目的是研究可持续精益患者价值在医疗保健环境中与长期健康状况相关的作用。实用主义研究理念用于利用开放数据源、半结构化访谈、焦点小组会议和参与者研讨会进行探索性研究，其中定量数据涵盖 60 个月，定性数据收集和分析涵盖 36 个月. 研究结果表明，精益医疗过度关注医疗保健提供者而不是患者，从而导致整个患者价值流中的价值未得到满足。为了将研究结果概念化并呈现结构及其关系，我们以归纳方式开发了精益患者医疗保健框架。基于框架中的关系提出了许多命题，这些命题为进一步探索长期条件下改进的精益医疗干预措施提供了基础。研究结果将有助于医疗保健学者、专业人士和患者群体发展和改进精益患者价值的理解和决策。这将有助于为医疗改革和变革有效地创造和发展精益患者价值，并有助于有效利用资源以改善和可持续的患者结果。