Practicing Lean Strategy: Hoshin Kanri and X-Matrix in a healthcare-centered simulation

• Purpose: This article builds on the debate regarding the application of Lean Strategy principles and tools in modern organizations, specifically focusing on the healthcare sector. This article’s aims are threefold: a) to highlight the potential role played by Lean Strategy tools for strategic planning and strategic management, particularly in reference to the Hoshin Kanri policy deployment system and the FAIR method; b) to discuss how Lean Strategy can be operationalized, specifically relying on the X-Matrix reporting tool; and c) to explore how simulation techniques, in the form of Role-Playing, may support the aforementioned operationalization of Lean Strategy while at the same time promoting policy-making and knowledge sharing. • Design/Methodology/Approach: This research adopts a case study approach. Specifically, the article relies on the use of a Role-Playing Lean Strategy project developed in a healthcare setting. • Findings: The article highlights the potential for the Hoshin Kanri policy deployment process in healthcare, also emphasizing the main strengths of X-Matrix reporting and the usefulness of the Role-Playing technique to support learning acquisition and decision-making. • Practical Implications: The article demonstrates how a Lean Strategy simulation project may be effectively used for strategic planning/management and to train professionals in healthcare. To achieve these aims, a methodology to design and implement simulation-based Lean Strategy projects in healthcare is presented and discussed. • Originality/Value: A review of the academic literature indicates that Lean Strategy is still an emerging research topic addressed by only a limited number of articles. The article contributes to a deeper understanding of the fundamentals of Lean Strategy (particularly Hoshin Kanri and X-Matrix) with particular reference to the healthcare sector.