Table 1

Literature related to research themes

AuthorStudy focusLean/AI/I4.0 elementKey contribution to waiting time reductionKey limitationsRelevance to this study
Bachelet et al. (2019) Interventions to reduce elective surgery waiting timesLean pathways, scheduling optimisationDemonstrates need for pathway redesign, prioritisation and OR planningVariability across settingsProvides baseline Lean pathway optimisation logic
Mahmoud et al. (2021) Impact of Lean management on staff and performanceLean managementShows reduction in waiting times and improved teamwork and learningRisk of work intensificationConfirms Lean effectiveness in reducing delays
Botha et al. (2024) AI risks in healthcare deliveryAI governance and safetyHighlights implementation risks affecting adoption of AI-driven schedulingConceptual and policy-orientedIdentifies barriers to AI integration in Lean systems
Stafinski et al. (2022) Policy and operational approaches to surgical wait timesLean/Six Sigma + system redesignShows effectiveness of standardised pathways, funding models and process redesignContext-specific policy variationSupports system-level Lean interventions
Dawson et al. (2022) Clinical outcomes of prolonged waiting timeOutcome-based healthcare analysisDemonstrates negative impact of long waiting times on patient outcomesMeasurement inconsistencyStrengthens urgency of reducing OT waiting time
Ebrahim et al. (2025) Rural surgical access delaysWorkforce and system coordinationShows structural causes of delays and need for integrated planningRural context limitationsHighlights importance of resource coordination
O'Rielly et al. (2021), Strömblad et al. (2021) Predictive models for surgical durationAI predictive analyticsImproves surgical scheduling accuracy and OT utilisationLimited real-time integrationDemonstrates AI role in OT scheduling optimisation
Abdallah and Alkhaldi (2019) Lean with JIT and TQM in healthcareLean + JIT + TQMImproves equipment efficiency and reduces operational delaysLimited digital integrationProvides Lean operational efficiency base

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