The first evidence about conceptual vs analytical lean healthcare research studies Ana Carla de Souza Gomes dos Santos Rio de Janeiro Federal Institute of Education Science and Technology Rio de Janeiro, Brazil and Celso Suckow da Fonseca Federal Centre of Technological Education, Rio de Janeiro, Brazil, and Augusto da Cunha Reis, Cristina Gomes de Souza, Igor Le~ ao dos Santos and Let  ıcia Ali Figueiredo Ferreira Celso Suckow da Fonseca Federal Centre of Technological Education, Rio de Janeiro, Brazil Abstract Purpose – Several authors have examined the lean healthcare literature, but besides all efforts made, articles comparing conceptual and analytical studies were not found. Thus, a systematic review is conducted aiming to understand the state of the art of lean healthcare by investigating and comparing how conceptual and analytical articles address tools/methods, application fields, implementation barriers and facilitators and positive and negative impacts. Design/methodology/approach – Articles in English about lean healthcare, published in journals in the last ten years (2009–2018) and indexed in Web of Science (WoS) or Scopus were examined and assessed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) protocol. A qualitative content analysis on the eligible articles was conducted, and results from the conceptual and analytical studies were compared. Findings – There is a literature gap regarding tools/methods in both conceptual and analytical approaches once they prioritize for different items. Barriers, facilitators and negative impacts are perceived differently within both categories and might require more extensive analysis. The same items prevail in both conceptual and analytical categories when analyzing healthcare fields and positive impacts. Originality/value – There is a lack of articles comparing conceptual and analytical studies concerning lean healthcare. So, this study’s relevance is in identifying theoretical and applied research gaps to strengthen the lean healthcare state of the art and to integrate theoretical-applied knowledge. For healthcare professionals, it might provide an overview of the key factors that can promote lean implementation. Keywords Lean healthcare, Systematic review, PRISMA, Conceptual analysis, Analytical analysis Paper type Literature review 1. Introduction The interest in lean methodology has been increasing in several research fields. Lean was originally proposed for application in manufacturing industries aiming to reduce costs and improve management and production processes (Redeker et al., 2019; Virginia et al., 2015). However, it can be implemented in any field that allows process mapping, goals measurement and resource management (Soares and Teixeira, 2014; R egis et al., 2019). In the healthcare field, lean methodology is denominated as lean healthcare. This methodology proposes a culture of continuous improvement applied to healthcare processes by eliminating nonvalue-added activities and providing safety, quality of patient care and Conceptual vs analytical lean healthcare research The authors of the project thank CAPES for their scholarships and for supporting the development of Brazilian scientific research. Received 22 January 2020 Revised 1 September 2020 Accepted 4 September 2020 Journal of Health Organization and Management © Emerald Publishing Limited 1477-7266 DOI 10.1108/JHOM-01-2020-0021 The current issue and full text archive of this journal is available on Emerald Insight at: https://www.emerald.com/insight/1477-7266.htm