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Introduction: Lean Thinking in healthcare has been mostly studied related to process outcomes rather than psychosocial work aspects, 1 despite that its importance is highlighted. 2 Studies show associations between Lean practices and psychosocial work environments but with limited evidence in the general as well as healthcare literature. 3-5 Lean, particularly in industry, is generally shown to deteriorate psychosocial work environments while a mix of positive and negative correlations are found in other disciplines including healthcare, 6 however based on limited information and empirical evidence. 7 One large scale industrial study3 reported that the relationship between Lean and stress differed depending on how the psychosocial working conditions had changed as a result of Lean. In that study, control over work speed and work flow, employee involvement and influence in the change process, team based …