This paper’s primary aim is to examine the impact of managerialcompetencies on the performance of healthcareorganizations in Bosnia and Herzegovina, with a particularfocus on the role of middle management.Research Methodology: A quantitative research approachwas employed, and data were collected through a structuredquestionnaire designed to measure six key dimensionsof managerial competencies: leadership, strategicthinking, communication, decision-making, teamwork, andchange management. The construction of the questionnairewas based on previous relevant research and theoretical models of managerial competencies, with particularattention given to the models developed by Boyatzis (1982)and later expanded by Whetten and Cameron (2011), as wellas findings from research on healthcare management, suchas Calhoun et al. (2008) on competencies for healthcareleaders. The items were adapted to the specific context ofhealthcare institutions in Bosnia and Herzegovina, and eachitem was rated on a 5-point Likert scale (1- Strongly Disagree;2-Disagree; 3 – Neutral; 4- Agree; 5- Strongly Agree).The questionnaire was distributed to a purposive sample of120 middle managers working in various healthcare institutionsacross Bosnia and Herzegovina. Data were collectedduring three months from January to April 2025. Descriptivestatistics were used for data analysis.Conclusion: The results indicate that communication andteamwork competencies were rated most positively and significantlycorrelated with organizational outcomes. In contrast,strategic thinking and change management receivedlower ratings. The instrument’s reliability was confirmedthrough high internal consistency (Cronbach α > 0.70).

Introduction: The basic postulate of the lean concept is that greater efficiency of the work process can be achieved through a process of continuous improvement,which aims to eliminate waste and maximize activities that add value.The Netherlands, Great Britain, Italy and the United States were examples of healthcare systems that implemented the lean concept.Aim: To examine the opinion of health workers of a public hospital in the Sarajevo area about the possibilities of improving business processes by implementing thelean concept.Method: The cross-sectional study was conducted using a questionnaire. The questionnaire was sent to the e-mail addresses of health workers of public health organizations. 91 respondents of both sexes (doctors ofmedicine, residents, registered nurses, nurses and administrative staff) were included.Results: A positive correlation was establishedin the attitude toward the effectiveness and efficiency of business processes. According to the participant’s opinion, the greater effectiveness of business processes contributes to greater efficiency (r=0.846; p<0,05). Spearman’s coefficient rs=0.81 shows a strong connection between the effectiveness and efficiency of business processes.Conclusion: The study showed that there is a positive attitude towards the impact of the lean concept on improving the efficiency of business processes. The reducexpected positive effects of the implementation of the lean concept are manifested through faster provision of services to patients, reduction of service waiting times and general improvement of business processes.

As a modern way of thinking lean methodology uses tools that are directed towards the continuous improvement of the functioning of the system with continuous perfection. Lean production (LP) means less work in the workplace, less manufacturing space, less investment, less time and fewer tools and supplies. The methodology is designed so that it is planned and managed in stages, necessary for the realization of the objectives defined production system. Lean companies are primarily focused on growth, increase profitability and customer value, but also increase productivity, improve the quality of products and processes, as well as the delivery systems are also important elements for improving business efficiency. This paper will present the methodology of implementation of lean concepts for improving productivity in manufacturing companies.