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Being open-minded means listening to others’ proposals, even if they go against our criteria. Although having an open mindset is the key to “open innovation,” we find that many managers are reluctant to make sustainable changes, either because they prefer to stick to what they know and prefer to stay in their comfort zone or just because they are embarrassed to assume errors or ignorance in certain issues of an environmental nature. The study aims to examine the role of green skills in overcoming defensive rigidity and defensive embarrassment barriers that hinder open innovation.

A questionnaire-based survey was administered to 208 SMEs in the Spanish textile industry. The data collected were processed and analyzed using the partial least squares structural equation modeling technique (PLS-SEM) and SmartPLS 4.

The study reveals that green skills significantly contribute to the development of open innovation and the mitigation of defensive routines among managers. This indicates that equipping managers with green skills can reduce their defensive rigidity and embarrassment, thereby fostering a more open and innovative organizational culture.

This research is original in its focus on the Spanish textile industry and its exploration of the specific psychological barriers that managers face in adopting sustainable innovations. By highlighting the importance of green skills, it provides a novel perspective on overcoming defensive routines to promote open innovation.

This study intends to reveal the existing research stream and predict future research avenues for lean healthcare (LH). This paper analyzes the progress of LH research and identifies key trends, research gaps and future directions. By mapping the knowledge structure, the study offers insights into the effects of LH on healthcare efficiency, patient care and organizational performance.

The review used the bibliometric approach, involving 319 journal articles retrieved from the Web of Science database. Two science mapping approaches (i.e. bibliographic coupling and co-word analysis) were performed to investigate the current knowledge structure and future research direction in LH.

The current research trend in LH focuses on developing frameworks and strategic implementation by considering critical determinants and decision-making strategies. In the future, the research on LH will emphasize the holistic frameworks and efficient strategies for healthcare excellence, along with strategies to overcome barriers to its implementation.

This study will benefit researchers and practitioners by advancing their understanding and applying LH principles.

This study provides valuable practical implications for healthcare managers to navigate the complexities of lean implementation, optimize processes and drive sustainable improvements in the healthcare context.