Background: Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies ofLean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extentto which changes over time in Lean maturity are associated with changes over time in care-giving, thriving andexhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and jobresources, as perceived by staff, have a moderated mediation effect.

Method: A longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care unitsresponded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings ofLean maturity reflect participants’ judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion andjob demands and resources reflect participants’ judgements regarding their own situation.

Results: First, over time, increased Lean maturity was associated with increased staff satisfaction with their care-givingand increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associatedwith decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that jobdemands and job resources had a moderated mediation effect.

Conclusion: The results indicate that primary care staff may benefit from working in organizations characterized by highlevels of Lean maturity and that caregiving may also be improved as perceived by staff.