Abstract: Recently, Malaysia healthcare industry has been continuously vigilant about healthcare system. The increase the number of medical schools showed that Malaysia is serious about providing quality healthcare. Healthcare system is faced with challenges and opportunities from a rapidly changing operating environment, including increasing expectations on the quality of healthcare. Hence, this paper attempts to review and proposed structural relationship model of lean healthcare practices (LHP) and a healthcare performance. A structural relationship model using Structural Equation Modeling (SEM) has been proposed. Based on the proposed conceptual model and reviewed, research hypotheses are being developed. The paper culminates with suggested future research work.