Facing the current socio-economic contingency while guaranteeing a high level of care quality is particularly challenging in the field of healthcare. Through an integrated adoption of emerging managerial solutions, projects that allow organizations to achieve both efficiency and patient safety improvements could be implemented, thereby transposing policy directives towards a safer and more sustainable healthcare system. Therefore, the purpose of this paper is to investigate the features of Lean & Safety (L&S) projects. Three Health Lean Management (HLM) projects that had unexpected patient safety results were selected from the same region. Differences and similarities among the cases have been highlighted and interesting points of evidence have been noted. Despite the fact that the projects were pursuing similar objectives and benefiting from comparable support, the obtained changes had direct impact on patient safety enhancement in the cases that involved the front-office processes, and an indirect impact on patient safely for the L&S project that focused on back-office activities. The implementation processes and the Information and Communication Technologies (ICT) adoption of the cases are also different.