The main purpose of this study is to propose a holistic approach for prioritizing lean SCM initiatives in healthcare service operations, based on relative weights of various initiatives on a range of performance measures for better understanding of what motivations and supporting factors influence the selection of LSCM initiative/strategy. Twenty-four LSCM initiatives were identified, using a comprehensive literature review. Q-sort method was initially used to categorize those initiatives into four categories: (a) Continuous process improvement; (b) Enterprise alignment/integration; (c) Waste elimination; and (d) Flow management/JIT. Fuzzy AHP was used to prioritize the four categories based on its relative weight of importance on three different performance dimensions. The result shows that continuous improvement is a dominating LSCM initiative in increasing operational and financial performance while enterprise alignment/integration is a dominating initiative in enhancing organizational images and operational performance. Finally, it is noted that customer needs and influence are the most important drivers to encourage hospital to adopt LSCM strategy.