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This article presents a literature review of the challenges and possibilities for Lean design in modern health-care facilities. Many of today's health-care facilities are in dire need of renovation since limited financial resources among health-care demand improved work process efficiency, safety and employee well-being. Lean philosophy has been successfully implemented into hospitals with up-and-running hospital processes, but has not been thoroughly tested as a design methodology. The principles of Lean do not contradict with user-centric, participatory or ergonomic design approaches and thus the possibilities of using Lean as a complementary design methodology to the aforementioned approaches are discussed in this article. Lean fundamentals are also useful when dealing with change management issues. Lean offers a fundamentally solid ideology and a wide range of toolsmany of which seem fitting to solve several urgent design problems in today's health-care design.

BackgroundA simple but countable electronic device has been developed to gain reliable information on elderly patients' perceived well-being. The device has been tested and proven to be technically functional and countable. It was now tested in two care homes for the elderly and two private homes to evaluate if it provided solid information about the well-being of elderly persons. This report illustrates the practical usage of the device and shows its efficiency in gathering solid well-being information from the focus group.MethodsThe test arrangement was carried out by assigning a group of volunteers (n = 10) in care homes for the elderly for two weeks. The time period was long enough to collect a sufficient amount of information to evaluate the perceived well-being of the test subjects. Perceived well-being was assessed by using a Con-Dis device and by filling out an attached questionnaire - RAI - at the same time. RAI consisted of questions concerning mood, pain and quality of life. A standardised RAVA questionnaire with 12 questions concerning test subject's health was also answered once during the two-week time period by each test subject. After the test period the data obtained by Con-Dis was compared with the findings collected using questionnaires.ResultsA statistically significant correlation was found between perceived well-being (measured by Con-Dis) and questionnaire-based mood (r = 0,66, Pearson Correlation Coefficient) and quality of life (r = 0,68). No statistically significant correlation was found between perceived well-being and pain (r = 0,28). Technical functionality and feasibility of Con-Dis were good during the test period. Some problems arose because the test subjects were elderly and some in poor physical condition.ConclusionOn the basis of the collected results, the Con-Dis device presented information on the test subjects' perceived well-being that appeared to correlate with certain aspects of their health status. The test subjects' mood and quality of life but not pain had a statistically significant association with the perceived well-being level measured by Con-Dis.

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