PurposeSeveral authors have examined the lean healthcare literature, but besides all efforts made, articles comparing conceptual and analytical studies were not found. Thus, a systematic review is conducted aiming to understand the state of the art of lean healthcare by investigating and comparing how conceptual and analytical articles address tools/methods, application fields, implementation barriers and facilitators and positive and negative impacts.Design/methodology/approachArticles in English about lean healthcare, published in journals in the last ten years (2009–2018) and indexed in Web of Science (WoS) or Scopus were examined and assessed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) protocol. A qualitative content analysis on the eligible articles was conducted, and results from the conceptual and analytical studies were compared.FindingsThere is a literature gap regarding tools/methods in both conceptual and analytical approaches once they prioritize for different items. Barriers, facilitators and negative impacts are perceived differently within both categories and might require more extensive analysis. The same items prevail in both conceptual and analytical categories when analyzing healthcare fields and positive impacts.Originality/valueThere is a lack of articles comparing conceptual and analytical studies concerning lean healthcare. So, this study's relevance is in identifying theoretical and applied research gaps to strengthen the lean healthcare state of the art and to integrate theoretical-applied knowledge. For healthcare professionals, it might provide an overview of the key factors that can promote lean implementation.

Brazilian public hospitals face several operational problems not only related to poor public management practices and their complex nature, but also the economic, and social contexts. Considering this scenario and the fact that efforts in supply management might affect a hospital organization’s excellence, this research aims to identify improvements in the logistic operations at the surgical center satellite warehouse of a Public Hospital located in Brazil. A case study based on an exploratory and qualitative approach was conducted by employing document analysis, semi-structured interviews, and on-site observations. Seven major problems concerning lack of surgical material, the non-definition of crucial logistic parameters, low information flow, surgical supply control, and management problems were pointed and addressed by seven independent but complementary actions that considered the Brazilian healthcare system’s particularities. Given the nature of exploratory research, the results are not exhaustive and cannot be generalized to different contexts. However, they help understand that reducing the waste of the logistics processes makes it possible to improve the attention to the local population that uses public health services.

PurposeLean healthcare (LHC) applies lean philosophy in the healthcare sector to promote a culture of continuous improvement through the elimination of non-value-added activities. Studies on the subject can be classified as conceptual (theoretical) or analytical (applied). Therefore, this research compares bibliometric indicators between conceptual and analytical articles on LHC.Design/methodology/approachFor data collection, the PRISMA Protocol was employed, and 488 articles published from 2009 to 2021, indexed in the Scopus and WoS databases, were retrieved.FindingsThis study reveals how conceptual and analytical LHC studies are organized in terms of the most relevant journals, articles, institutions, countries, the total number of citations, collaboration networks (co-authorship, international collaboration network and institutional collaboration network) and main co-words.Originality/valueOnly four papers conducting bibliometric analysis on LHC studies were identified in the Scopus and Web of Science databases. In addition, none of these papers compared conceptual and analytical bibliometric indicators to reveal the evolution, organization and trends of each category. Therefore, this work is not only the first to make this comparison but also the first to analyze the collaboration between authors, institutions and countries in relation to studies on LHC. The analyses performed in this work allow one new possible understanding, by researchers and health professionals, of the literature behavior in this field of study.

The metrology area is responsible for measurement properties and is present in the market through services related to calibration, standardization, maintenance, measurement traceability, and certification. While there is a demand from metrology companies for efficient methods of managing the quality of their services and operations, lean culture encompasses the most important management techniques with applications in various segments. Considering the aspects that permeate these two areas, the question arises about a possible intersection between the demands of companies and metrology laboratories to remain competitive and certified in the market and benefits provided by lean culture. Thus, this paper performs a systematic review, according to the PRISMA protocol, in order to verify if there is an intersection between lean and metrology in the scientific literature. Through bibliometric and qualitative analyses, the research shows a gap of application with a lack of articles in this area, as well as a great potential of places and tools to be implemented.

Emergency departments (ED) are responsible for the immediate care and stabilization of patients in critical health conditions. Several factors have caused overcrowding in the emergency care system, but the variability of patient arrival and the triage process requires special attention. The criticality of these components and their configuration directly impact the waiting times, length of stay and quality of service, being the subject of several studies. So, this paper aims to understand by means of Discrete Event Simulation how ED works with the variation of patient arrival and how this variation highlights the bottlenecks of the triage process. Varying the patient arriving interval between 0.1 and 7.6 in a 4-hour scenario,  the system saturation point was established in β = 1.1. Besides, with the variation in the number of triages points, a considerable decrease in the total length of stay spent and the waiting times were noticed, mainly when there was two triage points operating simultaneously.