Application of lean healthcare in hospital services: a review of the literature (2007 to 2017)

Abstract

Process reengineering methodologies have become an international management phenomenon (Waring & Bishop, 2010), as there have been a growing pressure on health services to increase their efficiency. To achieve this goal, health services have sought alternatives to traditional models, adopting methodologies for improving processes commonly used in the manufacturing sector, including lean manufacturing (Radnor et al., 2012). The lean methodology, originated at Toyota, and also known as the Toyota Production System (TPS), is considered a radical alternative to the traditional mass-production model. Lean is defined as a methodology that adopts the elimination of waste, as well as the aggregation of value to all processes, whose goal is to improve the final product (Brackett et al., 2013) and to maximize operational efficiency, quality, speed and cost of operations (Holweg, 2007). The lean approach finds popular appeal in health care as it seeks to redesign clinical practices and resources around simplified, efficient and value-added care (Waring & Bishop, 2010). The approach adopted in health systems is different from that adopted in manufacturing systems, since the processes are different, particularly for working with human lives. Thus, the definition of lean for health systems has different interpretations and practices, and is commonly called lean health care. Nelson-Peterson & Leppa (2007) state that lean health care is neither an adapted manufacturing tactic nor a cost reduction program; it is a management strategy based on process improvement in a system. Radnor et al. (2012)

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

“…Additionally, reviews on LH provide thematic analyses [ 65 ], updates [ 44 ], and operational definitions [ 66 ]. Still others are focused on hospital waste management [ 67 ], the choosing wisely approach [ 68 ], sustainability [ 69 ], leadership and management [ 70 ], and safety and patient care [ 71 ]. To the best of our knowledge there is not a SR focusing on inpatient care and outcomes related to patient flow and efficiency.…”

Lean Healthcare applied toward turning a Pharmacy Service Patient Centered

“…Among the literature on the applications of Lean Healthcare, studies in particular analyze how the process of Lean Healthcare was implemented in both national (17,18) and international (14,19,20) scenarios. The results of these studies and in many other reviews (4,16,19,21,22) showed the processes of implementing Lean Healthcare had many similarities based on an understanding of the processes involved in flows of patients, materials or information. The most common tools were visual management, spaghetti map, time and motion studies, value stream mapping (VSM), Kaizen principles, standardization, (17,18,23) process mapping (11,24) and semi-structured interviews, documentary analyses and nonsystematic observations (23).…”

Lean thinking in total nursing care for mechanically ventilated patients: A new concept in ICU

“…[1] Indeed, critical care nurses should be value oriented to all care practices for MVPs in which they are challenged with providing safe, efficient and effective care practices. [15] However, lean evaluation is the step that precedes the lean implementation and sustainability process. Value stream map (VSM) is a lean strategy that documents the time for each process step and helps critical care nurses determining which steps in the care process add value to MVPs and which steps take up resources and time and incur cost without adding value.…”