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

Abstract

Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review is to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve. The review was performed according to PRISMA. We used six databases to search for studies published from 2002 to 2019. Out of 5732 studies, 39 measuring one or more defined outcomes were included. Hospital length of stay (LOS) was measured in 23 studies, 16 of which reported a reduction, turnover time (TOT) decreased in six out of eight studies, while the turnaround time (TAT) and on-time starts (OTS) improved in all five and seven studies, respectively. Moreover, eight out of nine studies reported an earlier discharge time, and the boarding time decreased in all four cases. Meanwhile, the readmission rate did not increase in all nine studies. Lastly, staff and patient satisfaction improved in all eight studies. Our findings show that by focusing on reducing non-value-added activities, LH contributed to improving patient flow and efficiency within inpatient care.

The Role of Value Stream Mapping in Healthcare Services: A Scoping Review

“…Accordingly, the literature published about the VSM methodology in healthcare organizations has been growing, with certain ups and downs, over the years. The trend is similar to the publications on the lean approach in the healthcare sector [156,157]. It is a trend which is not exponential, as has happened with the publications of other operations management tools, such as the healthcare supply chain [156].…”

“…Taking into account the results shown in the articles reviewed in this study, the implementation of VSM is a potent tool to reduce waiting times for the patients. Also, the development of VSM improves patient flow and efficiency, similar to other tools related to lean healthcare [153,[157][158][159]. The improvements have mainly come by way of reducing wasted time [160][161][162][163], and improving service quality, patient satisfaction [162,164,165] and safety [162,166,167].…”

A Model for the Implementation of Lean Improvements in Healthcare Environments as Applied in a Primary Care Center

“…Recent research [ 9 , 10 , 11 , 12 , 13 ] highlighted the Lean philosophy as a strategy allowing companies in any sector to adapt to rapid changes in the market, in the economy, in technical and social complexity issues, and in the needs of customers as well as for the health sector to adapt to the demands discussed above. A bibliographic review found great diversity, for example, in the area of emergency care, one of the most complex and haphazard areas [ 12 , 13 , 14 , 15 , 16 ] where this philosophy was applied for process improvement with successful results. Other researchers, such as Guzmán [ 6 ], also showed how, in the last 10 years, general hospital departments published results of process improvement and time optimization in emergency medicine, surgery, pharmacy, nursing, oncology, and administration reflecting the success of having implemented the Lean philosophy.…”

The use of Lean tools to reduce inpatient waiting time in a Thai public hospital: an action research study

“…In Thailand, despite several attempts to promote patient safety in hospitals, patient waiting time remain a significant issue which is mainly due to inadequate hospital quality management systems (Limpanyalert, 2018). Moreover, Zepeda-Lugo et al (2020) identify that further research should evaluate critical success factors in the implementation of Lean within inpatient care. Therefore, this research aims to illustrate the use of Lean tools to reduce inpatient waiting time and to evaluate critical success factors of Lean implementation in an inpatient pharmacy in a Thai public hospital.…”