Increasing Competitiveness through the Implementation of Lean Management in Healthcare

Abstract

<jats:p>The main aim of this paper was two-fold: first, to design a participative methodology that facilitates lean management implementation in healthcare by adopting the action research approach; second, to illustrate the usefulness of this methodology by applying it to the sleep unit of a public hospital in Spain. This methodology proposes the implementation of lean management in its broadest sense: adopting both lean principles and some of its practical tools or practices in order to achieve competitive advantage. The complete service value chain was considered when introducing changes through lean management implementation. This implementation involved training and involving staff in the project (personnel pillar), detecting and analysing “waste” in value chain processes (processes pillar) and establishing control and measurement mechanisms in line with objectives (key performance indicators pillar) and putting in place improvement actions to achieve these objectives. The application of this methodology brought about an improvement in the management of patient flow in terms of effectiveness, efficiency and quality but also an internal transformation towards lean culture.</jats:p>

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

“…Previous research similar to this paper [ 18 ] suggests that there are not many references in the health care field to the action research approach [ 49 , 50 , 51 ]; it is a sector more focused on case studies.…”

“…Following the principles of the Lean philosophy [ 47 , 48 ] and using action research methodology [ 18 ], this section presents a scientific methodology as shown in Figure 1 below that allows the redesign of processes and that can be replicated with the same purpose in other health centers in order to improve patient care.…”

“…There are five phases of action research, which are constantly repeated giving rise to possible cycles [ 18 ]: Plan to initiate the change. Implement the change (act), observe the implementation process and its consequences.…”

“…The research team and collaborators/participants who were working on the improvement of processes in the primary care center realized that a work culture had been created in a short time [ 18 , 35 ]. Moreover, they decided to continue with the methodology they had established to adapt to the new needs of the environment as existing in-depth knowledge of the center’s processes allowed its staff to more quickly identify which activities were necessary and which were not according to the new needs of their patients.…”

“…This involved adapting the different industrial management approaches to the healthcare field, seeking the efficiency and effectiveness of the different processes and productivity systems. At the healthcare level, these new adapted approaches are a challenge of innovation in the new management of the service sector [ 17 , 18 ]. This new way of working in the health care field is known as Lean Healthcare, which, according to Dahlgaard, et al [ 19 ], seeks to develop a service standard marked by patient satisfaction via continuous improvement in the value-creating care delivery processes and activities, and to engage all participants in the value chain of care delivery work to reduce waste and to promote patient value creation throughout the patient flow.…”