Lean healthcare applied in emergency services: an empirical evaluation

Abstract

Purpose This study aims to analyse the setup time management using the single-minute exchange of die (SMED) method in 24 h Emergency Care Units (ECUs). Design/methodology/approach A total of 1,098 reports in A3 form format were analysed and grouped into analysis categories to evaluate the implications of SMED in managing setup time in the 24 h ECUs. The content analysis was based on Bardin (2011). The findings were grouped into three categories. Findings The findings demonstrate the contributions of the Lean Healthcare approach in the 24 h ECUs through SMED analysis to reduce setup time in activities characterised as waste in 24 h UPAs. Research limitations/implications In this study, data were collected directly from the Good Practices Application, from a specific project conducted in ECUs, which could generate selection bias. Finally, the datas were categorised according to the categories defined a posteriori, which may lead to interpretation bias. Practical implications The implications listed from the SMED perspective for setup time management allow us to guide managers, consultants, researchers, and health professionals to provide continuous improvement in 24 h ECUs. The findings can serve as a basis for reducing configuration time in other public and private healthcare service organisations. Social implications SMED applied in 24 h ECUs makes it possible to improve emergency services provided to society and increase the capacity to care for patients and society in general. In addition, reducing costs for health service financiers, such as government and private institutions. Originality/value To the best of the authors’ knowledge, this is the first study that correlates the setup time management of the SMED method in crucial areas of 24 h ECUs, demonstrating opportunities for its application in reducing time in patient journeys. The findings show the benefits of Lean in these environments and highlight several opportunities for applying SMED to reduce setup in activities characterised as waste in 24 h UPA. SMED allows for improved operational excellence in emergency units and enables target opportunities to increase user satisfaction and service capacity.