Making the value flow: application of value stream mapping in a Brazilian public healthcare organisation

Tortorella, Guilherme Luz; Fogliatto, Flávio Sanson; Anzanello, Michel J.; Marodin, Giuliano Almeida; Garcia, Mayara; Esteves, Rafael Reis

doi:10.1080/14783363.2016.1150778

Cited by 68 publications

(51 citation statements)

References 34 publications

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“…Currently, Brazil is facing a scenario of consumption contraction, population aging, and increased migration, especially in large urban centers. This scenario has been directly reflecting in its emergency care departments, overloading its capacity (BARBOSA FILHO, 2017;TORTORELLA et al, 2017;YARMOHAMMADIAN et al, 2017;EMINE et al, 2018;VANBRABANT et al, 2019). Thus, Brazilian E.Ds managers are dealing with increasingly challenging aspects.…”

Section: Introductionmentioning

confidence: 99%

Discrete event simulation for problem solving in the context of an emergency department

Ferreira

Santos

et al. 2020

Ind. Jour. Manag. & Prod.

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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.

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Section: Introductionmentioning

confidence: 99%

Discrete event simulation for problem solving in the context of an emergency department

Ferreira

Santos

et al. 2020

Ind. Jour. Manag. & Prod.

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“…Através da aplicação do MFV, é possível analisar o fluxo de valor e garantir que as ações implementadas serão realizadas nos pontos onde há maiores oportunidades e trazem benefícios reais ao negócio. Exemplos de aplicação do MFV podem ser achados no setor hospitalar (TORTORELLA et al, 2015;DICKSON et al, 2009;JIMMERSON et al, 2005), em indústrias de processamento contínuo (ABDULMALEK; RAJGOPAL, 2007), desenvolvimento de produto (TYAGI et al, 2015) e na área administrativa (TEGNER et al, 2016).…”

Section: Introductionunclassified

“…Contudo, cabe destacar algumas limitações envolvidas quanto ao uso desta técnica. Estudos que abordam o MFV costumam basear suas informações e inferências de melhorias a partir de uma perspectiva determinística, tais como Tortorella et al (2015), Tyagi et al (2015) e Dickson et al (2009). Em outras palavras, ao longo do fluxo de valor há várias fontes de incerteza, tais como estoques, tempos de processamento e setup, entre outras, as quais adicionam variabilidade aos processos de manufatura (STANDRIDGE; MARVEL, 2006), dificultando o gerenciamento da produção.…”

Section: Introductionunclassified

“…Consideram-se produtos de uma mesma família aqueles que apresentarem uma familiaridade de processos mínima de 80%. Assim, dentre as famílias identificadas, definem-se critérios para priorizar seus mapeamentos e análise, os quais podem ser participação no faturamento, volume de produção, entre outros (TORTORELLA et al, 2016). O setor de OPME atende diversas unidades do hospital, como por exemplo hemodinâmica e centro cirúrgico.…”

Section: Introductionunclassified

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Análise do fluxo de valor sob uma perspectiva estocástica

Souza¹,

Tortorella²,

Nascimento³

2018

Revista PO: R. Eletr. de Eng. de Produção e Correlatas

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A aplicação da produção enxuta (PE) surge como uma resposta à busca por aumento da competitividade em um mercado globalizado. Dentre as práticas utilizadas na aplicação da PE, o mapeamento do fluxo de valor (MFV) serve como meio para identificar desperdícios e direcionar a aplicação das demais práticas, sendo, consequentemente, uma das mais adotadas. O MFV permite mapear fluxos de materiais e informações de controle da produção. No entanto, o MFV possui uma abordagem determinística, o que limita o poder de modelagem e dificulta o mapeamento de modelos dinâmicos. Nesse sentido, este trabalho objetiva a proposição de um método de identificação de oportunidades de melhorias que combine o mapeamento de fluxo de valor e simulação de Monte Carlo, de modo a levar em consideração as incertezas do fluxo de valor na sua análise de lead time. Os resultados obtidos mostram que essa nova abordagem permite identificar oportunidades de melhoria que não seriam contempladas em uma aplicação tradicional do MFV, possibilitando atuar não somente em valores nominais dos processos, mas também em sua variação.

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“…However, this potential has not yet been explored in its entirety and requires implementation efforts in situations of greater complexity (Proudlove et al, 2008;Saurin et al, 2013;Mannon, 2014;Righi & Saurin, 2015). Similarly, despite the gains in efficiency and quality that lean practices have brought to manufacturing environments, the applicability and adaptation of these practices to healthcare still face challenges (Young & McClean, 2009), such as healthcare leadership development and process variability (Tortorella et al, 2017a). In addition, LH is often misinterpreted since healthcare organizations usually begin to implement practices without prior understanding of the structural and cultural conditions required for implementation (Dahlgaard & Mi Dahlgaard-Park, 2006).…”

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confidence: 99%

Assessment methodology for Lean Practices in healthcare organizations: case study in a Brazilian public hospital

Tortorella

Augusto

França

et al. 2019

Prod.

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1. Introduction Many attempts to apply quality management practices have been carried out in healthcare services (Ruiz & Simon, 2004), which generally lack an efficient management system. Long waiting times, unnecessary increase in the number of examinations, high operating costs, staff shortages, and medical errors are some of the recurring problems in health services (Silberstein, 2006). In this sense, it is necessary for managers and leaders of healthcare organizations to understand their processes, improving them in order to provide a treatment that is safer, more efficient and better qualifyed. In recent years, discussions have centered on the potential of applying principles

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Making the value flow: application of value stream mapping in a Brazilian public healthcare organisation

Cited by 68 publications

References 34 publications

Discrete event simulation for problem solving in the context of an emergency department

Discrete event simulation for problem solving in the context of an emergency department

Análise do fluxo de valor sob uma perspectiva estocástica

Assessment methodology for Lean Practices in healthcare organizations: case study in a Brazilian public hospital

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