Mapping lean experiences and emerging connections with clinical risk management in Italian context

Crema, Maria; Verbano, Chiara

doi:10.1108/bpmj-05-2014-0042

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…Case research is usually adopted to study emerging practices and it allows a rich description of a phenomenon (Voss et al, 2002;Eisenhardt and Graebner, 2007). Among the few healthcare providers that have implemented HLM in an advanced manner (Crema and Verbano, 2015c), three L&S projects have been selected from a hospital with an internationally known experience in HLM and with a well-defined strategy linked with it. All the selected cases report unexpected safety improvements linked to the patient care, even if they are dissimilar each other, assuring theoretical and literal replication (Yin, 2009).…”

Section: Objectives and Methodologymentioning

confidence: 99%

Safety improvements from health lean management implementation

Crema

Verbano

2016

IJQRM

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Purpose In a context where healthcare systems have to face multiple challenges, the development of a methodology that combines new managerial approaches could contribute to pursue and achieve multiple objectives. Inside the research stream that intends to combine health lean management (HLM) and clinical risk management (CRM), the purpose of this paper is to study the significant features that characterize HLM projects obtaining patient safety improvements (L&S projects). Design/methodology/approach The novelty of the research implies to adopt qualitative research methodology, analyzing in-depth case studies. L&S projects at different organizational levels have been selected from the same hospital. Following a research protocol, data have been collected through semi-structured interviews and they have been triangulated studying reports and archival documentation. Findings Comparing the three cases, it emerges that HLM can be a support for CRM since safety improvements can be achieved solving organizational issues. Analyzing the significant features of the three cases, relevant differences have been highlighted among them. At the end, first indications useful for achieving safety improvements from lean project implementation have been grasped. Originality/value This research provides a preliminary contribution to a new research stream that aims to develop a synergic methodology combining HLM and CRM. The first provided indications can be followed by hospital managers who wish to learn how to implement projects achieving patient safety improvements besides efficiency enhancement. After testing and exploiting the obtained results, a new methodology should be developed moving toward a safer and more sustainable healthcare system.

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Section: Objectives and Methodologymentioning

confidence: 99%

Safety improvements from health lean management implementation

Crema

Verbano

2016

IJQRM

Self Cite

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“…The Kaizen model has a high degree of problem identification and solution propositions, but a low degree in the implementations [ 31 ]. Crema realized that in a study of 22 clinical risk management project results, around 68% involved resource optimization and improvement of activities to increase efficiency and productivity, including cost and time reduction in routine execution [ 32 ].…”

Section: Research Problems Approaches and Applied Toolsmentioning

confidence: 99%

A Systematic Review on Lean Applications’ in Emergency Departments

et al. 2021

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This article presents the state of the art of Lean principles applied in Emergency Departments through a systematic literature review. Our article extends previous work found in the literature to respond to the following questions: (i) What research problems in emergency departments can Lean principles help overcome? (ii) What Lean approaches and tools are used most often in this environment? (iii) What are the results and benefits obtained by these practices? and (iv) What research opportunities appear as gaps in the current state of the art on the subject? A six-step systematic review was performed following the guidance of the PRISMA method. The review analysis identified six main research problems where Lean was applied in Emergency Departments: (i) High Waiting Time and High Length of Hospital Stay; (ii) Health Safety; (iii) Process redesign; (iv) Management and Lessons Learned; (v) High Patient Flow; (vi) Cost Analysis. The six research problems’ main approaches identified were Lean Thinking, Multidisciplinary, Statistics, and Six Sigma. The leading Lean tools and methodologies were VSM, Teamwork, DMAIC, and Kaizen. The main benefits of applying Lean Principles were (a) reductions in waiting time, costs, length of hospital stay, patient flow, and procedure times; and (b) improvements in patient satisfaction, efficiency, productivity, standardization, relationships, safety, quality, and cost savings. Multidisciplinary integration of managers and work teams often yields good results. Finally, this study identifies knowledge gaps and new opportunities to study Lean best practices in healthcare organizations.

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“…Only in recent years, it has emerged the need to manage all those behaviours affecting patient safety and the quality of treatments (Brusoni et al, 2009;Trinchero, 2016), also with new professional profiles oriented to managerial skills and aptitudes. The topic of clinical risk in health organizations and its management is gaining increasing attention (Agostini et al, 2020;Bettineschi and Delvecchio, 2014;Bolcato et al, 2019;Crema and Verbano, 2015). For instance, publications on management matters mainly deal with the relations between health lean management, clinical risk management and safety care (Crema and Verbano, 2015, 2016, 2017Verbano and Crema, 2013).…”

Section: Clinical Risk Managementmentioning

confidence: 99%

Improvement of health performance through clinical risk management: the maternal and child pathway

Sardi

Sorano

Guerrieri³

et al. 2020

MBE

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Purpose To improve the performance both in terms of patient safety and quality of treatments, this research studies one of the most delicate processes of health organizations, that is to say, the clinical risk management in maternal and child pathway. This paper aims to analyze the accidents that occurred in a complex health facility through the standard mapping of this pathway included in the CartoRisk, i.e. a risk assessment tool for the a priori analysis. Design/methodology/approach The research uses the case study methodology, as it explores a complex process in which a lot of variables and actors are involved. It analyzes the accidents occurred in the largest health facility at national and European level. Findings After a presentation of the regulatory framework and the studied health organization, the research analyzes the accidents occurred in maternal and child pathway from 2014 to 2018. It showed the main risks according to the standard mapping of the maternal and child pathway. Furthermore, it identified 11 new risks mainly associated with physiologic birth and Caesarean birth. Originality/value This study presents the regulatory framework, the health facility and the accidents of a health organization. Moreover, besides the accident analysis, the research integrates further risks into the standard mapping adopted to carry out this study and proposes a risk management approach. Therefore, the value of the research for operators will consist of the integration of the standard mapping used for a priori analysis to be reused in the hospitals where they work, while for researchers it will represent a deep knowledge of a real case.

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Mapping lean experiences and emerging connections with clinical risk management in Italian context

Cited by 12 publications

References 17 publications

Safety improvements from health lean management implementation

Safety improvements from health lean management implementation

A Systematic Review on Lean Applications’ in Emergency Departments

Improvement of health performance through clinical risk management: the maternal and child pathway

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