Process-based Management aimed at improving health care and financial results

Abstract

The limited resources allocated to the health area and the growing demands require leaders’ qualified and committed performance in hospital management. In this perspective, the objective of this study is to reflect on the management practices that can be applied to hospital facilities to achieve better care and financial results. Among them, process-based management proposes an approach for continuous process improvement to achieve desired results; the method Lean Six Sigma allows identifying and eliminating waste in production processes; the continuous improvement model combines practical knowledge with the knowledge of how the system to be improved works, through observations and changes that allow its results measurement; and cost management and value-based healthcare provides for care mapping, from beginning to end, to assess what actually adds value to patients. The contributions of implementing these practices are recognized worldwide; using them, processes can be increased, improving efficiency, reducing waste, adding value to the business, increasing its revenue, and resulting in savings that can be passed on to the consumer, by improving quality.

Lean methodology: contributions to improving work processes in health and nursing

“…From this perspective, Lean methodology adoption makes the use of strategic, tactical and operational indicators crucial, as it requires a clear definition of the objectives and goals to be achieved, with systematic and continuous measurements. Strategic map integration with this methodology enables a systemic view of the institution by identifying weaknesses and points that can be improved, seeking sustainability based on results indicators, with gains in the small, medium and long term ( 7 ) .…”

“…Among the studies analyzed, three corresponded to review articles ( 11 , 15 , 17 ) , which assessed the Lean tools used in research ( 17 ) , the results after implementing Lean methodology ( 16 ) and its sustainability ( 11 ) . In this integrative review, it was found that the Lean methodology can bring benefits to organizations ( 7 , 15 ) , and is associated with process improvements, waste reduction, increased efficiency and productivity, improvement in service quality ( 13 , 17 - 19 ) , contributing favorably to economic aspects ( 12 , 16 ) .…”

“…It is noteworthy that, in Brazil, resources allocated to the health sector are increasingly scarce and limited, and the commitment of leaders, regardless of the legal nature of the institutions (public, private or philanthropic), with the organizational management model, cost management and its repercussions on the viability of different work processes is essential to ensure the provision of safe, efficient, effective and financially sustainable health services ( 7 ) .…”

“…Furthermore, Lean requires a structural change, from top management to the production chain, not being a point of arrival in itself, but rather a path of continuous search for improvements and operational excellence ( 7 ) . In health service provision, this methodology is designed to create a culture that applies science to design, execute and continually improve the work provided, focusing on measurable value to patients.…”

Social determinants and access to health services in patients with COVID-19: a cross-sectional study

“…Studies that have analyzed health care in these two types of services have shown some factors that can affect or enhance access to these services, such as priority/rapidity in care and a greater number of referrals to private services, infrastructure problems, lower travel costs and a greater number of visits to the public network ( 22 , 23 ) . In addition, the COVID-19 pandemic has posed a number of challenges for health systems, mainly due to the increase in costs and the number of beds, making it necessary to review management models, access, processes and funding policies ( 24 ) .…”