Reducing Waste and Errors: Piloting Lean Principles at Intermountain Healthcare

Jimmerson, Cindy; Weber, Dorothy; Sobek, Durward K.

doi:10.1016/s1553-7250(05)31032-4

Cited by 220 publications

(217 citation statements)

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“…Furthermore, having to continually work around operational failures burns out employees and contributes to turnover (Beaudoin and Edgar 2003). Finally, operational failures delay care and can lead to errors that harm customers (Halbesleben et al 2008, Jimmerson et al 2005, Spear and Schmidhofer 2005. Despite their cumulative impact, operational failures prove difficult to address in practice, in part because they manifest as a wide-ranging set of small-scale problems rather than as a single, large problem (Beaudoin and Edgar 2003, Gurses and Carayon 2007, Gurses and Carayon 2009, Tucker 2004.…”

Section: Prior Research On Operational Failures and Lean Manufacturinmentioning

confidence: 99%

“…Furthermore, although SB's rules originated in automobile manufacturing, they have been applied to hospital work (Fredendall et al 2009, Furman and Caplan 2007, Jimmerson et al 2005, Shannon et al 2007, Spear and Schmidhofer 2005, Thompson et al 2003, Toussaint et al 2010, Wysocki 2004). …”

Section: Prior Research On Operational Failures and Lean Manufacturinmentioning

confidence: 99%

“…We compared what we learned to existing theory to determine which ones best reflected the underlying dynamics (Shah et al 2008). Our methods resembled those of other operations management scholars who conducted qualitative, interview and observation-based investigations of healthcare organizations to discover drivers of productivity (Fredendall et al 2009, Ghosh and Sobek 2006, Jimmerson et al 2005, Shah et al 2008, Sobek and Jimmerson 2003.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Lean in healthcare – history and recent developments

Sloan¹,

Fitzgerald²,

Hayes³

et al. 2014

Journal of Health Organization and Management

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Abstract:The performance gap between hospital spending and outcomes is indicative of inefficient care delivery. Operational failures-breakdowns in internal supply chains that prevent work from being completed-contribute to inefficiency by consuming 10% of nurses' time (Hendrich et al. 2008, Tucker 2004. This paper seeks to identify organizational factors associated with operational failures, with a goal of providing insight into effective strategies for removal. We observed nurses on medical/ surgical units at two hospitals, shadowed support staff who provided materials, and interviewed employees about their internal supply chain's performance. These activities created a database of 120 operational failures and the organizational factors that contributed to them. We found that employees believed their department's performance was satisfactory, but poorly trained employees in other departments caused the failures. However, only 14% of the operational failures arose from errors or training. They stemmed instead from multiple organizationally-driven factors: insufficient workspace (29%), poor process design (23%), and a lack of integration in the internal supply chains (23%). Our findings thus suggest that employees are unlikely to discern the role that their department's routines play in operational failures, which hinders solution efforts. Furthermore, in contrast to the "Pareto Principle" which advocates addressing "large" problems that contribute a disproportionate share of the cumulative negative impact of problems, the failures and causes were dispersed over a wide range of factors. Thus, removing failures will require deliberate crossfunctional efforts to redesign workspaces and processes so they are better integrated with patients' needs.

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Section: Prior Research On Operational Failures and Lean Manufacturinmentioning

confidence: 99%

Section: Prior Research On Operational Failures and Lean Manufacturinmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lean in healthcare – history and recent developments

Sloan¹,

Fitzgerald²,

Hayes³

et al. 2014

Journal of Health Organization and Management

View full text Add to dashboard Cite

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“…Asimismo Lean ha sido identificado como una alternativa a los enfoques tradicionales que buscan la solución de los problemas de calidad en un hospital o clínica ( [4]; [42]. Por lo tanto el propósito de Lean Healthcare es crear valor para el paciente y el valor es creado cuando se eliminan los desperdicios del proceso, con el propósito de darle un adecuado diagnóstico y tratamiento ( [24], [39], [43]; [44]). Muchos de los impactos y resultados de la aplicación de Lean Healthcare son: mejor cuidado de los pacientes, mejor calidad en los procesos de atención, mejor diseño de los procesos, mayor rendimiento financiero, mayor valor para el paciente, aumento de la productividad y oportuna prestación de servicios, mediante la reducción de los tiempos de espera, reducción de errores, incidentes y procedimientos inadecuados, y la disminución de costos ( [11], [22], [24], [45]; [46]; [47]; [48]; [49]; [50]; [51]; [52]; [53]; [54]; [55].…”

Section: Figura 4 Principales Autoresunclassified

Lean Healthcare: Una Revisión Bibliográfica Y Futuras Líneas De Investigación

Orjuela

Pimiento

2015

Sci. tech

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Resumen-La filosofía Lean a través del tiempo ha evolucionado y ha sido implementada en varios tipos de empresas tanto en el sector manufacturero como en el de los servicios, lo cual se evidencia en el gran número de estudios que investigan sobre la implementación de lean en dichos sectores. El propósito de este estudio es analizar las tendencias de las publicaciones, identificar los autores más influyentes y describir las futuras investigaciones en la aplicación de Lean en el sector salud. En esta investigación se presentan los resultados de un análisis bibliométrico realizadas a las publicaciones científicas acerca de la filosofía Lean Healthcare durante el periodo 1990-2015, en la base de datos: Isi Web of Knowladge, Scopus y PubMed. Los resultados de esta investigación contribuyen a identificar tópicos emergentes y ser un marco de referencia para futuras investigaciones en este tema de investigación.Palabras clave-análisis bibliómetrico, lean healthcare, servicios en salud, tendencias.Abstract-The lean philosophy through time, it has evolved and has been implemented in several types of companies both in the manufacturing sector and services, which is evident in the large number of studies that investigate on the implementation of lean in those sectors. The purpose of this study is to analyze the trends of the publications, identify the most influential authors and describe the future research in the application of Lean in the health sector. In this research presents the results of a bibliometric analysis carried out to the scientific publications about the philosophy of Lean Healthcare during the period 1990-2015, in the database: ISI Web of Knowladge, Scopus and PubMed. The results of this research will help to identify emerging topics and be a framework of reference for future research in this research topic.Key Word -bibliometric analysis, lean healtcare, health services, trends. , todas las definiciones que se plantean en las referencias anteriores son comunes ya que describen a Lean como una filosofía centrada en cumplir satisfactoriamente las necesidades del cliente, utilizando todos los recursos de producción disponibles con un mínimo de desperdicios, con la mayor calidad y al menor costo. Se puede concluir entonces con [8] que el propósito de Lean es minimizar las actividades que no agregan valor o desperdicios, y mejorar las actividades que si lo hacen; por lo tanto, se trata de la entrega del máximo valor a los clientes, mientras se utiliza la menor cantidad de recursos. I. INTRODUCCIÓN El término Lean¿Qué hizo que el concepto de Lean Manufacturing desarrollado en las últimas décadas por la empresa Toyota sea tan atractivo tanto para los académicos como para los empresarios? En primer lugar fue en Toyota donde se definió el propósito fundamental de la filosofía lean en los procesos productivos: eliminar desperdicios y agregar valor, lo cual permitió a los académicos y empresarios incorporar esta filosofía lean progresivamente a otros tipos de procesos de cualquier tipo de organización, por lo tanto...

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“…A systematic approach to shorten the time between customer (patient, physician, nurse, other) request and service delivery by identifying and eliminating sources of waste (non-value-added activities) (2).…”

Section: Introductionmentioning

confidence: 99%

Automation, Lean, Six Sigma: Synergies for Improving Laboratory Efficiency

Villa¹

2010

Journal of Medical Biochemistry

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Kratak sadr`aj: Patolo{ke slu`be {irom sveta, okru`ene pro izvodima, tragaju za re{enjima. Pristup cilja na ciklus bliske saradnje izme|u medicinskih radnika i laboratorijskih stru~njaka. Uprkos bud`etima ograni~enim na 2-3% uku pnih tro{kova zdravstva, laboratorije pru`aju informacije za >70% medicinskih postupaka. »Perianalitika« postaje fokus, razumevanje protoka informacija i uzoraka kroz ~itavo putovanje i procese. Analiza procesa je glavna stavka za razumevanje i oblikovanje najbolje kombinacije komponenata u dizajniranju finansijski zaista povoljnog re{enja za laboratoriju. Metodologije poput Lean (ili Toyota Pro duction System) i Six Sigma nedavno su po~ele da se usvajaju u zdravstvu kao i u laboratorijskom okru`enju. Posle razvoja u drugim sektorima, te tehnike su u zdravstvu pokazale uspe{nu primenu. Njihove alatke obra}aju se definicijama »vrednosti«, »otpada«, »protoka« kao klju~nim pokreta~ima za pobolj{anje performansi. Sinergija izme|u metoda dozvoljava donosiocima odluka da prepoznaju koji je stepen automatizacije stvarno potreban u njihovoj labo ra toriji, uz modernizovane procese. Razli~ite platforme na pravljene u industriji, za in vitro dijagnosti~ko testiranje, mogle bi postati finansijski nepristupa~ne i neefikasne bez pa`ljive procene potreba, putanja i varijabli vezanih za vred nost. Ukupna laboratorijska automatizacija ili samostalna »ostrva« za sisteme mogu se identifikovati i izabrati posle mapiranja procesa i preporuka primenjenih u tehnikama Lean i Six Sigma. Ovaj ~lanak isti~e neke klju~ne koncepte Leana i njegovog mesta u laboratorijskoj organizaciji, kao meto dologije koju treba implementirati pre odabira i usvajanja automatizovanog sistema.Klju~ne re~i: Lean, Six Sigma, laboratorijska automa tizacija, laboratorijska organizacija Summary: The Pathology Services worldwide, surrounded by products are today requesting solutions. The approach aims towards the brain-to-brain cycle between caregivers and laboratory professionals. Despite budgets limited to 2-3% of total healthcare expenses, Laboratories are providing information for >70% of medical actions. »Peri-analytics« is becoming the focus; understanding infor mation and sample flow in the whole journey and pro cesses. Process analysis is the main component to understand and shape the best combination of components in designing a truly cost-effective Laboratory solution. Methodologies like Lean (or Toyota Production System) and Six Sigma have started recently to be adopted also in healthcare and in the Laboratory environment. Those techniques showed already successful implementations in healthcare, after their development in other sectors. Their tools are addressing the definition of »value«, »waste«, »flow« as key drivers to improve performances. The synergy among the methods allows decision makers to identify the degree of automation really necessary in their laboratory, with stream lined processes. The different platforms made available by industries, for in vitro diagnostic testing, could become not cost-effective or efficient...

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Reducing Waste and Errors: Piloting Lean Principles at Intermountain Healthcare

Cited by 220 publications

References 1 publication

Lean in healthcare – history and recent developments

Lean in healthcare – history and recent developments

Lean Healthcare: Una Revisión Bibliográfica Y Futuras Líneas De Investigación

Automation, Lean, Six Sigma: Synergies for Improving Laboratory Efficiency

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