Enteral diet therapy: use of the Lean Healthcare philosophy in process improvement

Siqueira, Cibele Leite; Siqueira, Fernanda Ferreira; Lopes, Guilherme Calixtro; Gonçalves, Matuzalem de Carvalho; Sarantópoulos, Alice

doi:10.1590/0034-7167-2017-0746

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…Currently, Lean Health Care is not the sole management model that aims to restructure the health industry towards greater flexibilization of work and employment contracts, but many health organizations and systems apply Lean Health Care principles around the world. Some examples with higher prominence are the British National Health System (NHS) ( 27 ) ; the Virginia Mason Medical Center in Seattle, Washington, USA ( 28 ) , an institution associated to the Virginia Mason Institute, that created the Virginia Mason Production System inspired in Lean Production and makes consultations with diverse health institutions, among them the NHS itself; ThedaCare in Wisconsin, USA, that created the ThedaCare Improvement System based on Lean Production ( 29 ) ; the Institute for Healthcare Improvement in Cambridge, Massachusetts, USA ( 30 ) ; in addition to organizations in Brazil, Canada, Taiwan, New Zealand, Germany, Sweden, Italy and Holland ( 29 ,( 31 - 32 ) .…”

Section: Discussionmentioning

confidence: 99%

Nursing and society: Evolution of Nursing and of capitalism in the 200 years of Florence Nightingale

Silva

Ferreira

2021

Rev. Latino-Am. Enfermagem

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Objective: to analyze the relationships between the development of the Nursing labor and of capitalism over the 200 years of Florence Nightingale. Method: a logical-reflective and theoretical exposition based on interpretations of historical facts and Marxist theories. The analysis categories were the following: the creation and expansion of the Nightingalean Nursing Teaching System; the subsumption of the Nursing labor to capital; imperialism and international health; and the flexibilization of the Nursing labor. Results: the expansion of the Nightingale Teaching System has trained nurses on a global scale. The capitalist system transformed the Nursing labor in the twentieth century, culminating in the twenty-first century with precarious and intense turnover of nurses in their jobs. Conclusion: the Nursing labor, made professional by Nightingale, has assumed in the last 200 years a dialectical relationship with capitalism in which it both determines and is determined by it. New challenges, such as the Industry 4.0 technologies, are constantly imposed on the profession.

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Section: Discussionmentioning

confidence: 99%

Nursing and society: Evolution of Nursing and of capitalism in the 200 years of Florence Nightingale

Silva

Ferreira

2021

Rev. Latino-Am. Enfermagem

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“…Siqueira et al. (2019) used a case study with a survey of the root causes using the 5 whys tool, questioning the professionals in the focus unit of the work, who had been in it for at least 3 months.…”

Section: Theoretical Referencementioning

confidence: 99%

Lean healthcare applied systematically in a medium-sized medical clinic hospitalization

Drei

Ignácio

2022

JHOM

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PurposeThe objective of this paper is to propose a systematic application of Lean Healthcare in the hospitalization activity in the medical clinic entry process.Design/methodology/approachThe methodology used is established in three stages: the first aims to map the process in which the focus activity is inserted, using lean tools, as well as integrating the employees involved in the application. The second is the proposal to apply the systematic, together with the employees, using the A3 tool step by step. Finally, the third stage confirms the applied systematic, collecting the results and analyzing the initial situation with those reached.FindingsAs a result, improvements were made in the medical clinic entry process, such as reduced waiting time for patients, at approximately 53.8%, with a decrease in the standard deviation of the times – of approximately 79.14%, and displacement of those involved, of 72%, in addition to eliminating unnecessary activities for the process. Furthermore, the empirical results on the efficiency of this systemic application in medical clinic enable the replication of this proposal, generating a systematic.Research limitations/implicationsDespite establishing a systematic proposal with real results, it is focused on only one application, due to time limitations, may generate a subjective evaluation of the systematic. Thus, for future research, it is recommended to expand this systemic application in other activities of different processes.Practical implicationsThe practical implications of this paper are precisely related to the data obtained with the application made, developing a Lean Healthcare systematic not previously seen, which is strategic, systemic and has a roadmap to assist in its application and, in addition, brings with it practical results that prove their efficiency.Social implicationsThe social implications of this paper are presented in its empirical results, considering that the study hospital serves, in addition to its host city, 28 other smaller municipalities around it, improving the flow of processes, ensuring better management of the clinic doctor. In addition, the results can assist the processes flow of other medical clinics in hospitals around the world, especially at critical moments, such as pandemics or epidemics.Originality/valueDue to the positive results obtained in the systematic application, this paper fills a gap identified in the literature, proposing a systematic application of Lean Healthcare that is systemic and strategic, in addition to including a roadmap and analysis of data applied in a medium-sized Brazilian hospital, presenting positive practical results exposed in the paper.

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“…Isso gera um foco específico nas ferramentas em detrimento de uma implementação sistêmica relacionada ao processo de planejamento estratégico (BURGESS;RADNOR, 2013;MATTHIAS;BROWN, 2016). Siqueira et al (2019) utilizaram um estudo de caso com levantamento de causa raiz utilizando a ferramenta 5 porquês, questionando os profissionais da unidade foco do trabalho, que estavam nela há pelo menos três meses.…”

Section: Aplicações E Sistemáticas Do Lean Healthcareunclassified

Proposta de aplicação do Lean Healthcare na padronização de processos de uma clínica médica de um hospital de médio porte utilizando o PMBoK / Proposal for the application of Lean Healthcare in the standardization of processes in a medical clinic of a medium-sized hospital using the PMBoK

Drei¹,

Gutierrez²,

Meza³

2021

BJDV

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RESUMOO ambiente hospitalar é muito propício para incorporar a filosofia Lean, dado que tais organizações de saúde são lugares complexos com grande importância social. Uma vez que alguns especialistas atribuem muitos dos serviços de saúde a sistemas de trabalho ineficientes e não confiáveis, essas ferramentas Lean tem sido associadas alguns conceitos complementares, como a Gestão de Projetos. Dessa forma, o objetivo deste artigo é propor uma aplicação sistêmica do Lean Healthcare na clínica médica de um hospital de médio porte utilizando o PMBoK como ferramenta reguladora nas etapas do projeto. A metodologia consistiu em dois momentos, sendo que primeiramente foi avaliando os processos e foi proposto uma ferramenta de procedimento de trabalho padrão para a falta de padronização na internação da clínica médica e, em seguida, foi proposto a aplicação da ferramenta, seguindo o PMBoK. Como resultados, o artigo conseguiu contemplar todos os pontos do PMBoK e propor uma aplicação concisa do Lean Healthcare, para diminuir os desperdícios existentes dentro da saúde pública brasileira, concluindo que a qualidade e os benefícios podem ser mantidos para os pacientes, enquanto o hospital não precisa arcar com nenhum tipo de aquisição ou custo extra.

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Enteral diet therapy: use of the Lean Healthcare philosophy in process improvement

Cited by 8 publications

References 5 publications

Nursing and society: Evolution of Nursing and of capitalism in the 200 years of Florence Nightingale

Nursing and society: Evolution of Nursing and of capitalism in the 200 years of Florence Nightingale

Lean healthcare applied systematically in a medium-sized medical clinic hospitalization

Proposta de aplicação do Lean Healthcare na padronização de processos de uma clínica médica de um hospital de médio porte utilizando o PMBoK / Proposal for the application of Lean Healthcare in the standardization of processes in a medical clinic of a medium-sized hospital using the PMBoK

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