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

Tortorella, Guilherme Luz; Augusto, Byanca Pinheiro; França, Sérgio Luiz Braga; Sawhney, Rapinder

doi:10.1590/0103-6513.20180080

Cited by 7 publications

(6 citation statements)

References 64 publications

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“…This script should be organized in a way to capture the complexity of the qualitative research and to facilitate the comprehension of the perspective and reality of the hotel supply chain under study. Thus, the interview script was designed in such a way as to allow the interviewer some freedom in asking the questions in order to investigate in the best possible way and according to his own judgment the need to delve into certain points that may be raised by the interviewee (Tortorella et al, 2019). It was divided into three parts.…”

Section: Methodsmentioning

confidence: 99%

Assessment of Lean implementation in Hotels’ supply chains

Tortorella

Rosa

Caiado

et al. 2019

Prod.

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Paper aims: This article aims at investigating the implementation level of Lean Supply Chain (LSC) practices in hotels' supply chains. Originality: The proposed method allows to characterize LSC implementation in such an unusual context, identifying improvement opportunities and checking for discrepancies in their implementation. Research method: Six different supply chains of high-quality hotels were analyzed through semi-structured interviews. Interviewees played key roles in their purchasing departments and presented large experience in the hospitality sector. Main findings: Results were consolidated and for each case attributes were assigned to measure the implementation level of ten practices. Implementation scores were compared to a perceived average importance degree in order to verify convergences and divergences between the desired and actual improvement initiatives. Implications for theory and practice: The applicability of LSC practices in services still needs further exploration. In the hospitality sector, whose evidence is even scarcer, this study provides a more holistic approach enabling a deeper understanding of the necessary adaptation for a successful implementation.

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Section: Methodsmentioning

confidence: 99%

Assessment of Lean implementation in Hotels’ supply chains

Tortorella

Rosa

Caiado

et al. 2019

Prod.

Self Cite

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“…There were 3 mixed-method studies from the 2020 data pull. Tortorella et al, 40 who authored 2 of the 3, developed a method for assessing Lean practices in health care organizations. Combining questionnaires and interviews of front-line staff to ascertain the frequency of problems encountered and the degree of implementation of Lean practices, the assessment is intended to assist leaders in prioritizing Lean practices to better fit their organizational context.…”

Section: Quantitative Resultsmentioning

confidence: 99%

Lean Management Systems in Health Care: A Review of the Literature

Winner

Reinhardt

Benishek

et al. 2022

Quality Management in Health Care

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Background and Objectives: Many health care organizations now employ Lean tools to improve value in health care, yet reports of their effectiveness vary. This variation may be explained by the context in which Lean is implemented, whether as a tool or as a management system. This article reports on a structured literature review conducted to understand the evidence base for the impact of Lean Management System implementation in health care. Methods: A search of PubMed, Scopus, Emerald, EMBASE, CINAHL, and Business Source Complete databases was conducted in November 2017 and repeated in July 2020 to assess the evidence for the impact of Lean Management Systems in health care from 2000 to July 2020. Articles were included if they (1) reported on a Lean Management System or (2) reported on Lean Management System components as described by Mann1 (ie, leader standard work, visual controls, daily accountability process, and discipline). Results: A total of 52 articles met the inclusion criteria. Although all articles described some combination of leader standard work, visual management, and daily accountability as part of their Lean Management System, only a handful described use of all 3 components together. Only one explicitly mentioned the fourth component, discipline, required to consistently apply the first 3. The majority reported on single-unit or department implementations and most described daily huddles at the unit level that included review of key performance indicators, identification of improvement opportunities, and problem solving. The role of the leader in a Lean Management System was described a coach and a mentor. Barriers to adoption such as insufficient training and increased workload for nurses were noted along with the importance of relevance to the local context for unit teams to find value in huddle boards and huddles. As yet, evidence of Lean Management System effectiveness in driving health care improvement is absent due to weak study designs and lack of statistical rigor. Conclusion: Well-designed research on Lean Management Systems in health care is lacking. Despite increasing adoption of Lean Management Systems over the past 10 years and anecdotal reports of its effectiveness, very few articles provide quantitative data. Those that do report unit-level implementation only, little use of a comprehensive package of Lean Management Systems elements, and weaker study designs and statistical methods. More rigorous study designs and robust statistical analysis are needed to evaluate effectiveness of Lean Management Systems in health care. This represents a rich area for future health care management research.

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“…The current issue and full text archive of this journal is available on Emerald Insight at: https://www.emerald.com/insight/2042-6747.htm the key process improvement philosophy (Gupta and Sharma, 2016;Radnor et al, 2012) that adds value to the processes by removing waste within the chain (Sisson and Elshennawy, 2015). Despite the promising positive effects of lean in healthcare SCs, adoption in health care is still at an infancy stage (Tortorella et al, 2019). Many authors argue that the applicability and implementation of lean in health care is still clouded by uncertainty, including unpredictable demand for medicines and medical supplies (Young and McClean, 2009;Terra and Berssaneti, 2018;Tortorella et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the promising positive effects of lean in health-care SCs, adoption in health care is still at an infancy stage (Tortorella et al , 2019). Many authors argue that the applicability and implementation of lean in health care is still clouded by uncertainty, including unpredictable demand for medicines and medical supplies (Young and McClean, 2009; Terra and Berssaneti, 2018; Tortorella et al , 2019). Young and McClean (2009) showed that the focus in health sector has mainly been on resource efficiency instead of flow efficiency of integrated resources, which is among the cause of failures of lean in health care.…”

Section: Introductionmentioning

confidence: 99%

Lean thinking in medical commodities supply chains: applicability and success factors for Tanzanian health supply chains

Kessy

Salema

Simwita

2023

JHLSCM

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Purpose This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical commodity supply chain, and the existing lean tools and practices together with their application in the supply chain processes. The paper also examined the challenges and success factors for effective lean application in the medical commodities supply chains. Design/methodology/approach The study used qualitative approaches, in-depth interviews and focus group discussions with key informants to form the basis for data collection. Through thematic analysis, the collected data were analyzed by developing themes reflecting the objectives of the study. Findings The main drivers for waste associated with the supply chain were demand management, supplier development, institutional framework and governance. The wastes were observed at the level of inventory, operation costs, transaction costs, delays in terms of service, commodity delivery time and quality. Digitalization, information technology and standardization were the tools for medical supply chain. Poor infrastructure, unreliable internet supply, environmental uncertainty and poor management support were challenges to realizing an effective supply chain. Research limitations/implications Although the qualitative approach used in the study provides detailed information, a quantitative study covers a larger sample for generalization. Practical implications Capacity building and professionalism should be given a priority because the philosophy of lean focuses on waste removal and continuous improvement, which highly depends on the quality of human resource (Brito et al., 2020). Limited human resource capabilities in supply chain management will, therefore, result into poor operational efficiency, which are wasted. Moreover, systems interoperability is key waste minimization and, therefore, demands interventions. Social implications The government under the Ministry of Health and other key sector ministries such as local and regional governments should better understand the role of the waste drivers and adopt system-wide reforms to support improvements to remove waste in the medical supply chain. For example, the current institutional framework creates an administrative block and hence leads to wastes. This bureaucratic procedure should be removed to minimize wastes along the chain. Originality/value This study is among the first studies to determine applicability and implementation of lean in a resource-constrained context. The paper identifies contextual factors for lean implementation. This paper focused on a holistic view of the entire supply chains to enhance a well-functioning supply chain in delivering health commodities.

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

Cited by 7 publications

References 64 publications

Assessment of Lean implementation in Hotels’ supply chains

Assessment of Lean implementation in Hotels’ supply chains

Lean Management Systems in Health Care: A Review of the Literature

Lean thinking in medical commodities supply chains: applicability and success factors for Tanzanian health supply chains

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