Analysis of hospital flow management: the 3 R’s approach

Gayer, Bruna Dones; Marcon, Érico; Bueno, Wagner Pietrobelli; Wachs, Priscila; Saurin, Tarcísio Abreu; Ghinato, Paulo

doi:10.1590/0103-6513.20200033

Cited by 5 publications

(6 citation statements)

References 27 publications

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“…Brambilla et al gathered detailed information on ED operations from medical, economic, social, managerial, technological, and statistical perspectives, while paying less attention to the relationship between the ED layout and its functional interactions with emergency-care services (ESs) and hospital support services [1]. Focusing on hospital facilities in general, several studies have discussed the design attributes of healthcare environments with the aim of making them more effective [5,20], investigating aspects such as the circulation conditions in relation to users' perceptions and experiences [21], infection control [5], and logistics [11].…”

Section: Challenges and Complexities Of Emergency Departmentsmentioning

confidence: 99%

“…In regard to contamination risks-a discussion that has been aggravated by the COVID-19 pandemic-the literature suggests that the design of the environment strongly affects hospital infection rates, due to cross-contamination [5,22]. Even before the sanitary emergency of COVID-19, several studies addressed the issues that are related to the flow of activities in order to improve healthcare conditions, focusing on the circulation [21,23], the waiting times [24], crowded patient environments [18], transport, and the storage of materials [11]. From a logistical perspective, effective hospital design can improve the flow of materials, reducing valueless activities and the activity time that is linked to the unavailability of adequate environments and infrastructure [11].…”

Section: Challenges and Complexities Of Emergency Departmentsmentioning

confidence: 99%

“…Evidence-based design (EBD) allows for the improvement of the design decisions for planned or existing environments [3,5,6]. Research that is oriented toward design and facility management (FM) has also focused on mapping, modeling, and simulating the building performance [7], behavior [8,9], and organization [10], the allocation of resources [4,11], the flow of people and activities [9,11], the operational efficiency [12,13], the space and layout [14,15], and the optimal paths [16]. Among the existing modeling, simulation, and evaluation methods, there is a lack of straightforward and logical resources that can be used to assess whether the allocation of activities in a built environment is congruent.…”

Section: Introductionmentioning

confidence: 99%

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Congruence Mapping of the Activity Flows Allocated in Built Environments: A Pilot Application of Under-Development Software in an Emergency-Care Service

et al. 2023

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Due to the large number of activities that must be carried out by emergency-care services (ESs), the tasks of facility managers and architects are challenging and complex. Several strategies, guides, and diagnoses have already been developed in order to improve ESs. Part of the solution to this problem depends on obtaining a normative and universal understanding of the problem, and another part depends on conducting a specific and relational analysis between the environment and the flow of activities that are allocated within it. This paper presents the results of a study that was conducted using a software program that is currently under development for mapping the congruence relationship between activities and environments. Here, we present a discussion of the first results that were obtained with the instrument, which was applied to a single case. For this purpose, the fundamentals of the instrument, as well as the environment and the flows of an ES at a university hospital, are described. The forms of analysis, benefits, and limitations of the instrument were investigated, with a view towards its use in supporting the management and the design of large and complex environments, such as emergency departments. In this program, the relationships that are hidden from the managers, the designers, and the researchers due to the aforementioned complexity are revealed through the use of matrices. This mapping can supplement the decision making of the managers and the designers. The application showed advantages in modeling with fewer inputs, mainly in pre-design evaluations.

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Section: Challenges and Complexities Of Emergency Departmentsmentioning

confidence: 99%

Section: Challenges and Complexities Of Emergency Departmentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Congruence Mapping of the Activity Flows Allocated in Built Environments: A Pilot Application of Under-Development Software in an Emergency-Care Service

et al. 2023

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“…Finally, Gayer et al. (2020) propose to study the logistics problems in Brazilian hospitals through Lean methods, approaching different aspects of logistics and the procedures adopted in health institutions such as receiving, storage and transporting.…”

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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“…Therefore, the VSM visually identifies what are the steps involved in creating this value, while shedding light to the wastes identified in the value stream. The construction of a VSM then supports processes improvement initiatives, eliminating and/or simplifying non‐essential activities that do not add value, and giving visibility the waste originated by the way the activities necessary for the creation of value are arranged (Gayer et al, 2020). VSM, however, does not provide an automatic execution model, making it unsuitable for automation in its native form (Zor et al, 2010).…”

Section: Theoretical Backgroundmentioning

confidence: 99%

A tentative integration of value stream mapping (VSM) and BPMN for improved process mapping

Soliman

Esteves

Trevisan

et al. 2022

Knowl Process Manag

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To promote knowledge management and operations improvement, companies and organizations use different tools to map and analyze their processes, such as Value Stream Mapping (MFV) and Business Process Modeling and Notation (BPMN). However, each of these techniques has advantages and limitations, often requiring the same process to be mapped in more than one notation. To overcome this issue, this research aimed to explore how VSM and BPMN can be integrated for improving process mapping. Initially, we selected a business process for case study and mapped it with both VSM and BPMN notations. Then, we drawn a new process map using a tentative hybrid notation proposed by the authors that combine elements from both BPMN and VSM in a single depiction. For each process instantiation, we analyzed how the selected notation influences comprehension, treatment of complex processes, continuous improvement, and the use of performance metrics. Results show that the hybrid BPMN‐VSM notation has the potential to overcome many limitations reported in literature regarding the individual use of VSM or BPMN, while preserving the most valued characteristics of both. Although further developments are still necessary, the use of the proposed hybrid notation proved to be a promising alternative for mapping complex processes. To our knowledge, this is the first attempt to explore the possibility of a hybrid notation inspired from BPMN and VSM.

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Analysis of hospital flow management: the 3 R’s approach

Cited by 5 publications

References 27 publications

Congruence Mapping of the Activity Flows Allocated in Built Environments: A Pilot Application of Under-Development Software in an Emergency-Care Service

Congruence Mapping of the Activity Flows Allocated in Built Environments: A Pilot Application of Under-Development Software in an Emergency-Care Service

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

A tentative integration of value stream mapping (VSM) and BPMN for improved process mapping

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