Lean Healthcare in the institutional, professional, and patient perspective: an integrative review

Abstract

Objective: To analyze the scientific evidences in the literature about the evaluation of Lean Healthcare after its implementation. Method: An integrative review conducted in the CINAHL, Scopus, WOS, and Embase databases, and in the PubMed portal, resulting in 18 articles published in English, Spanish and Portuguese, from 2008 to 2019. Results: The findings were categorized into results for the institution, professional, and patient. The predominant category was institutional, with cost analysis and increased productivity, followed by the professional, with job satisfaction and leadership, and finally the patient, with satisfaction, attitudes, and behaviors. Conclusion: This study reinforces the need to establish, for management, a systematic method of monitoring the results achieved in the Lean Healthcare implementation phase. Since the value in this method is defined by the patient, further research in this aspect may lead to new evidence.

Jogo Das Ferramentas Lean: Um Jogo Para O Ensino Do Lean Healthcare

“…O Lean é uma filosofia originalmente desenvolvida para a área industrial que foi adaptada para outros segmentos, como o da saúde, preconizando a revisão de processos para gerar valor para o paciente, equilibrando e otimizando os recursos requeridos. Essa filosofia está associada à melhoria do fluxo de trabalho, redução de desperdícios, aumento da satisfação do paciente e dos profissionais, melhoria da qualidade do atendimento e otimização da estrutura física, repercutindo, assim, na liderança transformacional e melhoria dos resultados operacionais e financeiros, os quais impactam diretamente nos custos e no aumento da produtividade (FERNANDES, 2020). A importância do Lean Healthcare se traduz em sua aplicabilidade em um sistema com inúmeras organizações, que não atendem somente a população, como também requisitos de órgãos regulatórios e governamentais.…”

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

“…The lean model is an industrial philosophy that has been adapted to the Health area, advocating the review of processes to generate value for the patient, balancing and optimizing the required resources. This is associated with improving the workflow, reducing waste, improving patient and professional satisfaction, improving the quality of care, optimizing the physical structure, impacting on transformational leadership and on the improvement of operational and financial results, which directly affect the costs and lead to productivity increase (11) .…”

“…The way to face this challenge is to place the client in a central position and, consequently, to reorganize the care delivery chain. This approach is called value-based healthcare, focusing on delivering the best outcomes, defined by the customer's perspective, and at the lowest cost possible (11) .…”

“…The concept of value-based health comprises care mapped from end to end, from beginning to end of the process, aiming to evaluate what adds value to clients and how this process can be improved from its conception (11) .…”

5S management improves the service quality in the outpatient-emergency pharmacy: from management process optimisation to staff capacity enhancement

“…Any disordered operation in the hospital could possibly have serious consequences, even medical negligence, threatening the health and lives of patients. The complexity of the organisation and its target for high quality and efficiency drive the application and popularisation of Lean management in a hospital, which has been demonstrated successfully in workspace standardisation and quality improvements 4–9. As an important part of the medical service in a hospital, the outpatient pharmacy is in urgent need of a management pattern pursuing both quality and efficiency to satisfy the medication needs of patients from all the outpatient clinical departments.…”