A case-based methodology for lean implementation in hospital operations

Abstract

Purpose Although there are general methodologies for lean implementation in manufacturing companies, a specific methodology for the implementation of lean healthcare in hospitals has not been addressed by the literature. Addressing this gap, the purpose of this paper is to develop a practice-driven methodology for implementing lean in hospital operations. Design/methodology/approach Three case studies were conducted to collect evidence on the lean implementation process in Brazilian hospitals. From empirical evidence and literature, the implementation methodology was proposed and submitted to critical assessment by experts from the field. Findings The process of lean implementation was very similar in all cases, triggered by strategic planning and operationalized by continuous improvement projects. On the other hand, in all cases, the lean implementation teams had to deal with employees’ resistance. These findings were valuable inputs to the development of the implementation methodology. After refinement, it was proposed a feasible, useful and user-friendly methodology. Research limitations/implications The proposed methodology was raised from the practice through case study research. However, the proposed methodology was not fully applied, and the associated performance measures were not elaborated in this paper. Therefore, more case studies and applications will be necessary to generalize the findings. Practical implications The methodology provides practical guidelines that support lean implementation in hospital operations. Although it demands adaptations for each specific hospital setting, this initial step may encourage hospital managers to start the lean journey. Originality/value This study addressed the gap in the literature regarding the lack of methodologies for implementing lean healthcare in hospital operations. The methodology synthesizes the knowledge, principles and tools of lean thinking that can be applied in hospital operations.

Lean Manufacturing Implementation through DMAIC Approach: A Case Study in the Automotive Industry

“…The applicability of lean thinking has been proven in the literature by hundreds of successful case studies, such as in banking sector (Hidayati, Tarigan and Tarigan, 2019), construction (Li, Fang and Wu, 2020), pharmaceuticals (Sieckmann et al, 2018), electronics (Nguyen and Do, 2016), services (Piercy and Rich, 2009), metallurgy (Ching, Hoe, Hong, Ghobakhloo, in Pin, 2015), shipbuilding (Sharma and Gandhi, 2017), health (Régis, Santos and Gohr, 2019), as well as its implementation in universities (Balzer et al, 2016) where all these sectors have demonstrated the applicability and adaptability of the Lean concept. Its implementation has also been linked and integrated with other concepts, services or paradigms.…”

What Can Nurses Do to Implement Lean Hospitals?

“…Change causes high pressures in carrying out hospital operations (Hugh, Gliebe & Sendlhofer, 2019). Other problems are also faced by management which due to the employees who are resistant to change (Regis, Santos & Gohr, 2019).…”

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

“…In manufacturing, it is possible to observe systematic methodologies for the application of Lean (Karim and Arif-Uz-Zaman, 2013); however, in the literature, a standardized system was not identified to the health service, as described in Régis et al . (2019).…”