Does Value Stream Mapping affect the structure, process, and outcome quality in care facilities? A systematic review

Abstract

BackgroundQuality improvement within health and social care facilities is needed and has to be evidence-based and patient-centered. Value Stream Mapping, a method of Lean management, aims to increase the patients’ value and quality of care by a visualization and quantification of the care process. The aim of this research is to examine the effectiveness of Value Stream Mapping on structure, process, and outcome quality in care facilities.MethodsA systematic review is conducted. PubMed, EBSCOhost, including Business Source Complete, Academic Search Complete, PSYCInfo, PSYNDX, SocINDEX with Full Text, Web of Knowledge, and EMBASE ScienceDirect are searched in February 2016. All peer-reviewed papers evaluating Value Stream Mapping and published in English or German from January 2000 are included. For data synthesis, all study results are categorized into Donabedian’s model of structure, process, and outcome quality. To assess and interpret the effectiveness of Value Stream Mapping, the frequencies of the results statistically examined are considered.ResultsOf the 903 articles retrieved, 22 studies fulfill the inclusion criteria. Of these, 11 studies are used to answer the research question. Value Stream Mapping has positive effects on the time dimension of process and outcome quality. It seems to reduce non-value-added time (e.g., waiting time) and length of stay. All study designs are before and after studies without control, and methodologically sophisticated studies are missing.ConclusionsFor a final conclusion about Value Stream Mapping’s effectiveness, more research with improved methodology is needed. Despite this lack of evidence, Value Stream Mapping has the potential to improve quality of care on the time dimension. The contextual influence has to be investigated to make conclusions about the relationship between different quality domains when applying Value Stream Mapping. However, for using this review’s conclusion, the limitation of including heterogeneous and potentially biased results has to be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0563-y) contains supplementary material, which is available to authorized users.

Protocol: Value Stream Maping in Healthcare. A systematic literature review

“…Son muy escasas las revisiones que se centran específicamente en VSM y sector de servicios sanitarios (Nowak et al, 2017;Vidal-Carreras et al, 2015). En ellas se concluye que no hay suficiente material para aportar evidencias y dar respuesta concluyente a sus preguntas de investigación.…”

“…Dado que han pasado algunos años (finales del 2014 o principios de 2016) desde la fecha de las ultimas referencias utilizadas en las revisiones localizadas (Nowak et al, 2017;Vidal-Carreras et al, 2015), consideramos conveniente hacer una nueva revisión sistemática de VSM en servicios sanitarios y comprobar si se han publicado nuevos trabajos que permitan aportar nuevas evidencias y superar algunas de las limitaciones de las anteriores revisiones sistemáticas en el área.…”

“…Some publications reveal that the barriers from using such tools can overcome facilitators in public service contexts (Marin-Garcia et al, 2018b). Very few reviews have focused specifically on the VSM and the health services sector (Nowak et al, 2017;Vidal-Carreras et al, 2015). Both conclude that there is not enough material to provide evidence for and a conclusive answer to our research questions.…”

Clinical Integration in a Dental School Clinic Through an Enhanced Patient Intake Process

“…4 System wastes include transport (unnecessary movement); inventory (amount not commensurate with that required for the operation); motion (generally relects poor facility design); waiting (something or someone is waiting for the next step); overproduction (generating more than is required); overprocessing (unnecessary process steps); and defects (suboptimal results requiring rework or replacement). 13,15,16 The separate PI clinic operations at OSU negatively inluenced clinical experiences for students and patients, who are the customers in the dental school environment. 14 A recognized set of process improvement tools/techniques are employed to realize process improvement goals.…”

“…The routinely applied Lean tools/techniques include the following: go see (observing and understanding each step of a process); value stream mapping (mapping a process from beginning to end, recognizing value-added steps); small cycles of change (testing small modiications to a process); and an A3 report (capturing project information on a single sheet of paper). 13,15,16 The separate PI clinic operations at OSU negatively inluenced clinical experiences for students and patients, who are the customers in the dental school environment. The PI process did not align with an integrated practice model, and it generated limited revenue.…”