Features and Results of Conducted Studies Using a Lean Management Approach in Emergency Department in Hospital: A Systematic Review

Abstract

Objective:To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which influence on their performance. Method:The necessary information in the first stage was collected by searching these keywords: "Lean principles" “Lean Six Sigma", "Lean Process", “Lean thinking”, “Lean Methodology”, “Toyota Production System lean processing”, "lean techniques", "emergency department”, “emergency medicine”, “emergency room” and “emergency care ” . And in the next stage the keywords such as “lean management” and “emergency” was collected from SID, Medlib, IranDoc, Google Scholar, MagIran, IranMedex data bases. For extracting the data data-extracting forms was prepared. The information we got from the forms was organized in information-extracting forms and was analyzed manually. The diagrams were drawn in Excel: 2010.Results:Finally, 26 essays have been included. Most of the studies were accomplished in Canada and U.S.A. only in one of the cases, the authors used the control group. Each of these terms, “lean techniques” and “lean principals”, with five times repetitions had the highest frequency. The most important team of implementation of lean management included: hospital management team or the manager of Emergency department, physicians, nurses, staffs and external counselors. Generally, 51 indicators were studied which among them the length of stay and the timing had the most frequency. After implementation of lean management, almost all studied indicators have significantly improved. 14 barriers, 14 facilitators and 10 effective factors were recognized in implementing the lean management.Conclusion:According to the studies, responsibility of organization’s senior management and his/her supports; increasing the knowledge of the characteristics and dimension of lean among the providers of health service; and decreasing the resistance and consulting with external counselors can have great effect on the success of lean management.

Lean Six Sigma methodology application in health care settings: an integrative review

“…Reduction in assistance time is crucial and directly impacts patient satisfaction, especially in emergency services. A review study that highlighted a greater number of improvements related to reduction in length of hospital stay, waiting time, volume of care and increased satisfaction, corroborates the statement (42) .…”

Lean Healthcare Tools for Processes Evaluation: An Integrative Review

“…These principles and waste are the theoretical foundations that constitute lean manufacturing philosophy [28]. With this, it is already known that lean is a philosophy that has been increasingly implemented in the health area over the past years [9]. With the results obtained through this review, it was possible to verify which tools are being used more in this area and which are the main results achieved.…”

“…The studies found were published, predominantly, in the English language, probably due to the fact that the majority were carried out in the United States, one of the pioneers in the application of lean healthcare [9]. The second country that published the most research on the subject was Brazil, demonstrating that lean has been the target of growing interest in the country.…”

“…Articles on the use of lean tools have increased significantly in recent years [9]. At this point, the lean healthcare literature presents, however, an important gap, that is, which tools are being applied health services and which are results of such applications.…”

Meaningful inhibitors of the lean journey: a systematic review and categorisation of over 20 years of literature

“…( Arkader and Janeiro, 2001;Deloitte and Touche, 2002;Hacker and Doolen, 2005;Radnor and Walley, 2008;Radnor and Boaden, 2008;Scorsone, 2008;Young and McClean, 2009;Suárez-Barraza and Ramis-Pujol, 2010;Poksinska, 2010;Grove et al, 2010;Wong and Wong, 2011;Eswaramoorthi et al, 2011;Scherrer-Rathje, 2012a, 2012b;Machado Guimarães et al, 2013;Rymaszewska, 2014;Dora et al, 2014;Sisson and Elshennawy, 2015;Zimmermann and Bollbach, 2015;Matthias and Brown, 2016;Cherrafi et al, 2016;Sahai, Virmani and Saha, 2017;Pearce et al, 2018;Rexeisen et al, 2018;Tezel et al, 2018;Thanki and Thakkar, 2018;De Oliveira et al, 2018;Caldera et al, 2019;Isfahani et al, 2019;Sindhwani et al, 2019;Gao and Gurd, 2019) Resources constraints  Budget constraints;  Financial (Er et al, 2000;Bateman and Rich, 2003;Canadian…”