Lean healthcare in developing countries: evidence from Brazilian hospitals

Abstract

The present study evaluates how five sectors of two Brazilian hospitals have implemented lean healthcare concepts in their operations. The main characteristics of the implementation process are analyzed in the present study: the motivational factor for implementation, implementation time, form (consultancy or internal), team (hospital and consultants), lean implementation continuity/sustainability, lean healthcare tools and methods implemented, problems/improvement opportunities, lean healthcare barriers faced during the implementation process, and critical factors that affected the implementation and the results obtained in each case. The case studies indicate that reducing patient lead times and costs and making financial improvements were the primary factors that motivated lean healthcare implementation in the hospitals studied. Several tools and methods were used in the cases studied, especially value stream mapping and DMAIC. The barriers found in both hospitals are primarily associated with the human factor. Additionally, the results obtained after implementation were analyzed and improvements in financial aspects, productivity and capacity, and lead time reduction of the analyzed sectors were observed. Further, this study also exhibited four propositions elaborated from the results obtained from the cases that highlighted barriers and challenges to lean healthcare implementation in developing countries. Two of these barriers are hospital organizational structure (and, consequently, how the senior management works with medical staff), and outsourcing hospital activities. This study also concluded that the initialization and maintenance of lean healthcare implementation rely heavily on external support because lean healthcare subject knowledge is not yet available in the healthcare organization, which represents a challenge. Copyright © 2015 John Wiley & Sons, Ltd.

Improving Nurses’ Hand-off Process on Oncology Setting Using Lean Management Principles

“…Lean management is considered a management system aims to organize the operation design which reduced waste and time-consuming, improved safety and quality, and decreased the costs in health industries by using several tools such as Fishbone, flow chart in addition to redesign the operational work (Costaet al, 2017;D'Andreamatteo et al, 2015). Many health organizations such as National Health Service (NHS) and Institute for Healthcare Improvement (IHI) have recommended utilizing the lean concepts in health setting to enhance work efficiency (Costa et al, 2017;D'Andreamatteo et al, 2015;Machado et al, 2013;Sloan et al, 2014).…”

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Implementação Do Lean Healthcare: Experiências E Lições Aprendidas Em Hospitais Brasileiros

“…In agreement with previous reports, these teams were formed and conducted the projects in the three studied cases. In agreement with Costa et al (2015) and Bertani (2012), employee commitment was the critical factor for LP implementation in the three studied cases. In addition, as suggested by Zidel (2006), LP implementation began with the contracting of a consulting company.…”

A Systematic Literature Review for Better Understanding of Lean Driven Sustainability

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