Lean management in health care: effects on patient outcomes, professional practice, and healthcare systems

Rotter, Thomas; Plishka, Christopher; Adegboyega, Lawal; Fiander, Michelle; Harrison, Elizabeth; Flynn, Rachel; Chan, James G.; Kinsman, Leigh

doi:10.1002/14651858.cd012831

Cited by 12 publications

(11 citation statements)

References 30 publications

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“…Internationally, research is still ongoing, on how lean improvements are affecting patients' experience, professional practice, and healthcare systems. [18,19]…”

Section: Lean Performance Improvementmentioning

confidence: 99%

The experience of tertiary care public hospital in Oman: Lean performance improvement to enhance universal health coverage

Fannah

Rashdi

Harithy

et al. 2019

JHA

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Healthcare systems at an organizational level need to equip its people with tools that ensure continuous performance improvement to help sustain Universal Health Coverage (UHC). A large tertiary care public hospital in Oman (Royal Hospital [RH]), is sharing its experience in performance improvement using lean methodology. The RH introduced lean performance improvement to improve the efficiency of its administrative and clinical processes. This remarkable change was a cultural shift as it empowered clinical and non-clinical teams to improve the performance of the hospital operations continuously. Hospital leaders need to create opportunities for sustainable UHC at an organizational level. Introducing lean improvement methods at the hospital level leads to better problem definition and resolution. The people who do the work, need to improve the work, and eliminate waste in the processes as a day to day work style.

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“…Internationally, research is still ongoing, on how lean improvements are affecting patients' experience, professional practice, and healthcare systems. [18,19]…”

Section: Lean Performance Improvementmentioning

confidence: 99%

The experience of tertiary care public hospital in Oman: Lean performance improvement to enhance universal health coverage

Fannah

Rashdi

Harithy

et al. 2019

JHA

View full text Add to dashboard Cite

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“…It will include lean management as one of the approaches used to improve efficiency and quality in service provider organizations 61 65 ; and, 8) Supervision , defined as routine control visits by senior primary care staff to providers and facilities 66 72 .…”

Section: Intervention and Outcomes Of Interestmentioning

confidence: 99%

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

et al. 2018

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Background . For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion . Applications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda.

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“…In this category, we identified eight interventions of relevance including: 1) In-service training , a form of positive behavior support aimed at increasing the capabilities of individual primary care system actors 78 ; 2) Reminders , manual or computerized interventions that prompt individual providers to perform an action during a clinical exchange and can include, among others, job aids, paper reminders, checklists, and computer decision support systems 71 , 79 – 83 ; 3) Clinical practice guidelines , or systematically developed statements to assist healthcare providers and patients to decide on appropriate health care for specific circumstances 71 , 84 – 88 ; 4) Continuous education, referring to courses, workshops, or other educational meetings aimed at increasing the technical competencies of primary care providers; 5) Clinical incident reporting, or systems for reporting critical incidents and adverse or undesirable effects as a means to improving the safety of healthcare delivery 33 ; 6) Local opinion leaders , referring to the identification and use of identifiable local opinion leaders to promote good clinical practices 31 , 89 ; 7) Continuous quality improvement defined as the iterative process to review and improve care that includes involvement of healthcare teams, analysis of a process or system, a structured process improvement method or problem-solving approach, and use of data analysis to assess changes 71 . It will include lean management as one of the approaches used to improve efficiency and quality in service provider organizations 90 – 94 ; and, 8) Supervision , defined as routine control visits by senior primary care staff to providers and facilities 95 – 101 .…”

Section: Specific Intervention and Outcomes Of Interestmentioning

confidence: 99%

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

Munar¹,

Snilstveit²,

Stevenson³

et al. 2018

Gates Open Res

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Background. For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion. Implications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda.

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Lean management in health care: effects on patient outcomes, professional practice, and healthcare systems

Abstract: This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:• To assess effects of Lean management in health care on patient, professional, and systems outcomes by addressing the following question.

Cited by 12 publications

References 30 publications

The experience of tertiary care public hospital in Oman: Lean performance improvement to enhance universal health coverage

The experience of tertiary care public hospital in Oman: Lean performance improvement to enhance universal health coverage

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

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