Lean thinking transformation of the unsedated upper gastrointestinal endoscopy pathway improves efficiency and is associated with high levels of patient satisfaction

Hydes, Theresa; Hansi, Navjyot; Trebble, T M

doi:10.1136/bmjqs-2011-000173

Cited by 37 publications

(22 citation statements)

References 19 publications

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“…[17][18][19] However, in a 2015 systematic review of use of lean techniques in health care, researchers reported positive but not conclusive evidence of improved quality and safety outcomes. These inconclusive results may be due in part to a need to delineate what implementation strategies led to the success of QI initiatives.…”

Section: Discussionmentioning

confidence: 99%

Quality Improvement Intervention to Decrease Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery

Hefner¹,

Tripathi²,

Abel³

et al. 2016

American Journal of Critical Care

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BackgroundIn 2010, the incidence of prolonged mechanical ventilation (> 24 hours) after isolated coronary artery bypass graft (CABG) surgery was 26.9% at the study site, The Ohio State University Wexner Medical Center, compared with the national like-hospital rate of 10.9%. Objectives To use the principles of lean management to reduce the incidence of prolonged mechanical ventilation and to assess the sustainability of that reduction over time. Methods A multidisciplinary prolonged ventilation task force conducted a gap analysis leading to 3 interventions: (1) a standardized extubation protocol, (2) dry erase boards in patients' rooms to facilitate team communication, and (3) edits of the postoperative order set within the electronic health record. Outcomes of mechanical ventilation in CABG patients before and after the interventions are compared. Results All target outcomes changed significantly after the interventions, including a reduction in the median hours of initial mechanical ventilation (from 11.4 hours to 6.9 hours, P < .001). The percentage of patients reintubated did not increase (a decrease from 11.8% to 3.5% was not significant, P = .08). The rate of prolonged ventilation decreased from 29.4% to 8.6% (P = .004), and this reduction was sustained for 4 years after the interventions. Conclusions Success factors included the multidisciplinary task force and continual protocol reeducation among front-line staff.

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Section: Discussionmentioning

confidence: 99%

Quality Improvement Intervention to Decrease Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery

Hefner¹,

Tripathi²,

Abel³

et al. 2016

American Journal of Critical Care

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“…A lean transformation of an out-patient department phlebotomy service in a teaching affiliate to Harvard Medical School reduced the average patient waiting times from 21 to 5 min, and improved patient satisfaction 16. Similar benefits from lean improvement strategies in the outpatient environment have been demonstrated in the UK and the Netherlands 17 18. There are indeed other benefits, in addition to workflow improvement, from lean thinking service redesign, although these were beyond the scope of this pilot project.…”

Section: Discussionmentioning

confidence: 66%

Restructuring of the Diabetes Day Centre: a pilot lean project in a tertiary referral centre in the West of Ireland

et al. 2013

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This project reflects the successful application of VSM as a lean tool in a pilot study at our institution as evidenced by improved patient flow and a significant reduction in patient journey time through the clinic. Through the incorporation of Lean into the ethos of the hospital, we have the potential to deliver excellent care in a safe environment and in an efficient manner, while benefiting the patient, employees and tax-payer.

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“…É possível que haja efeitos indiretos nos resultados, pois o VSM é uma ferramenta operacional de aplicação restrita a um processo ou a um serviço específico. No entanto Chiarini (2014) bem como Faulkner e Bardurdeen (2014), relatam efeitos positivos do VSM no meio ambiente enquanto que Hydes et al (2012) e Souza et al (2013) relatam melhor atendimento ao cliente como resultados finais.…”

Section: Saídas E Resultadosunclassified

“…No entanto, existe um significativo número de pesquisas feito no setor de health care (17 casos), onde 5 (cinco) publicações estão relacionadas ao setor privado como Kaale et al (2005), Kocakulah e Upson (2005), Ng et al (2010), Schwarz et al (2011), Wong et al (2012, 10 (dez) publicações ao setor público como Lummus et al (2006), Grove et al (2010), L'Hommedieu e Kappeler (2010), Cima et al (2011), Carter et al (2012), Chiarini, (2012, Hydes et al (2012), Teichgraber e de Bucourt (2012), Chiarini (2013), Abdelhadi e Shakoor (2014) e 2 (duas) publicações, como Cookson et al (2011) e Xie e Peng (2012), o setor econômico não foi mencionado.…”

Section: Contextounclassified

Framework de Value Stream Mapping a partir de uma Revisão Sistemática da Literatura

Thomé

Oliveira

Silva

2017

P&P

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RESUMOO Value Stream Mapping (VSM) é uma das ferramentas de Lean Manufacturing que tem sido amplamente discutido na literatura para mapeamento de processos de produção e serviços com foco em redução de desperdícios. Apesar da crescente quantidade de publicações sobre o tema, a literatura acadêmica evidencia a ausência de uma pesquisa sistemática que apresente o estado da arte. Desta forma, este artigo, por meio de uma revisão sistemática da literatura, objetiva reunir informações sobre o VSM de forma a identificar suas principais características, tendências e oportunidades para novos desdobramentos e pesquisas futuras. A revisão inclui 263 resumos e 91 artigos selecionados para a revisão e classificação. A estudo propõe uma síntese, em forma de framework, que apresenta como VSM é adotado em determinados contextos e motivações, traçando um melhor entendimento de como a ferramenta é implementada e as respectivas saídas e resultados que podem ser gerados. Palavras-chave:Value stream mapping; revisão sistemática da literatura; redução de desperdícios. ABSTRACTThe Value Stream Mapping (VSM) is one of the Lean Manufacturing tools that has been widely discussed in the literature for mapping production processes and services with a focus on reduction of waste. Despite the growing number of publications on the subject, the academic literature reveals the absence of systematic research to present the state of the art. Thus, this dissertation, through a systematic review of the literature, aims to gather information on the VSM to identify its main characteristics, trends and opportunities for new developments and future research. The review includes 263 abstracts and 91 articles selected for review and classification. The study proposes a synthesis in the form of framework, presenting as VSM is adopted in certain contexts and motivations,

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Lean thinking transformation of the unsedated upper gastrointestinal endoscopy pathway improves efficiency and is associated with high levels of patient satisfaction

Cited by 37 publications

References 19 publications

Quality Improvement Intervention to Decrease Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery

Quality Improvement Intervention to Decrease Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery

Restructuring of the Diabetes Day Centre: a pilot lean project in a tertiary referral centre in the West of Ireland

Framework de Value Stream Mapping a partir de uma Revisão Sistemática da Literatura

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