Mejora de la eficiencia de un servicio de rehabilitación mediante metodología Lean Healthcare

Davila, Shannon; González, J. Tinoco

doi:10.1016/j.cali.2015.03.002

Cited by 12 publications

(10 citation statements)

References 11 publications

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“…131 In terms of target or standard compliance while implementing LH, only a few of the reviewed studies indicated a local or national standard 1,22,85,97 ; instead, the stated goal was usually to improve performance. 95 Additional operational indicators associated with LH include increased service capacity, 132,133 increased productivity, 134,135 lower costs per case/service, 23,136 reduced inventory/space, 93,135 minimized transit/transportation time, 27,137 boarding time, 1 lead time in radiology, 138 and time increase for nurses to care patients, 139 among others. These efforts seem to be a war on waste, which would be justified by the need to reduce costs that are not essential for patient care.…”

Section: Discussionmentioning

confidence: 99%

Effects of Lean Healthcare on Patient Flow: A Systematic Review

et al. 2020

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Objectives: To assess the effects of lean healthcare (LH) on patient flow in ambulatory care and determine whether waiting time and length of stay (LOS) decrease after LH interventions. Methods: A systematic review was performed with close adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched for studies of healthcare organizations applying LH interventions within ambulatory care published between 2002 and 2018. Six databases and grey literature sources were used. Two reviewers independently screened and assessed each study. When consensus was difficult to reach, a third reviewer intervened. Finally, a summary of findings was generated. Results: Out of 5627 studies, 40 were included. Regarding LOS for all patients, 19 out of 22 studies reported a decrease. LOS for discharged patients decreased in 11 out of 13 studies, whereas LOS for admitted patients was reduced in 6 out of 7 studies. Waiting time for patients before seeing a healthcare professional decreased in 24 out of 26 studies. Waiting time to treatment and waiting time for appointments were minimized in 4 and 2 studies, respectively. Patients who left without being seen by a doctor decreased in 9 out of 12 studies. Finally, patient and staff satisfaction were measured in 8 and 2 studies, respectively, with each reporting improvements. Conclusions: According to our findings, LH helped to reduce waiting time and LOS in ambulatory care, mainly owing to its focus on identifying and minimizing non-value added (NVA) activities. Nevertheless, evidence of the impact of LH on patient/ staff satisfaction and the translation of the obtained benefits into savings is scarce among studies.

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Section: Discussionmentioning

confidence: 99%

Effects of Lean Healthcare on Patient Flow: A Systematic Review

et al. 2020

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“…From the institutional perspective, the studies brought results related to the work environment (32) ; waste reduction (22,26,29) ; cost analysis (22,26,28,33) ; increase in productivity (11,22,24,26) ; financial return (22,24) ; response time (24,26) , permanence (28,30) and waiting time of the patient (30) ; improvement in the performance of institutional indicators (23,36) ; increase in the installed capacity of the services (24) ; improvement in quality of care (26,32) ; optimization of the physical structure (11) ; turnover time (11) , and impacts on transformational leadership (27) .…”

Section: Discussionmentioning

confidence: 99%

“…The pilot intervention of the 5S management method generated changes in the quality of the services and in the attitude and behavior of the employees and patients in a health facility with few resources. VI Dávila (33) 2015 Spain…”

Section: Institutional Professionalmentioning

confidence: 99%

“…Regarding the professional perspective, the studies presented findings related to job satisfaction (23,26) and regarding the care provided (20) ; medical adherence (21) to Lean; workforce flexibility (27) ; leadership of the team (27,36) ; attitudes (31)(32) ; behavior (31) ; commitment (32) ; time devoted to assistance (33) , and the change of roles and responsibilities with the implementation of Lean (34) .…”

Section: Institutionalmentioning

confidence: 99%

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Lean Healthcare in the institutional, professional, and patient perspective: an integrative review

Fernandes

Jesus

Silva

et al. 2020

Rev. Gaúcha Enferm.

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Objective: To analyze the scientific evidences in the literature about the evaluation of Lean Healthcare after its implementation. Method: An integrative review conducted in the CINAHL, Scopus, WOS, and Embase databases, and in the PubMed portal, resulting in 18 articles published in English, Spanish and Portuguese, from 2008 to 2019. Results: The findings were categorized into results for the institution, professional, and patient. The predominant category was institutional, with cost analysis and increased productivity, followed by the professional, with job satisfaction and leadership, and finally the patient, with satisfaction, attitudes, and behaviors. Conclusion: This study reinforces the need to establish, for management, a systematic method of monitoring the results achieved in the Lean Healthcare implementation phase. Since the value in this method is defined by the patient, further research in this aspect may lead to new evidence.

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“…In the economical component, while reducing waste, LH helps to reduce costs. Worldwide, there have been many LH implementations with an impact on operational indicators, these include the increase in service capacity [ [36]; [23]]; productivity increase [ [37]; [38]]; reduction in cost per case/service [ [30]; [39]]; reduction of inventory/space [ [38]; [14]; [40]]; reduction in transit/transportation time [ [41]; [14]]; and reduction in process cycle time among others [ [29]; [17]; [42]; [13]].…”

Section: Lean Healthcare and The Economic Environmental And Social Pmentioning

confidence: 99%

Efficiency through a Lean Healthcare Implementation in a Public Hospital

Rosas-Hernandez¹,

Tlapa²,

Báez-López³

et al. 2019

Preprint

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Hospitals face challenges to improve efficiency in order to meet an increasing demand for high quality of care and low costs. Industry-based methods such as lean healthcare (LH) are implemented to improve healthcare systems. This study presents a LH implementation following the DMAIC approach (Define-Measure-Analysis-Improve-Control) in a Mexican public hospital, and contributes to the literature by analyzing the relation of waste reduction and sustainability. We focused on improving the medical supply chain from a temporary warehouse (TW) to the operating room (OR). Therefore, we analyzed the value stream including main surgical procedures and their related medical supplies, and identified different causes of inefficiency, which were evaluated and controlled. As a result, five types of waste were reduced through different tools including: value stream map, Kanban, 5’s, among others. Over-processing requests were reduced 15.3%; similarly, defective identification numbers were reduced up to 46.5%, redundant processing was improved by 94.8%, unnecessary inventories were reduced near to 2.8% of the TW inventory, and transportation waste was reduced up to 16.7%. As a consequence, the lead-time for the main supplies was reduced 33 days. Results indicate that LH and DMAIC are effective to reduce waste and highly conducive to improve healthcare process sustainability.

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Mejora de la eficiencia de un servicio de rehabilitación mediante metodología Lean Healthcare

Cited by 12 publications

References 11 publications

Effects of Lean Healthcare on Patient Flow: A Systematic Review

Effects of Lean Healthcare on Patient Flow: A Systematic Review

Lean Healthcare in the institutional, professional, and patient perspective: an integrative review

Efficiency through a Lean Healthcare Implementation in a Public Hospital

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