Técnicas «Lean» para la mejora del flujo de los pacientes críticos de una región sanitaria con epicentro en el servicio de medicina intensiva de un hospital de referencia

Sirvent, Josep Ma; Gil, M.; Álvarez, Tania Roig; Martín, S.; Vila, Noelia Araújo; Colomer, Mónica; March, Evarist; Loma-Osorio, Pablo; Metje, T.

doi:10.1016/j.medin.2015.08.005

Cited by 24 publications

(12 citation statements)

References 12 publications

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“…Sixteen studies informed a LOS decrease following LH interventions, with 105.85 days representing the longest reduction [85]. Conversely, only seven studies stated no variation after the interventions [20,29,[86][87][88][89][90]. For turnover time (TOT), six studies confirmed a decrease, whereas only two studies reported no change [26,27].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, the turnaround time (TAT) decreased in the five studies that addressed it. Boarding time was only evaluated in four LH interventions, with better results in all of them [3,19,29,91].…”

Section: Resultsmentioning

confidence: 99%

“…Other important outcomes reported included the percentage of day of surgery cancellations [8], reduction in surgery times [94], reduction of time to surgery [95], reduction of unnecessary instruments delivered to the OR [94,96], and savings in nursing time [97]. Additional measures of efficiency after LH intervention included an increase in capacity for extra patients [97], additional ED bed hours per day [91], an increase in capacity of open beds per day [19,98], a reduction in transfer due to lack of beds [29], improved OR utilization [8,26,27], and an increase in surgical admissions receiving appropriate perioperative antibiotics [86]. Finally, mortality was measured in six studies, four of which reported no change after LH intervention [17,18,28,29], while two studies reported a decreased [87,98].…”

Section: Resultsmentioning

confidence: 99%

“…Hence, additional indicators include turnover time (TOT) [8,21,22], turnaround time (TAT) [23][24][25], and on-time starts (OTS) [8,26,27]. A related outcome is the readmission or revisit rate [28,29]. Within inpatient care, hospital overcrowding has become a widespread problem, with constrained bed capacity and admission bottlenecks having negative impacts on quality and safety.…”

Section: Introductionmentioning

confidence: 99%

“…In the U.S., a survey found that about 70% of hospitals implement LH or similar approaches [46]. Since its introduction, LH has been implemented in virtually all hospital departments, including cardiology, surgery, and intensive care units (ICUs) [21,28,29,[47][48][49][50][51][52][53].…”

Section: Introductionmentioning

confidence: 99%

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Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Zepeda-Lugo

Tlapa

Báez-López

et al. 2020

IJERPH

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Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review is to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve. The review was performed according to PRISMA. We used six databases to search for studies published from 2002 to 2019. Out of 5732 studies, 39 measuring one or more defined outcomes were included. Hospital length of stay (LOS) was measured in 23 studies, 16 of which reported a reduction, turnover time (TOT) decreased in six out of eight studies, while the turnaround time (TAT) and on-time starts (OTS) improved in all five and seven studies, respectively. Moreover, eight out of nine studies reported an earlier discharge time, and the boarding time decreased in all four cases. Meanwhile, the readmission rate did not increase in all nine studies. Lastly, staff and patient satisfaction improved in all eight studies. Our findings show that by focusing on reducing non-value-added activities, LH contributed to improving patient flow and efficiency within inpatient care.

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