Lean healthcare applied systematically in a medium-sized medical clinic hospitalization

J Health Organ Manag. 2022 Apr 21;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-05-2021-0194.

Abstract

Purpose: The objective of this paper is to propose a systematic application of Lean Healthcare in the hospitalization activity in the medical clinic entry process.

Design/methodology/approach: The methodology used is established in three stages: the first aims to map the process in which the focus activity is inserted, using lean tools, as well as integrating the employees involved in the application. The second is the proposal to apply the systematic, together with the employees, using the A3 tool step by step. Finally, the third stage confirms the applied systematic, collecting the results and analyzing the initial situation with those reached.

Findings: As a result, improvements were made in the medical clinic entry process, such as reduced waiting time for patients, at approximately 53.8%, with a decrease in the standard deviation of the times - of approximately 79.14%, and displacement of those involved, of 72%, in addition to eliminating unnecessary activities for the process. Furthermore, the empirical results on the efficiency of this systemic application in medical clinic enable the replication of this proposal, generating a systematic.

Research limitations/implications: Despite establishing a systematic proposal with real results, it is focused on only one application, due to time limitations, may generate a subjective evaluation of the systematic. Thus, for future research, it is recommended to expand this systemic application in other activities of different processes.

Practical implications: The practical implications of this paper are precisely related to the data obtained with the application made, developing a Lean Healthcare systematic not previously seen, which is strategic, systemic and has a roadmap to assist in its application and, in addition, brings with it practical results that prove their efficiency.

Social implications: The social implications of this paper are presented in its empirical results, considering that the study hospital serves, in addition to its host city, 28 other smaller municipalities around it, improving the flow of processes, ensuring better management of the clinic doctor. In addition, the results can assist the processes flow of other medical clinics in hospitals around the world, especially at critical moments, such as pandemics or epidemics.

Originality/value: Due to the positive results obtained in the systematic application, this paper fills a gap identified in the literature, proposing a systematic application of Lean Healthcare that is systemic and strategic, in addition to including a roadmap and analysis of data applied in a medium-sized Brazilian hospital, presenting positive practical results exposed in the paper.

Keywords: Hospitalization; Lean healthcare; Medical clinic; Systemic application.

MeSH terms

  • Ambulatory Care Facilities*
  • Delivery of Health Care
  • Efficiency, Organizational*
  • Hospitalization
  • Hospitals
  • Humans
  • Total Quality Management / methods