Estudio sobre la aplicación de Lean Healthcare en el sector hospitalario en Medellín

A pesar de que parece a veces simple, no es fácil explicar la esencia del término Lean -- Lean ayuda a las organizaciones a optimizar sus costos a través de la eliminación de los desperdicios lo que conlleva a un aumento de productividad que se debe traducir en una mejora en la rentabilidad de la empresa -- Esta mejora en la productividad es un elemento clave al momento de elegir Lean como herramienta de trabajo, debido a que está demostrado que no es una moda pasajera y que verdaderamente su aplicación puede rendir frutos en la manufactura y los servicios -- El presente trabajo pretende partir del termino Lean desde sus generalidades, examinando once herramientas que apoyan su implementación tanto en ambientes de manufactura como de servicios, para llegar a lo que se conoce hoy como Lean Healthcare, examinando la aplicación de esas mismas herramientas en ambientes hospitalarios -- Se realizó una revisión de la literatura que abarca tanto Lean como Lean Healthcare, haciendo énfasis en once herramientas (Hoshin Kanry, fábrica visual, 5´s, VSM, Poka Yoke, Heijunka, Kanban, Andon, Jidoka, Kaizen, Smed) que permiten identificar la aplicación de estas tanto en ambientes industriales como hospitalarios -- El resultado describe que herramientas son las más usadas en el sector hospitalario, en qué áreas se han aplicado los conceptos de Lean Healthcare, que impactos ha tenido la aplicación de estas herramientas y que implicaciones ha tenido para las instituciones la aplicación Lean Healthcare -- Toda esta revisión se enfocó luego en las instituciones de salud de la ciudad de Medellín a las cuales se les aplicó una encuesta para medir el grado de familiaridad que tienen en relación con las técnicas lean mencionadas

A karcsú (lean) elvek alkalmazásának tapasztalatai az egészségügyi folyamatok fejlesztésében (Experiences of the adaptation of lean management in the development of healthcare processes)

Az elmúlt néhány évben a külföldi sajtóban és szakmai publikációkban egyre többször jelenik meg a „lean egészségügy”, azaz a karcsú menedzsment alkalmazása az egészségügyben mint téma. Habár az ez irányú kutatások még nemzetközi szinten is csak legfeljebb a hajnalukon tartanak, Magyarországon még szinte teljes a sötétség. Ennek a cikknek az a célja, hogy egyrészről felhívja a kutatók, de még inkább a egészségügyi dolgozók, menedzserek figyelmét erre a menedzsmenteszközre és filozófiára, mely új lehetőségeket kínál, másrészről, hogy áttekintést adjon a területen végzett nemzetközi kutatások eredményeiről. A tanulmány ennek megfelelően alapvetően két részre bontható. Az első felében az egészségügyi szolgáltatások helyzetének rövid jellemzése után a karcsú menedzsment alapjait és az egészségügyi szolgáltatásokban való alkalmazásának eszményét mutatja be. A második fele ugyanakkor 16 esettanulmány elemzésén keresztül bemutatja, hogy meddig jutott a világ a „lean egészségügy” ideájának megvalósításában. _______ In the past few years “Lean Healthcare” – the adaptation of lean management into healthcare settings – turns up as a topic often and often in foreign press and the in the professional publications. Although researches at international level in this field are at best at their dawning, in Hungary the darkness is almost complete. This article aims at one side to draw researchers’ and even more healthcare employees’ and managers’ attention to this management tool and philosophy, which offers new possibilities. From the other side to provide an overview of the results of the researches conducted in this field. Reflecting this doubled aim the study is divided into two major sections. In the first part the situation of the health care providers is shortly described followed by the introduction of the basics of the lean management and the idea of applying it into healthcare services. While the second part of the study shows how far the World reached in realizing the idea of “Lean Healthcare” by analyzing 16 cases.

Implementação da filosofia Lean na gestão dos serviços de saúde: o caso português

Dissertação apresentada ao Instituto Politécnico do Porto para obtenção do Grau de Mestre em Gestão das Organizações, Ramo de Gestão de Empresas. Orientada por Prof. Dra. Maria Rosário Moreira e Prof. Dr. Paulo Sousa

Aplicação de princípios e ferramentas lean numa unidade de cirurgia de ambulatório de um hospital

Dissertação de mestrado integrado em Engenharia Industrial

Aplicação do paradigma Lean em processos clínicos do Centro Hospitalar do Alto Ave

Dissertação de mestrado em Engenharia Industrial

Gestão de fluxos de produção numa unidade cirúrgica de ambulatório

Dissertação de mestrado em Engenharia Industrial

Treating the entire person

[Excerpt] A critical case from a Portuguese hospital reveals how the ultimate healthcare customer, the patient, is a complete system, not a jumble of parts. (...) The lean production philosophy has made inroads into service sectors, including medical care in the United Kingdom and the United States. Unfortunately, numerous medical organizations in those two countries and the rest of the world treat patients like they are made up of parts, not as a whole system. This leads to disjointed handoffs, bottlenecks in information flow that delay treatment, and sending the patient back and forth from department to department. The following case in Portugal shows how most of the world’s health systems still suffer from functional silos and how waste is all over the place. In this case, the missing links in communication between doctors, nurses, auxiliary staff, the patient and her family led to the patient’s death. Adopting lean healthcare with its proven tools would be a solution to many of the problems described. When a patient dies in a hospital, the family often is told that the doctors did everything they could. Normally, that is the case, as healthcare providers – doctors, nurses, auxiliary staff, therapists – do their best with the system they have.

Análise do Mapa da Cadeia de Valor em um Hospital do Vale do Paraíba

The Lean Thinking is a method used by various industries in order to eliminate waste and ensure quality for the customer. In the current scenario, Lean has been used in other areas such as the hospital in which many tools are being adopted in order to improve its internal processes. One such tool is the Value Stream Mapping, which proved to be an effective tool in industrial environments, and is being adopted by several hospitals. Thus, this paper presents a case study on the use of this tool in a sector of a hospital in the Vale do Paraíba, evaluating its importance, its impacts, positive and negative points and future projections. This is in the context of Lean Healthcare, a new model based on the principles of Lean Thinking which has been adopted by several hospitals and clinics throughout Brazil successfully

A lean elvek alkalmazása az egészségügyi folyamatok fejlesztésében = Applying lean principles in healthcare process development

A fejlett társadalmak egészségügyi szolgáltató rendszerei napjainkban kettős kihívással néznek szembe: miközben a társadalom a szolgáltatási színvonal emelkedését, a hibák számának a csökkenését várja el, addig a költségvetési terhek miatt a költségcsökkentés is feltétlenül szükséges. Ez a kihívás nagyságában összevethető azzal, amellyel az USA autóipara nézett szembe az 1970-es évektől. A megoldást az autóipar esetében a konkurens „lean” menedzsment elvek és eszközök megértése és alkalmazása jelentette. A tanulmány arra keresi a választ, hogy vajon lehetséges-e ennek a megoldásnak az alkalmazása az egészségügy esetében is. A cikk az egészségügy problémájának bemutatása után tárgyalja a lean menedzsment kialakulását és hogy milyen módon került köztudatba. A tanulmány második felében a szakirodalomban fellelhető, a témával kapcsolatos tapasztalatokat foglalja össze, majd levonja a következtetéseket. = In developed societies healthcare service systems are facing double challenge; society expects service level to rise and the number of mistakes to drop, but at the same time, because of the overloaded budgets, cutting cost is also absolutely necessary. This challenge compares to the one the US automotive industry was facing in the 1970-s. In case of the automotive industry the solution was the comprehension and application of the principles and the tools of lean management. This study aims to answer the question whether it is possible to apply this solution also in the case of the healthcare system. The article first introduces the problems in the healthcare system, than describes the formation of lean management concept and its wide spread. The second half of the study summarizes the available knowledge in the literature and drives conclusions.

A lean kultúra értelmezése és mérése egy egészségügyi szolgáltatónál (The interpretation and measurement of the lean culture – in case of a healthcare service provider)

A lean menedzsment egészségügyi szolgáltatásokra való alkalmazásával elérhető eredmények egyre inkább nyilvánvalóvá válnak. Ennek köszönhetően a szektorban dinamikus növekedés tapasztalható ezen a téren. A kutatások azonban arra hívják fel a figyelmet, hogy a lean menedzsment alkalmazásával elért eredmények csak akkor lesznek fenntarthatóak, ha az eszközök alkalmazását a kultúra átalakulása is követi. A kultúra változásának követéséhez annak folyamatos értékelésére van szükség. A szervezeti kultúra lean-specifikus méréséhez azonban – a szerzők tudomása szerint – még nincs kidolgozott eszköz. Ezért cikkükben a kapcsolódó szakirodalom áttekintése után kidolgoztak egy lean kultúra kérdőívet, majd bemutatják a kérdőív tesztelését és annak eredményeit. Összegzésként elmondható, hogy az itt bemutatott kérdőív az első tesztelés alapján további fejlesztésre szorul. / === / The results that can be obtained by applying lean management in healthcare services become more and more clear. This generates a dynamic increase of lean applications in healthcare. However, researches are warning that the res ults obtained by lean applications can only be sustained, if next to the use of the lean tools cultural change will also take place. In order to track changes in culture its constant evaluation is necessary. According to the authors’ knowledge today does not exist any lean-specific culture evaluation tool. In this paper they elaborate a lean culture questionnaire based on the review of relevant literature. Than they describe its test and the results of the test. The authors conclude that the questionnaire as introduced here needs further improvement.

Lean Methods and Digital Technologies in Healtchare

The experiences of several healthcare organizations were considered to distinguish the most frequently used lean tools, the success and failure factors, and the obstacles that may appear while implementing lean. As a result, two approaches to “go lean” were defined, and analyzed from the prospective of the applicability to healthcare processes. Industrialization of healthcare was studied, and the most promising digital technology tools to improve healthcare process were highlighted. Finally, the analysis of healthcare challenges and feasible ways to address them was conducted and presented as the main result of this work. The possible ways of implementation of the findings and limitations were described in the conclusion.

Förändringsprogram i hälso- och sjukvården : Nätverkskonstruktioner som möjliggör och försvårar införandet av lean

Within the public sector great change efforts are currently made to meet future challenges. In the area of health care, change initiatives are implemented to enhance quality and efficiency. To this end, a lean change programme is being widely introduced in Sweden as well as internationally. The overriding aim of this study is to increase knowledge of what happens when change programmes, CP, such as lean are implemented in a healthcare organisation, HCO. Previous research has shown that the main obstacle to implementing CP in HCO:s is their complexity. However, the complexity has often been reduced, as different factors such as management, professions, organisation and control have been studied separately. To fully capture the complexity of the HCO the Actor Network Theory, ANT, was used in this study. In line with ANT, introducing lean can be described in terms of a translation process in which human and non-human actors are woven into a network. This approach allows for the incorporation of various factors in the study of a change process in a complex organisation. Drawing on ANT, this thesis explores how network constructions enable or impede change programmes. The approach is based on ethnographic monitoring of the implementation of lean in the Värmland county council public healthcare organisation. As a result of the holistic perspective, the study provides detailed descriptions of how complexity impacts on the implementation. It displays the relations enabling or impeding the implementation of CP and the methods actors use to establish and defend the relations. The contribution of the study is threefold. Empirically, the study monitors a HCO aiming to implement full-scale lean as philosophy, principle and tool. Methodologically, the study evaluates ANT as a methodological theory to study CP in a HCO. Finally, the domain-specific contribution of the study is its identification of the relations and methods that impact on lean deployment.