The Lean Healthcare approach in health services: A Systematic Review of the Literature
DOI:
https://doi.org/10.31686/ijier.vol8.iss7.2403Keywords:
Lean Healthcare, Hospital applications, Systematic reviewAbstract
Lean principles are being successfully applied in the most diverse sectors beyond industry. In the health area, the so-called Lean Healthcare is gaining space with the implementation of lean methods that contribute to the maximization of value and quality to the patient. The objective of this work was to carry out a systematic review of the literature to identify and analyze the practice of Lean Healthcare and its tools in hospital environments. Scientific articles available in the database of the CAPES Periodic Portal were selected, and 161 articles were found, among which, 16 were selected. The results point to recent research, with practical applications where case studies are predominant. Lean tools have been applied in several countries to promote improvements in hospital environments, and the main ones are MFV, 5S, Standardization, Kaizen and Kanban. With this study, it was possible to observe that the use of lean techniques in health has been promoting significant benefits in the work environments, in the team's conduct, and the patients' experience, and that the human factor is what most hinders the implementation of these techniques.
Downloads
References
Al Hroub, A., Obaid, A., Yaseen, R., El-Aqoul, A., Zghool, N., Abu-Khudair, H., Al Kakani, D., & Alloubani, A. (2019). Improving the Workflow Efficiency of an Outpatient Pain Clinic at a Specialized Oncology Center by Implementing Lean Principles. Asia-Pacific Journal of Oncology Nursing, 6(4), 381.
Bhamu, J., & Sangwan, K. S. (2014). Lean manufacturing: literature review and research issues. International Journal of Operations & Production Management.
Bhat, S., Antony, J., Gijo, E. V., & Cudney, E. A. (2019). Lean Six Sigma for the healthcare sector: a multiple case study analysis from the Indian context. International Journal of Quality & Reliability Management.
Blouin-Delisle, C. H., Drolet, R., Gagnon, S., Turcotte, S., Boutet, S., Coulombe, M., & Daneau, E. (2018). Improving flow in the OR. International Journal of Health Care Quality Assurance.
Costa, L. B. M., Filho, M. G., Rentes, A. F., Bertani, T. M., & Mardegan, R. (2017). Lean healthcare in developing countries: evidence from Brazilian hospitals. The International Journal of Health Planning and Management, 32(1), e99-e120.
Costa, L. B. M., & Godinho Filho, M. (2016). Lean healthcare: review, classification and analysis of literature. Production Planning & Control, 27(10), 823-836.
Cronin, P., Ryan, F., & Coughlan, M. (2008). Undertaking a literature review: a step-by-step approach. British Journal of Nursing, 17(1), 38-43.
D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: a comprehensive review. Health Policy, 119(9), 1197-1209.
Dias, A. C., Reis, A. C., Oliveira, R. P., Maruyama, Ú., & Martinez, P. (2018). Lean manufacturing in healthcare: a systematic review of literature. Revista Produção e Desenvolvimento, 4(2), 111-122.
Doğan, N. Ö., & Unutulmaz, O. (2016). Lean production in healthcare: a simulation-based value stream mapping in the physical therapy and rehabilitation department of a public hospital. Total Quality Management & Business Excellence, 27(1-2), 64-80.
Ferreira, W. de P., da Silva, A. M., Tanaka, W. Y., & de Felice Zampini, E. (2016). Lean & Healthcare organizations-a systematic literature review with bibliometric analysis on application of Lean Healthcare in Brazil. Brazilian Journal of Operations & Production Management, 13(4), 422-428.
Gupta, S., Kapil, S., & Sharma, M. (2018). Improvement of laboratory turnaround time using lean methodology. International Journal of Health Care Quality Assurance.
Hallam, C. R., & Contreras, C. (2018). Lean healthcare: scale, scope and sustainability. International Journal of Health Care Quality Assurance.
Hitti, E. A., El-Eid, G. R., Tamim, H., Saleh, R., Saliba, M., & Naffaa, L. (2017). Improving emergency department radiology transportation time: a successful implementation of lean methodology. BMC Health Services Research, 17(1), 625.
Hussain, A., Stewart, L. M., Rivers, P. A., & Munchus, G. (2015). Managerial process improvement: a lean approach to eliminating medication delivery. International Journal of Health Care Quality Assurance.
Improta, G., Romano, M., Di Cicco, M. V., Ferraro, A., Borrelli, A., Verdoliva, C., Triassi, M., & Cesarelli, M. (2018). Lean thinking to improve emergency department throughput at AORN Cardarelli hospital. BMC Health Services Research, 18(1), 914.
Johannessen, K. A., & Alexandersen, N. (2018). Improving accessibility for outpatients in specialist clinics: reducing long waiting times and waiting lists with a simple analytic approach. BMC Health Services Research, 18(1), 827.
Kamiya, Y., Ishijma, H., Hagiwara, A., Takahashi, S., Ngonyani, H. A., & Samky, E. (2017). Evaluating the impact of continuous quality improvement methods at hospitals in Tanzania: a cluster-randomized trial. International Journal for Quality in Health Care, 29(1), 32-39.
Kanamori, S., Sow, S., Castro, M. C., Matsuno, R., Tsuru, A., & Jimba, M. (2015). Implementation of 5S management method for lean healthcare at a health center in Senegal: a qualitative study of staff perception. Global Health Action, 8(1), 27256.
Lacerda, A. P., Xambre, A. R., & Alvelos, H. M. (2016). Applying Value Stream Mapping to eliminate waste: a case study of an original equipment manufacturer for the automotive industry. International Journal of Production Research, 54(6), 1708-1720.
Levy, Y., & Ellis, T. J. (2006). A systems approach to conduct an effective literature review in support of information systems research. Informing Science, 9.
McDermott, C. M., & Venditti, F. J. (2015). Implementing lean in knowledge work: Implications from a study of the hospital discharge planning process. Operations Management Research, 8(3-4), 118-130.
Miller, R., & Chalapati, N. (2015). Utilizing lean tools to improve value and reduce outpatient wait times in an Indian hospital. Leadership in Health Services.
Mĺkva, M., Prajová, V., Yakimovich, B., Korshunov, A., & Tyurin, I. (2016). Standardization–one of the tools of continuous improvement. Procedia Engineering, 149, 329-332.
New, S., Hadi, M., Pickering, S., Robertson, E., Morgan, L., Griffin, D., Collins, G., Rivero-Arias, O., Catchpole, K., & McCulloch, P. (2016). Lean Participative Process Improvement: Outcomes and Obstacles in Trauma Orthopaedics. PloS One, 11(4).
Oliveira, R. I. de, Sousa, S. O., & de Campos, F. C. (2019). Lean manufacturing implementation: bibliometric analysis 2007–2018. The International Journal of Advanced Manufacturing Technology, 101(1-4), 979-988.
Ramaswamy, R., Rothschild, C., Alabi, F., Wachira, E., Muigai, F., & Pearson, N. (2017). Using Value Stream Mapping to improve quality of care in low-resource facility settings. International Journal for Quality in Health Care, 1-5.
Rauch, E., Damian, A., Holzner, P., & Matt, D. T. (2016). Lean Hospitality-Application of Lean Management methods in the hotel sector. Procedia CIRP; 41:614-619.
Regis, T. K. O., Gohr, C. F., & Santos, L. C. (2018). Lean Healthcare Implementation: experiences and lessons learned from Brazilian hospitals. Revista de Administração de Empresas, 58(1), 30-43.
Spagnol, G. S., Min, L. L., & Newbold, D. (2013, September). Lean principles in Healthcare: an overview of challenges and improvements. In IFAC Proc (Vol. 2013, p. 46).
Suarez-Barraza, M. F., Miguel-Davila, J. A., & Fabiola Vasquez-Garcia, C. (2016). Supply chain value stream mapping: a new tool of operation management. International Journal of Quality & Reliability Management, 33(4), 518-534.
Tranfield, D., Denyer, D., & Smart, P. (2003). Towards a methodology for developing evidence‐informed management knowledge by means of systematic review. British journal of management, 14(3), 207-222.
Vashi, A. A., Sheikhi, F. H., Nashton, L. A., Ellman, J., Rajagopal, P., & Asch, S. M. (2019). Applying lean principles to reduce wait times in a VA emergency department. Military medicine, 184(1-2), e169-e178.
Veres, C., Marian, L., Moica, S., & Al-Akel, K. (2018). Case study concerning 5S method impact in an automotive company. Procedia Manufacturing, 22, 900-905.
Verma, J. Y., & Amar, C. (2015). Can a Healthcare" Lean Sweep" Deliver on What Matters to Patients?: Comment on" Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping". International journal of health policy and management, 4(11), 783.
Yin, R. K. (2015). Estudo de Caso-: Planejamento e métodos. Bookman editora.
Young, F. Y. (2014). The use of 5S in healthcare services: A literature review. International Journal of Business and Social Science, 5(10).
Zakaria, N. H., Mohamed, N. M. Z. N., Ab Rahid, M. F. F., & Rose, A. N. M. (2017). Lean manufacturing implementation in reducing waste for electronic assembly line. In MATEC Web of Conferences (Vol. 90, p. 01048). EDP Sciences.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Rosely Costa da Silva Bandeira, Armando Araújo de Souza Junior, Sandy Rebelo Bandeira, Marcelo Albuquerque de Oliveira

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Copyrights for articles published in IJIER journals are retained by the authors, with first publication rights granted to the journal. The journal/publisher is not responsible for subsequent uses of the work. It is the author's responsibility to bring an infringement action if so desired by the author for more visit Copyright & License.