Lean management approach in hospitals: a systematic review

Abstract

Purpose In the recent few years, the Lean management has made significant improvements in providing quality service to patients in many health-care centers. Thus, this study aims to systematically review features and results of conducted studies using a lean management approach in hospitals. Design/methodology/approach In this systematic review, eight databases, including PubMed, Web of Knowledge, Google Scholar, Scopus, Iranmedex, SID, Magiran and Medlib, were searched using keywords including “Lean principles,” “Lean Six Sigma,” “Lean Process SID,” “Lean thinking,” “Lean Methodology,” “Toyota Production System lean processing,” “lean techniques” and “hospital,” as well as their Persian equivalents. Required data were extracted using an extraction table and were analyzed using content analysis method. Findings Out of 967 identified articles, 48 articles were included in the study. Most of the studies have been conducted in developed countries such as America, Britain, The Netherlands and Canada. The highest number of studies has been conducted in the overall hospital and emergency departments. Lean Six Sigma and Lean methodology were the most frequent terms used for lean management. The five-phase Six Sigma methodology was one of the most important methods used for the implementation of the Lean management. Performing the process at the first time (timing) and length of stay had the highest frequencies among indicators assessed in the studies. All indicators assessed in the studies have improved after the implementation of Lean management. Among 150 assessed indicators, 69 were meaningfully improved (p < 0.05) and 12 indicators did not have a meaningful improvement (p > 0.05) and 69 indicators did not show any meaningful changes. Practical implications A number of implications are drawn out to aid academics, practitioners and policymakers in improving knowledge and skills. The elimination of production wastes is the most important principle of Lean thinking and paying attention to the clients and increasing the value. This will significantly improve quality of services to the patients and reduce costs and losses through preventing wastes. Suitable metrics in Lean management need to be established. A move to placing greater emphasis on understanding the contexts in which theory is implemented is another application. Research/limitation The limitation of this study is selection of studies in English and Persian language, excluding gray literatures and unpublished studies and relying on a relatively limited number of databases for the identification of potentially eligible studies. In addition, because of the enormous heterogeneity in the methods and results of the studies, performing a meta-analysis in this study was not possible. Originality/value The results of this study show that there were many dispersions and heterogeneities in the way of implementation and content of Lean management in hospitals.

Lean management in health care: a review of reviews of socio-technical components for effective impact

“…Other indicators related to patient are health/clinical outcomes (considered in 12 reviews), such as: a reduction in mortality rate (D'Andreamatteo et al , 2015; Ferreira et al , 2018; Hallam and Contreras, 2018; Mazzocato et al , 2010; Mousavi Isfahani et al , 2019; Abdallah and Alkhaldi, 2019); the effectiveness of care (three reviews) (Abdallah and Alkhaldi, 2019; Crema and Verbano, 2013, 2017); increased capacity (increasing the provision of services or the number of patients who can be adequately serviced without sacrificing other measures, such as patient safety, quality of care, and so forth) (three reviews) (Costa and Godinho Filho, 2016; Crema and Verbano, 2015; Parkhi, 2019); the appropriateness of treatment (two reviews) (Abdallah and Alkhaldi, 2019; Crema and Verbano, 2017); improved accessibility (two reviews) (D'Andreamatteo et al , 2015; Poksinska, 2010); and infection reduction (Deblois and Lepanto, 2016).…”

Increasing Competitiveness through the Implementation of Lean Management in Healthcare

“…At the same time, this approach, based on the direct immersion experience of the researcher, is particularly interesting when studying organisational transformation processes such as those associated with the implementation and deployment of lean management. According to some authors [10,[24][25][26][27], there are scarce references to adoption of the action research approach in the search for improvements in health services. This is because the literature mainly centres analysis on case studies (e.g., [4,12,13]).…”

“…This is because the literature mainly centres analysis on case studies (e.g., [4,12,13]). Other papers reflect on, synthesize and review the case studies, looking at them in terms of tools, adopted practices or activities, indicators, affected areas or departments as well as the results obtained (e.g., [9][10][11]). In this context, the approach taken by this paper is not so much to describe why lean management is of interest in the health sector but rather to propose how to implement it successfully, using a scientific methodology that can be replicated and applied in other contexts.…”

“…Accordingly, more and more hospitals have redesigned their internal management with respect to processes, resources and objectives, gearing themselves towards more effective and efficient management, and indeed enhancing the quality of service. Academic literature shows cases where hospitals have achieved this thanks to the adoption of management approaches coming from industrial sectors which with minor nuances or differences among them seek improved efficiency and efficacy of processes and productive systems [3][4][5][6][7][8][9][10][11][12][13]; these approaches include continuous improvement, kaizen, total quality management (TQM), just in time (JIT), six sigma and, particularly, lean management. One key to success in the adoption of these approaches is for affected staff to participate directly [14][15][16][17].…”

Quality Management In Precast Concrete Industry: Problems And Perspectives

“…The results of implementing experience approaches were reflected in the works of (Alexander, Anthony, & Rodgers, 2017;Alkunsol, Sharabati, AlSalhi, & El-Tamimi, 2016, Deamonita, Pujiyanto, & Rosyidi, 2017Nemati, Dave, Sias, & Perkins, 2019;Kȩsek, Bogacz, & Mirza, 2019;Mousavi Isfahani, Tourani, & Seyedin, 2017;Yadav, Mathiyazhagan, & Kumar, 2017;Salam, 2008;Sigrid Nordby, 2017;Messinger, Rogers, & Hawker, 2019) analysis of which highlights one common essential point: the success of the implementation of any approaches depends on strict compliance with the conditions, the assessment of the existence and implementation of which is not subject to formalization, it is subjective, meanwhile underperformance or non-performance of these conditions are inherently flawed as a quality management system project: 1) it should be initiated by top -management of a company;…”