Purpose – The aim of this paper is to provide a review of the existing literature on lean healthcare. It seeks to describe how this concept has being applied and to assess how trends and methods of approach in lean healthcare have evolved over the years.Design/methodology/approach – The paper surveys the applications of lean healthcare in the current literature and classifies over 90 works according to a taxonomy suggested.Findings – Though there seems to exist an agreement about the potential of lean healthcare, it remains a challenge for academics and practitioners to evaluate lean healthcare under a more critical perspective.Practical implications – This work is helpful not only for healthcare practitioners and for researchers in private and public organisations, but also for journal editors and reviewers because it offers ready access to an up to date comprehensive review.Originality/value – Since lean started being applied in healthcare, no effort to provide a complete resource surveying the existing...

Trends and approaches in lean healthcare

Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

https://ibisuva.nl/assets/publicaties/artikelen/2006-dekoning-lean.pdf

Lean Six Sigma in Healthcare

Lean in healthcare: A comprehensive review

The purpose of this paper is to perform the analysis of literature review of lean production (LP). The analysis involved studying 546 research articles published from 1988 to 2011 in selected 24 operations research journals. The articles are classified by: time distribution of articles, research methodology, research stream, authorship patterns, sector-wise focus, popular elements in lean literature, focus of the articles on lean waste, and implementation status and performance measurement of various existing frameworks/models. Then, the suggestions for the future scope of research possibilities and development are identified. The study provides a taxonomical and integrated review of articles, puts up perspective into the conceptualisation and various critical parameters for research. The findings include: increase in empirical approach research articles, need of applying lean principles in the field of product development and enterprise level areas, need of more interregional research collaborations, nee...

Lean production: literature review and trends

Background:
The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery.

Methods:
MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business™ Elite, the Health Management Information Consortium and PsycINFO® were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically.

Results:
Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial.

Conclusion:
QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare.

Six Sigma is a quality improvement approach aimed at optimising processes while reducing defects and costs. It has been developed and is widely used in industry and recently has been introduced, on a limited scale, in healthcare. In this article, we discuss the results of the implementation of Six Sigma at the Red Cross Hospital in Beverwijk, the Netherlands. From the initial start in 2002, up to now, 44 projects have been initiated and 21 projects are closed. Projects are initiated in various departments and disciplines. Co-workers on almost all levels within the organisation are being trained and have been provided with tools to perform projects that improve quality and reduce costs of healthcare delivery. The results show that the completed projects produced €1.2 million in annual savings. The expected total net annual savings of all running projects are €3 million.

/pdf/six-sigma-in-healthcare-lessons-learned-from-a-hospital-4tcprxb90m.pdf

Six Sigma in healthcare: lessons learned from a hospital

Inefficient utilization of operating rooms is a major problem in hospitals worldwide. A study of 13 hospitals in Belgium and the Netherlands showed that surgery began consistently late. Two hospitals were selected to record the start times for the first..

/pdf/reducing-start-time-delays-in-operating-rooms-zrxrsudarz.pdf

John P. S. Verver

Papers

Lean Six Sigma in Healthcare

Six Sigma in healthcare: lessons learned from a hospital

Reducing Start Time Delays in Operating Rooms