Abstract
The healthcare industry faces challenges in delivering high-quality care with limited resources. Inefficiencies like long waiting times and excessive staff workload contribute to patient dissatisfaction. Lean methodology, specifically Lean Healthcare, offers improvement opportunities. However, barriers to implementation exist, including resistance from healthcare practitioners. This chapter proposes solutions for implementing Lean principles in healthcare. It suggests adapting vocabulary and symbols for a patient-centered approach, grouping patients into “patient pathways” for process efficiency, addressing employee feedback, collecting process data for evidence-based decision-making, and maximizing human resources. Clear communication, employee motivation, and ongoing improvement efforts are crucial. Implementing Lean effectively improves efficiency, patient satisfaction, and healthcare quality.
TopIntroduction
The goal of the healthcare field is, for all intents and purposes, to maximize the value of services provided to clients and patients (Singh et al., 2022; Costa et al., 2022). When thinking about hospitals, clinics, and other healthcare facilities, it's important to remember that the outcomes and items given are health and treatments for patients, who are the focus of the healthcare industry (Maione et al., 2020).
One of the ways to achieve this while meeting organizational goals is through the Lean methodology adoption (Davis, 2010; Bonamigo et al., 2022), which can be applied in healthcare facilities through the Lean Healthcare use. Providing reliable, safe, and quality care while constantly seeking efficiencies is one of the challenges in healthcare that require careful consideration of Lean Healthcare principles (Hallam & Contreras, 2018). Combined with the Lean approach to cost and waste reduction, Lean Healthcare offers great opportunities to become a significant area of research for healthcare organizations and researchers alike.
In healthcare, there are many inefficient systems that cause more harm than good for patients (Singh et al., 2022). These inefficiencies are often deeply ingrained in the daily operations of healthcare businesses and are the main source of patient dissatisfaction (Leite et al., 2020). One of the key factors that reduces the value of service for patients is long waiting times, which are associated with negative experiences (Barlow, 2002; Bielen & Demoulin, 2007). The Single-Minute Exchange of Die (SMED) technique is a Lean tool that focuses on optimizing setup activities and reducing idle time. While SMED is widely used in manufacturing, there are few studies on its implementation in healthcare. Some criticize its origins in manufacturing and caution against the cultural differences between manufacturing and healthcare operations (Chiarini & Baccarani, 2016).
Most hospitals use conventional management thinking, which prioritizes local improvement of individual healthcare activities rather than process improvement. In contrast, Lean Thinking focuses on improving the entire process of care, from determining the need for a service to delivering that service without interruption. The focus must be shifted from individual tasks to the patient pathway, defined as a set of activities that must be performed in the appropriate sequence and at the appropriate time to meet the patient's needs (de Souza & Pidd, 2011).
The healthcare industry faces numerous challenges, including limited resources, increased demand due to population growth and unhealthy lifestyles, and economic crisis (Maione et al., 2020). Due to the indeterministic nature of healthcare systems, which makes it difficult to anticipate future states and configurations, it is crucial to find new ways to provide care effectively while also meeting customer expectations (Crema & Verbano, 2021).
Delivering and financing high-quality healthcare services has been a major global goal recently, mainly because healthcare quality reflects citizens' perceptions of their quality of life. However, according to Maione et al. (2020), this ecosystem faces important challenges such as:
Key Terms in this Chapter
Lean Healthcare: A methodology that focuses on improving healthcare delivery through the adoption of lean principles, which include eliminating waste, enhancing value for patients, improving patient flow, reducing waiting time, increasing efficiency, enhancing quality and safety, empowering employees, and promoting continuous improvement ( Lawal et al., 2014 ).
Lean Management: A systematic approach to identify and eliminate waste through continuous improvement by flowing the product at the pull of the customer in pursuit of perfection ( Plenert, 2011 ).
Lead Time: Total time from the moment the customer places an order to the moment that customer receives the order ( Womack & Jones, 1997 ).
Waiting Time: Idle or non-productive time during which a product, service, or information is delayed or held up in a process, often due to inefficiencies, bottlenecks, or interruptions. It is a form of waste that does not add value to the customer and is targeted for elimination or reduction in lean thinking.
Continual Improvement Process: A systematic and ongoing approach used by organizations to enhance their products, services, processes, and overall performance over time. It involves identifying areas for improvement, setting objectives, implementing changes, and evaluating the results in a continuous cycle.
Set-Up Time: The time required to change a process or machine from the last part of a production lot to the first good part of the next lot ( Shingo, 2019 ).
Value: Any action or process that a customer would be willing to pay for ( Womack & Jones, 1997 ).
SMED: A system for dramatically reducing the time it takes to complete equipment changeovers. The essence of the SMED system is to convert as many changeover steps as possible to “external” (performed while the equipment is running), and to simplify and streamline the remaining steps ( Shingo, 2019 ).
Flow: Refers to the progressive achievement of tasks along a value stream so that a product proceeds from design to launch, order to delivery, and raw materials into the hands of the customer with no stoppages, scrap, or backflows ( Womack & Jones, 1997 ).
Toyota Production System: A philosophy of manufacturing that emphasizes the elimination of waste in all forms and respects the fact that constantly improving this system is a never-ending process. It is a set of principles and practices that focus on designing out overburden and inconsistency so that work is performed smoothly, and the result is that workers develop a deep commitment to the goals of the organization ( Liker, 2004 ).