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Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Author

Listed:
  • Carlos Zepeda-Lugo

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico)

  • Diego Tlapa

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico)

  • Yolanda Baez-Lopez

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico)

  • Jorge Limon-Romero

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico)

  • Sinue Ontiveros

    (Facultad de Ciencias de la Ingeniería, Administrativas y Sociales, Universidad Autónoma de Baja California, Tecate 21460, Mexico)

  • Armando Perez-Sanchez

    (Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Tijuana 22260, Mexico)

  • Guilherme Tortorella

    (Department of Systems and Production Engineering, Universidade Federal de Santa Catarina, Florianópolis 88040, Brazil)

Abstract

Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review is to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve. The review was performed according to PRISMA. We used six databases to search for studies published from 2002 to 2019. Out of 5732 studies, 39 measuring one or more defined outcomes were included. Hospital length of stay (LOS) was measured in 23 studies, 16 of which reported a reduction, turnover time (TOT) decreased in six out of eight studies, while the turnaround time (TAT) and on-time starts (OTS) improved in all five and seven studies, respectively. Moreover, eight out of nine studies reported an earlier discharge time, and the boarding time decreased in all four cases. Meanwhile, the readmission rate did not increase in all nine studies. Lastly, staff and patient satisfaction improved in all eight studies. Our findings show that by focusing on reducing non-value-added activities, LH contributed to improving patient flow and efficiency within inpatient care.

Suggested Citation

  • Carlos Zepeda-Lugo & Diego Tlapa & Yolanda Baez-Lopez & Jorge Limon-Romero & Sinue Ontiveros & Armando Perez-Sanchez & Guilherme Tortorella, 2020. "Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review," IJERPH, MDPI, vol. 17(15), pages 1-24, August.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:15:p:5609-:d:394255
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    References listed on IDEAS

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    1. Cagatay Tasdemir & Rado Gazo, 2018. "A Systematic Literature Review for Better Understanding of Lean Driven Sustainability," Sustainability, MDPI, vol. 10(7), pages 1-54, July.
    2. Nurul Fadly Habidin & Nurul Aifaa Shazali & Naimah Ali & Nur Afni Khaidir & Noor Hidayah Jamaludin, 2014. "Exploring lean healthcare practice and supply chain innovation for Malaysian healthcare industry," International Journal of Business Excellence, Inderscience Enterprises Ltd, vol. 7(3), pages 394-410.
    3. Steve New & Mohammed Hadi & Sharon Pickering & Eleanor Robertson & Lauren Morgan & Damian Griffin & Gary Collins & Oliver Rivero-Arias & Ken Catchpole & Peter McCulloch, 2016. "Lean Participative Process Improvement: Outcomes and Obstacles in Trauma Orthopaedics," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-13, April.
    4. Vineet Jain & Puneeta Ajmera, 2019. "Modelling of the factors affecting lean implementation in healthcare using structural equation modelling," International Journal of System Assurance Engineering and Management, Springer;The Society for Reliability, Engineering Quality and Operations Management (SREQOM),India, and Division of Operation and Maintenance, Lulea University of Technology, Sweden, vol. 10(4), pages 563-575, August.
    5. Pierre-Luc Fournier & Marie-Hélène Jobin, 2018. "Understanding before implementing: the context of Lean in public healthcare organizations," Public Money & Management, Taylor & Francis Journals, vol. 38(1), pages 37-44, January.
    6. D’Andreamatteo, Antonio & Ianni, Luca & Lega, Federico & Sargiacomo, Massimo, 2015. "Lean in healthcare: A comprehensive review," Health Policy, Elsevier, vol. 119(9), pages 1197-1209.
    7. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    8. Chiara Verbano & Maria Crema, 2019. "Applying lean management to reduce radiology turnaround times for emergency department," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1711-1722, October.
    9. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    Cited by:

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    3. Pilar I. Vidal-Carreras & Julio J. Garcia-Sabater & Juan A. Marin-Garcia, 2022. "Applying Value Stream Mapping to Improve the Delivery of Patient Care in the Oncology Day Hospital," IJERPH, MDPI, vol. 19(7), pages 1-18, April.
    4. Agnieszka Zdęba-Mozoła & Anna Rybarczyk-Szwajkowska & Tomasz Czapla & Michał Marczak & Remigiusz Kozłowski, 2022. "Implementation of Lean Management in a Multi-Specialist Hospital in Poland and the Analysis of Waste," IJERPH, MDPI, vol. 19(2), pages 1-23, January.
    5. Juan A. Marin-Garcia & Pilar I. Vidal-Carreras & Julio J. Garcia-Sabater, 2021. "The Role of Value Stream Mapping in Healthcare Services: A Scoping Review," IJERPH, MDPI, vol. 18(3), pages 1-25, January.
    6. Agnieszka Zdęba-Mozoła & Remigiusz Kozłowski & Anna Rybarczyk-Szwajkowska & Tomasz Czapla & Michał Marczak, 2023. "Implementation of Lean Management Tools Using an Example of Analysis of Prolonged Stays of Patients in a Multi-Specialist Hospital in Poland," IJERPH, MDPI, vol. 20(2), pages 1-23, January.
    7. Diego Tlapa & Guilherme Tortorella & Flavio Fogliatto & Maneesh Kumar & Alejandro Mac Cawley & Roberto Vassolo & Luis Enberg & Yolanda Baez-Lopez, 2022. "Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review," IJERPH, MDPI, vol. 19(15), pages 1-23, July.
    8. Oscar Morell-Santandreu & Cristina Santandreu-Mascarell & Julio J. Garcia-Sabater, 2021. "A Model for the Implementation of Lean Improvements in Healthcare Environments as Applied in a Primary Care Center," IJERPH, MDPI, vol. 18(6), pages 1-30, March.

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