IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i15p5609-d394255.html
   My bibliography  Save this article

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
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/15/5609/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/15/5609/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Diego Tlapa & Ignacio Franco-Alucano & Jorge Limon-Romero & Yolanda Baez-Lopez & Guilherme Tortorella, 2022. "Lean, Six Sigma, and Simulation: Evidence from Healthcare Interventions," Sustainability, MDPI, vol. 14(24), pages 1-25, December.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Diego Tlapa & Ignacio Franco-Alucano & Jorge Limon-Romero & Yolanda Baez-Lopez & Guilherme Tortorella, 2022. "Lean, Six Sigma, and Simulation: Evidence from Healthcare Interventions," Sustainability, MDPI, vol. 14(24), pages 1-25, December.
    2. 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.
    3. Åhlin, Philip & Almström, Peter & Wänström, Carl, 2022. "When patients get stuck: A systematic literature review on throughput barriers in hospital-wide patient processes," Health Policy, Elsevier, vol. 126(2), pages 87-98.
    4. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    5. Su Keng Tan & Wai Keung Leung & Alexander Tin Hong Tang & Roger A Zwahlen, 2017. "Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-20, October.
    6. Alessandro Concari & Gerjo Kok & Pim Martens, 2020. "A Systematic Literature Review of Concepts and Factors Related to Pro-Environmental Consumer Behaviour in Relation to Waste Management Through an Interdisciplinary Approach," Sustainability, MDPI, vol. 12(11), pages 1-50, May.
    7. Jacob Elnaggar & Fern Tsien & Lucio Miele & Chindo Hicks & Clayton Yates & Melisa Davis, 2019. "An Integrative Genomics Approach for Associating Genetic Susceptibility with the Tumor Immune Microenvironment in Triple Negative Breast Cancer," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 15(1), pages 1-12, February.
    8. Hyun Kim & Navneet Kaur Baidwan & David Kriebel & Manuel Cifuentes & Sherry Baron, 2018. "Asthma among World Trade Center First Responders: A Qualitative Synthesis and Bias Assessment," IJERPH, MDPI, vol. 15(6), pages 1-14, May.
    9. Giuseppe La Torre & Remigio Bova & Rosario Andrea Cocchiara & Cristina Sestili & Anna Tagliaferri & Simona Maggiacomo & Camilla Foschi & William Zomparelli & Maria Vittoria Manai & David Shaholli & Va, 2023. "What Are the Determinants of the Quality of Systematic Reviews in the International Journals of Occupational Medicine? A Methodological Study Review of Published Literature," IJERPH, MDPI, vol. 20(2), pages 1-12, January.
    10. Frank Peinemann & Ulrich Grouven & Nicolaus Kröger & Carmen Bartel & Max H Pittler & Stefan Lange, 2011. "First-Line Matched Related Donor Hematopoietic Stem Cell Transplantation Compared to Immunosuppressive Therapy in Acquired Severe Aplastic Anemia," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-16, April.
    11. Jonathan Kingsley & Aisling Bailey & Nooshin Torabi & Pauline Zardo & Suzanne Mavoa & Tonia Gray & Danielle Tracey & Philip Pettitt & Nicholas Zajac & Emily Foenander, 2019. "A Systematic Review Protocol Investigating Community Gardening Impact Measures," IJERPH, MDPI, vol. 16(18), pages 1-12, September.
    12. Wei-Wei Chen & Feng Wang & Rui-Hua Xu, 2013. "Platinum-Based Versus Non-Platinum-Based Chemotherapy as First Line Treatment of Inoperable, Advanced Gastric Adenocarcinoma: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-8, July.
    13. Giovanni Vinti & Valerie Bauza & Thomas Clasen & Kate Medlicott & Terry Tudor & Christian Zurbrügg & Mentore Vaccari, 2021. "Municipal Solid Waste Management and Adverse Health Outcomes: A Systematic Review," IJERPH, MDPI, vol. 18(8), pages 1-26, April.
    14. Hanna Górska-Warsewicz, 2022. "Consumer or Patient Determinants of Hospital Brand Equity—A Systematic Literature Review," IJERPH, MDPI, vol. 19(15), pages 1-36, July.
    15. André Ramalho & João Serrano & Rui Paulo & Pedro Duarte-Mendes & António Rosado & João Petrica, 2021. "Emerging Qualitative Research Trends (2010–2021) on Sedentary Behaviour among Older Adults: A Systematic Literature Review Protocol," IJERPH, MDPI, vol. 18(21), pages 1-8, November.
    16. S. Rajsic & H. Gothe & H. H. Borba & G. Sroczynski & J. Vujicic & T. Toell & Uwe Siebert, 2019. "Economic burden of stroke: a systematic review on post-stroke care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 107-134, February.
    17. Sibonokuhle Ndlovu, 2023. "Preparedness and Response to COVID-19 Disruptions and Learning Challenges for Students with Disabilities in South Africa: A Systematic Review," Sustainability, MDPI, vol. 15(2), pages 1-17, January.
    18. João Carlos Belloti & Aldo Okamura & Jordana Scheeren & Flávio Faloppa & Vinícius Ynoe de Moraes, 2019. "A systematic review of the quality of distal radius systematic reviews: Methodology and reporting assessment," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-12, January.
    19. Abbas Mardani & Dalia Streimikiene & Edmundas Kazimieras Zavadskas & Fausto Cavallaro & Mehrbakhsh Nilashi & Ahmad Jusoh & Habib Zare, 2017. "Application of Structural Equation Modeling (SEM) to Solve Environmental Sustainability Problems: A Comprehensive Review and Meta-Analysis," Sustainability, MDPI, vol. 9(10), pages 1-65, October.
    20. Luísa Bandeira Lopes & João Albernaz Neves & João Botelho & Vanessa Machado & José João Mendes, 2021. "Regenerative Endodontic Procedures: An Umbrella Review," IJERPH, MDPI, vol. 18(2), pages 1-17, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:15:p:5609-:d:394255. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.