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Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review

Author

Listed:
  • Diego Tlapa

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autonoma de Baja California, Ensenada 23080, Mexico)

  • Guilherme Tortorella

    (Department of Mechanical Engineering, The University of Melbourne, Melbourne, VIC 3010, Australia)

  • Flavio Fogliatto

    (Industrial Engineering Department, Universidade Federal do Rio Grande do Sul, Porto Alegre 90010-150, Brazil)

  • Maneesh Kumar

    (Cardiff Business School, Cardiff University, Cardiff CF5 2YB, UK)

  • Alejandro Mac Cawley

    (Departamento de Ingeniería Industrial y de Sistemas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile)

  • Roberto Vassolo

    (IAE Business School, Universidad Austral, Buenos Aires B1630FHB, Argentina)

  • Luis Enberg

    (Departamento de Ingeniería Industrial y de Sistemas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile)

  • Yolanda Baez-Lopez

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autonoma de Baja California, Ensenada 23080, Mexico)

Abstract

Despite the increasing utilization of lean practices and digital technologies (DTs) related to Industry 4.0, the impact of such dual interventions on healthcare services remains unclear. This study aims to assess the effects of those interventions and provide a comprehensive understanding of their dynamics in healthcare settings. The methodology comprised a systematic review following the PRISMA guidelines, searching for lean interventions supported by DTs. Previous studies reporting outcomes related to patient health, patient flow, quality of care, and efficiency were included. Results show that most of the improvement interventions relied on lean methodology followed by lean combined with Six Sigma. The main supporting technologies were simulation and automation, while emergency departments and laboratories were the main settings. Most interventions focus on patient flow outcomes, reporting positive effects on outcomes related to access to service and utilization of services, including reductions in turnaround time, length of stay, waiting time, and turnover time. Notably, we found scarce outcomes regarding patient health, staff wellbeing, resource use, and savings. This paper, the first to investigate the dual intervention of DTs with lean or lean–Six Sigma in healthcare, summarizes the technical and organizational challenges associated with similar interventions, encourages further research, and promotes practical applications.

Suggested Citation

  • 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.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9018-:d:870802
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    References listed on IDEAS

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    1. Syed Salleh & Praveen Thokala & Alan Brennan & Ruby Hughes & Andrew Booth, 2017. "Simulation Modelling in Healthcare: An Umbrella Review of Systematic Literature Reviews," PharmacoEconomics, Springer, vol. 35(9), pages 937-949, September.
    2. Mazen Hassanain & Mohammed Zamakhshary & Ghada Farhat & Ahmed Al-Badr, 2017. "Use of Lean methodology to improve operating room efficiency in hospitals across the Kingdom of Saudi Arabia," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(2), pages 133-146, April.
    3. 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.
    4. Eva K. Lee & Hany Y. Atallah & Michael D. Wright & Eleanor T. Post & Calvin Thomas & Daniel T. Wu & Leon L. Haley, 2015. "Transforming Hospital Emergency Department Workflow and Patient Care," Interfaces, INFORMS, vol. 45(1), pages 58-82, February.
    5. Mohammad Asif Salam & Sami A. Khan, 2016. "Value creation through lean management: a case study of healthcare service operations," International Journal of Services and Operations Management, Inderscience Enterprises Ltd, vol. 25(3), pages 275-293.
    6. Maria Pia Ciano & Patrick Dallasega & Guido Orzes & Tommaso Rossi, 2021. "One-to-one relationships between Industry 4.0 technologies and Lean Production techniques: a multiple case study," International Journal of Production Research, Taylor & Francis Journals, vol. 59(5), pages 1386-1410, March.
    7. Agnetis, Alessandro & Bianciardi, Caterina & Iasparra, Nicola, 2019. "Integrating lean thinking and mathematical optimization: A case study in appointment scheduling of hematological treatments," Operations Research Perspectives, Elsevier, vol. 6(C).
    8. Chaloner Chute & Tara French, 2019. "Introducing Care 4.0: An Integrated Care Paradigm Built on Industry 4.0 Capabilities," IJERPH, MDPI, vol. 16(12), pages 1-17, June.
    9. 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.
    10. Hung-Wen Tsai & Su-Wen Huang & Yin-Lurn Hung & Yu-Shan Hsu & Chien-Chung Huang, 2021. "Use of the Smart Lean Method to Conduct High-Quality Integrated Perioperative Management Prior to Hospitalization," IJERPH, MDPI, vol. 18(24), pages 1-16, December.
    11. Sven-Vegard Buer & Marco Semini & Jan Ola Strandhagen & Fabio Sgarbossa, 2021. "The complementary effect of lean manufacturing and digitalisation on operational performance," International Journal of Production Research, Taylor & Francis Journals, vol. 59(7), pages 1976-1992, April.
    12. Baril, Chantal & Gascon, Viviane & Miller, Jonathan & Côté, Nadine, 2016. "Use of a discrete-event simulation in a Kaizen event: A case study in healthcare," European Journal of Operational Research, Elsevier, vol. 249(1), pages 327-339.
    13. Bergey, Meredith R. & Goldsack, Jennifer C. & Robinson, Edmondo J., 2019. "Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team," Social Science & Medicine, Elsevier, vol. 235(C), pages 1-1.
    14. Dimitris Mourtzis, 2020. "Simulation in the design and operation of manufacturing systems: state of the art and new trends," International Journal of Production Research, Taylor & Francis Journals, vol. 58(7), pages 1927-1949, April.
    15. Miguel Ortiz-Barrios & Juan-José Alfaro-Saiz, 2020. "An integrated approach for designing in-time and economically sustainable emergency care networks: A case study in the public sector," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-28, June.
    16. 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.
    17. 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.
    18. Shivam Gupta & Sachin Modgil & Angappa Gunasekaran, 2020. "Big data in lean six sigma: a review and further research directions," International Journal of Production Research, Taylor & Francis Journals, vol. 58(3), pages 947-969, February.
    19. Cláudia Pinho & Luis Mendes, 2017. "IT in lean-based manufacturing industries: systematic literature review and research issues," International Journal of Production Research, Taylor & Francis Journals, vol. 55(24), pages 7524-7540, December.
    20. 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:

    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. Daniele La Forgia & Gaetano Paparella & Rahel Signorile & Francesca Arezzo & Maria Colomba Comes & Gennaro Cormio & Antonella Daniele & Annarita Fanizzi & Agnese Maria Fioretti & Gianluca Gatta & Miri, 2022. "Lean Perspectives in an Organizational Change in a Scientific Direction of an Italian Research Institute: Experience of the Cancer Institute of Bari," IJERPH, MDPI, vol. 20(1), pages 1-15, December.
    3. Seokho Ahn & Jaesung Kim & Seok Chan Jeong & Myungil Kim & Cheolyoung Kim & Dongki Park, 2022. "Stress Distribution Analysis of Threaded Implants for Digital Dentistry," IJERPH, MDPI, vol. 19(19), pages 1-14, October.
    4. Bertha Leticia Treviño-Elizondo & Heriberto García-Reyes & Rodrigo E. Peimbert-García, 2023. "A Maturity Model to Become a Smart Organization Based on Lean and Industry 4.0 Synergy," Sustainability, MDPI, vol. 15(17), pages 1-24, September.

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