Lean in healthcare: A comprehensive review

被引:349
作者
D'Andreamatteo, Antonio [1 ]
Ianni, Luca [1 ]
Lega, Federico [2 ]
Sargiacomo, Massimo [1 ]
机构
[1] Univ G DAnnunzio, Dept Management & Business Adm, I-65127 Pescara, Italy
[2] Bocconi Univ, Dept Policy Anal & Publ Management, CeRGAS Publ Management &Policy SDA, I-20136 Milan, Italy
关键词
Lean; Lean Six Sigma; Lean thinking; Healthcare; Operational excellence; Continuous quality improvement; Review; 6; SIGMA; QUALITY IMPROVEMENT; THINKING IMPLEMENTATION; ACTOR ASSOCIATIONS; REDESIGNING CARE; MANAGEMENT; LESSONS; CHALLENGES; SYSTEM; HOSPITALS;
D O I
10.1016/j.healthpol.2015.02.002
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Lean seems to be the next revolution for a better, improved, value-based heal-hcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Method: Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. Findings: 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number. Conclusion: Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:1197 / 1209
页数:13
相关论文
共 120 条
[1]   Translating 10 Lessons From Lean Six Sigma Project in Paper-Based Training Site to Electronic Health Record-Based Primary Care Practice: Challenges and Opportunities [J].
Aleem, Sohaib .
QUALITY MANAGEMENT IN HEALTH CARE, 2013, 22 (03) :224-235
[2]  
Andersson R., 2006, THE TQM MAGAZINE, V18, P282, DOI [DOI 10.1108/09544780610660004, 10.1108/09544780610660004]
[3]  
[Anonymous], 2008, INT J 6 SIGMA COMPET, DOI DOI 10.1504/IJSSCA.2008.021839
[4]  
[Anonymous], PRODUCTIVE WARD RELE
[5]  
[Anonymous], 2009, SYSTEMATIC REV CRDS
[6]  
[Anonymous], MEASURING MANAGING R
[7]  
[Anonymous], INT J CLIN LEADERSHI
[8]  
[Anonymous], 2006, INT J 6 SIGMA COMPET
[9]  
[Anonymous], INT J HLTH CARE QUAL
[10]   Nurse-led liaison mental health service for older adults: Service development using lean thinking methodology [J].
Atkinson, Paula ;
Mukaetova-Ladinska, Elizabeta B. .
JOURNAL OF PSYCHOSOMATIC RESEARCH, 2012, 72 (04) :328-331