Hallam Cory R A, Contreras Carolina
University of Texas at San Antonio , San Antonio, Texas, USA.
Int J Health Care Qual Assur. 2018 Aug 13;31(7):684-696. doi: 10.1108/IJHCQA-02-2017-0023.
Lean healthcare is highlighted in the literature as an approach to quality improvement and operational efficiency. The purpose of this paper is to study how Lean healthcare has been implemented by analyzing empirical outcomes.
DESIGN/METHODOLOGY/APPROACH: The authors used a literature review as the primary research method, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses process. Peer-reviewed journals were analyzed - searching for Lean healthcare implementation, tools used, wastes addressed, outcomes and sustainability.
Evidence suggests that Lean can improve healthcare operational effectiveness. However, empirical studies show implementation is still highly localized with small successes. Most transformations are focused on implementing one or two Lean tools that primarily target patient waiting times and there is minimal evidence about sustainability. Establishing clear definitions for healthcare-related Lean terminology may improve practice, especially episodic care and service quality.
ORIGINALITY/VALUE: This work provides a Lean healthcare case review. The research makes a significant contribution to Lean healthcare by increasing understanding (scale, scope and sustainability). From a theory building perspective, the authors suggest that barriers to adoption include a common healthcare-specific Lean terminology, and a need to expand implementation beyond small successes. This understanding will help identify key areas for further research in Lean healthcare management.
精益医疗在文献中被视为一种提高质量和运营效率的方法。本文旨在通过分析实证结果来研究精益医疗是如何实施的。
设计/方法/途径:作者采用文献综述作为主要研究方法,遵循系统评价和Meta分析的首选报告项目流程。对同行评审期刊进行分析,搜索精益医疗的实施情况、使用的工具、解决的浪费问题、结果和可持续性。
有证据表明精益能提高医疗运营效率。然而,实证研究表明实施仍高度局限,成效不大。大多数变革都集中在实施一两种主要针对患者等待时间的精益工具上,关于可持续性的证据很少。为与医疗相关的精益术语建立明确的定义可能会改善实践,尤其是 episodic 护理和服务质量。
原创性/价值:这项工作提供了一个精益医疗案例综述。该研究通过增进理解(规模、范围和可持续性)对精益医疗做出了重大贡献。从理论构建的角度来看,作者认为采用的障碍包括常见的特定于医疗的精益术语,以及需要在小成功之外扩大实施范围。这种理解将有助于确定精益医疗管理中进一步研究的关键领域。