Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico.
Facultad de Ciencias de la Ingeniería, Administrativas y Sociales, Universidad Autónoma de Baja California, Tecate 21460, Mexico.
Int J Environ Res Public Health. 2020 Aug 4;17(15):5609. doi: 10.3390/ijerph17155609.
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.
医疗保健服务在提高效率、护理质量和应对需求激增方面面临挑战。为此，一些医院已经实施了精益医疗保健。本系统评价的目的是评估精益医疗保健 (LH) 干预对内科护理的影响，并确定患者流量和效率结果是否有所改善。该综述是根据 PRISMA 进行的。我们使用了六个数据库来搜索 2002 年至 2019 年期间发表的研究。在 5732 项研究中，有 39 项研究测量了一个或多个定义的结果。23 项研究测量了医院住院时间 (LOS)，其中 16 项报告了减少，8 项研究中的 6 项报告了周转率 (TOT) 减少，而所有 5 项研究中的周转时间 (TAT) 和按时开始 (OTS) 均有所改善，分别为 7 项。此外，9 项研究中有 8 项报告提前出院时间，所有 4 项研究的住院时间均减少。同时，9 项研究中的再入院率均未增加。最后，所有 8 项研究都提高了员工和患者的满意度。我们的研究结果表明，通过专注于减少非增值活动，LH 有助于改善内科护理中的患者流量和效率。
