Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autonoma de Baja California, Ensenada 23080, Mexico.
Department of Mechanical Engineering, The University of Melbourne, Melbourne, VIC 3010, Australia.
Int J Environ Res Public Health. 2022 Jul 25;19(15):9018. doi: 10.3390/ijerph19159018.
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.
尽管精益实践和与工业 4.0 相关的数字技术（DTs）的应用日益增多，但这些双重干预对医疗服务的影响仍不清楚。本研究旨在评估这些干预措施的效果，并全面了解它们在医疗保健环境中的动态。该方法包括遵循 PRISMA 指南的系统评价，搜索由 DTs 支持的精益干预措施。纳入了报告与患者健康、患者流量、护理质量和效率相关结果的先前研究。研究结果表明，大多数改善干预措施依赖于精益方法，其次是精益与六西格玛相结合。主要支持技术是模拟和自动化，而急诊室和实验室是主要场所。大多数干预措施侧重于患者流量结果，报告了在服务获取和服务利用方面的积极效果，包括周转时间、住院时间、等待时间和交接时间的缩短。值得注意的是，我们发现关于患者健康、员工福利、资源利用和节约的结果很少。本文首次调查了 DTs 与精益或精益六西格玛在医疗保健中的双重干预，总结了类似干预措施相关的技术和组织挑战，鼓励进一步研究，并促进实际应用。
