Effects of Lean Healthcare on Patient Flow: A Systematic Review
Objectives: To assess the effects of lean healthcare (LH) on patient flow in ambulatory care and determine whether waiting time and length of stay (LOS) decrease after LH interventions. Methods: A systematic review was performed with close adherence to Preferred Reporting Items for Systematic Revi...
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| Other Authors: | , , , , , , |
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| Format: | Artículo |
| Language: | English |
| Published: |
2020
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| Subjects: | |
| Online Access: | https://doi.org/10.1016/j.jval.2019.11.002 https://www.sciencedirect.com/science/article/pii/S1098301519352179 |
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| Summary: | Objectives: To assess the effects of lean healthcare (LH) on patient flow in ambulatory care and determine whether waiting
time and length of stay (LOS) decrease after LH interventions.
Methods: A systematic review was performed with close adherence to Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA). We searched for studies of healthcare organizations applying LH interventions within ambulatory
care published between 2002 and 2018. Six databases and grey literature sources were used. Two reviewers independently
screened and assessed each study. When consensus was difficult to reach, a third reviewer intervened. Finally, a summary of
findings was generated.
Results: Out of 5627 studies, 40 were included. Regarding LOS for all patients, 19 out of 22 studies reported a decrease. LOS for
discharged patients decreased in 11 out of 13 studies, whereas LOS for admitted patients was reduced in 6 out of 7 studies.
Waiting time for patients before seeing a healthcare professional decreased in 24 out of 26 studies. Waiting time to treatment
and waiting time for appointments were minimized in 4 and 2 studies, respectively. Patients who left without being seen by a
doctor decreased in 9 out of 12 studies. Finally, patient and staff satisfaction were measured in 8 and 2 studies, respectively,
with each reporting improvements.
Conclusions: According to our findings, LH helped to reduce waiting time and LOS in ambulatory care, mainly owing to its
focus on identifying and minimizing non-value added (NVA) activities. Nevertheless, evidence of the impact of LH on patient/
staff satisfaction and the translation of the obtained benefits into savings is scarce among studies. |
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