A Framework for Implementing Lean Management in the Hospital Emergency Department

Abstract

Background: Lean management is based on eliminating any waste of resources, increasing productivity, and creating sustainable value. Improving the quality of health services is achieved by knowing the system’s performance and using appropriate managerial methods and tools. Objectives: The purpose of this research was to provide solutions for the proper implementation of lean management in the emergency department of the hospital. Methods: The current research employed a qualitative methodology. In order to provide operational solutions, the existing literature was first reviewed. Then, a sample population was selected from the research community, including experts in the field of health, management, and statistics. Fifteen subjects were interviewed purposefully. In order to obtain the information desired, interviews and focus groups were held, and NVIVO10 software was used to code and store all interview documents. Results: In this study, by reviewing the available literature and conducting interviews with experts, the steps and activities, tools, techniques, and facilities that should be considered for guiding and developing the lean management project in the emergency department were identified and organized. In the next step, based on the Deming cycle, a model was designed to implement lean management in the emergency department. In this 6-step model, the necessary activities for the establishment of a lean management system in the emergency department, as well as the techniques related to each step, were presented along with the enablers needed for the successful implementation of the project. Conclusions: Many hospital inefficiencies can be attributed to the waste of resources and facilities. Therefore, it is necessary to reduce and eliminate waste sources by applying practical solutions and formulating executive instructions for these solutions. Applying the recommendations of the lean management system can cut waste in different fields in hospitals, just like in manufacturers. Using the lean management approach can reduce waste in different dimensions, such as inventory, waiting, processes, and services.