Use Of Lean Principles Research Articles

Application of lean Management Principles in Hospitals in Slovakia

Introduction: Healthcare worldwide is struggling with many problems that have been escalated by the Covid-19 pandemic and the military conflict in Ukraine. The gap between the possibilities and the needs in the provision of health services is opening more and more. Therefore, it is necessary to look for ways to streamline processes at the level of the hospitals themselves and their management. Research aim and objectives: The aim of the research was to examine the mutual connections between the use of lean management principles and the ratings of hospitals in the Slovak Republic and to identify the influence of external and internal factors in this relationship. The sample consisted of 175 managers from 35 hospitals. Methods: To verify the hypotheses, the SEM method was used in the Smart Pls 3.3 software at a significance level of 0.05. Results: We discovered that there is a statistically significant connection between the use of lean principles and hospital ratings. If other variables enter the model, the overall effect of the mentioned variables is significantly increased. The stakeholder demands variable has a significant mediating effect (β = 0.470; p=0.000). The social lean climate variable has a lower indirect effect in the Slovak environment (β = 0.291; p=0.000). Conclusion: Our research shows the unequivocal importance of applying the principles of lean management in healthcare. There is ever-increasing pressure to increase quality and improve process efficiency from various stakeholders as well as pressure from within hospitals.

Lean practices and the adoption of digital technologies in production

The use of Lean principles has long enabled the improvement of efficiency and competitiveness in manufacturing firms, but during the last decade, advanced digital and automated solutions have been ...

Identification of Key Performance Indicators in Project-Based Organisations through the Lean Approach

For the time being, companies and organisations are being forced to compete in utterly complex and globalised environments, facing massive natural, economic, and technological challenges on a daily basis. Addressing these challenges would be impossible without a proper approach that helps them identify, measure, understand, and control the performance of their organisations. Lean principles and techniques rise as a solution. This paper justifies and proposes the use of lean principles and techniques to identify key performance indicators (KPIs) in project-based organisations based on their organisational and operational needs. The research focuses mainly on the identification and categorisation of KPIs through a qualitative approach, based on systematic literature review (SLR) of performance indicators, project management, and project success. As a case study, an analysis of relevant information of an R&D and innovation project-based organisation, such as quality manuals, a benchmarking process, internal studies, and surveys regarding what success means for different kinds of stakeholders and for the organisation itself was conducted. As a result, this research is of a high value for project-based organisations, especially those that are not apprised of how to correctly formulate a series of KPIs, or whose path to it is still not clear.

Applying Lean in Process Innovation in Healthcare: The Case of Hip Fracture

Academic literature and practitioners acknowledge that there is a need to improve efficiency and service quality in the healthcare industry. In Spain, osteoporotic fractures represent a great cost in socio-economic and morbi-mortality terms, hip fracture being the surgical pathology with the second highest consumption of resources. The research questions that govern this study concern the use of Lean principles to identify waste, and an evaluation of the application of an innovative approach in the hip fracture surgery process. A research design based on a case study and action research was developed. Findings relate to (i) the identification of the main types of waste or muda (being the most frequent delay, transportation, over-processing and defects); (ii) the analysis of existing processes based on a Lean approach (identifying opportunities for improvement as a reduction of the number of steps and participants, improving communication, automation, standardization, etc.); and (iii) the application of an innovative process based on the Lean approach and action research in the healthcare industry. This research provides insights for academia, practitioners, management, and society: waste identification and process redesign helps to continue the improvement of operations, increase efficiency, reduce costs, and enhance services, providing benefits to patients, families, hospital employees, and the healthcare system.

Using Lean to Improve Patient Safety and Resource Utilization After Pediatric Adenotonsillectomy.

The objective of this quality improvement project was to decrease the rate of nonemergent use of emergency department (ED) resources in children undergoing adenotonsillectomy by 50% and/or reach a future state of 5% or less overall ED visits among all postoperative patients within 1 year. A secondary objective was to standardize the preoperative, intraoperative, and postoperative management of these patients. The study was a quality improvement project using Lean. The target population was children younger than 18 years undergoing tonsillectomy with or without adenoidectomy. A retrospective review of adenotonsillectomy was performed for a 12-month period. Lean tools including A3 Thinking, Ishikawa "fishbone" diagram, and value stream mapping were used to analyze the problem and identify interventions. Postintervention data were collected for a 10-month period. Compared with the baseline period, the ED visit rate after adenotonsillectomy decreased from 36.2% to 15.5% (P = 0.0095). The rate of ED visits for nonbleeding complaints decreased from 30.4% to 12.1% (P = 0.01748). There was no significant change in rate of ED visits for bleeding (decreased from 5.8% to 3.5% [P = 0.6873]). There was no significant change in the use of intraoperative dexamethasone and acetaminophen. Postadenotonsillectomy patients often use emergency resources better reserved for other patients. Addressing this problem with Lean principles significantly decreased postoperative ED visit rates by more than 50%. To our knowledge, this is the first reported use of Lean principles to decrease utilization of emergency resources in the postoperative period. Lean can be applied to other processes in our field to eliminate waste and add value to improve patient outcomes. NA.

Using lean thinking to improve hypertension in a community health centre: a quality improvement report

BackgroundAchieving better care at lower cost in the US healthcare safety net will require federally qualified health centres (FQHC) to implement new models of team-based population healthcare. Lean thinking may...

Workplace violence prevention standardization using lean principles across a healthcare network

PurposeThe purpose of this paper is to describe the process used to standardize a Workplace Violence Prevention Program (WVPP) within a five-hospital healthcare system in Veterans Health Administration (VHA).Design/methodology/approachA description of the lean process improvement principles, used to bring the WVPP into compliance with Occupational Safety and Health Administration (OSHA) and other agencies through streamlining/standardizing processes.FindingsThere was significant standardization in both the threat assessment and education arms of the WVPP. Compliance with all major US Department of Labor OSHA requirements, as well as substantial time savings, were realized as part of this process improvement.Originality/valueVHA is leading the way in inter/multidisciplinary assessment and mitigation of workplace violence, however, there are significant competing demands on staff time. This first ever use of lean principles to streamline processes around workplace violence prevention freed up clinician time for care while improving internal and external customer satisfaction, representing a major step forward in workplace violence risk mitigation.

Using lean principles to drive operational improvements in intermodal container facilities

Purpose – The purpose of this paper is to explore the use of lean principles to drive operational improvements in intermodal container facilities. Intermodal terminals have an important role in today’s globally complex supply networks. In the case of bottleneck-derived terminalization, operational issues such as achieving effective material flow remains a significant and common challenge. To assist with such challenges, the paper develops a conceptual framework built on the principles of lean. Design/methodology/approach – In this paper, a theory-building approach is adopted and a lean terminalization framework developed by combining aspects of lean- and intermodal transport theory with practical insights. The framework was developed in conjunction with two intermodal container facilities within the Scandinavian region. Findings – The conceptual framework demonstrates how lean approaches can be used to identify improvement areas, as well as to develop solutions for improved material flow in the context of intermodal transport operations. The framework can be used to guide the lean implementation process in small to medium intermodal container facilities. Research limitations/implications – The development of the framework represents the first stage of a two-stage project. The second stage will involve implementing and empirically testing the framework in the practical settings of the two-case facilities. Practical implications – Lean is a philosophical approach that consists of a set of principles that drive organizations to continually add value to their operations. The application of lean practices enhances necessary process steps and eliminates those that fail to add value, thereby improving material flow and performance. Social implications – Improving the operational efficiency and effectiveness of container terminals out not only assists the profitability of the facilities but also has flow-on benefits for stakeholders, external customers, consumers and the environment. Originality/value – Lean has been successfully applied in manufacturing because the 1990s, and though it has also found relevance in a number of other industries, applications of lean within the intermodal transport sector is limited.

Applying lean principles to continuous renal replacement therapy processes.

The application of lean principles to continuous renal replacement therapy (CRRT) processes in an academic medical center is described. A manual audit over six consecutive weeks revealed that 133 5-L bags of CRRT solution were discarded after being dispensed from pharmacy but before clinical use. Lean principles were used to examine the workflow for CRRT preparation and develop and implement an intervention. An educational program was developed to encourage and enhance direct communication between nursing and pharmacy about changes in a patient's condition or CRRT order. It was through this education program that the reordering workflow shifted from nurses to pharmacy technicians. The primary outcome was the number of CRRT solution bags delivered in the preintervention and postintervention periods. Nurses and pharmacy technicians were surveyed to determine their satisfaction with the workflow change. After implementation of lean principles, the mean number of CRRT solution bags dispensed per day of CRRT decreased substantially. Respondents' overall satisfaction with the CRRT solution preparation process increased during the postintervention period, and the satisfaction scores for each individual component of the workflow after implementation of lean principles. The decreased solution waste resulted in projected annual cost savings exceeding $70,000 in product alone. The use of lean principles to identify medication waste in the CRRT workflow and implementation of an intervention to shift the workload from intensive care unit nurses to pharmacy technicians led to reduced CRRT solution waste, improved efficiency of CRRT workflow, and increased satisfaction among staff.

MASS CUSTOMIZATION ENABLEMENT THROUGH LEAN DESIGN & SET-BASED CONCURRENT ENGINEERING APPLICATION

This research, which is an expanded version of a paper presented at the XVII SIMPOI - Symposium of Production Management, Logistics and International Operations, purported to discuss the concepts of mass customization in the automotive industry and how the use of lean principles in product development enables a profitable Design and Production customization. The results of a case study performed at an automaker plant in southern Rio de Janeiro state, Brazil, proved the efficiency of the company practice to develop simultaneously multiple concepts for each mechanism or Project detail, with substantial increase in design reliability, reducing redesign, cost, and development time, although cultural barriers were found.DOI: 10.12660/joscmv7n2p124-139URL: http://dx.doi.org/10.12660/joscmv7n2p124-139

A lean approach for service productivity improvements: synergy or oxymoron?

PurposeService productivity continues to receive ever‐greater amounts of attention as service covers a greater portion of the economy. As competition increases, service productivity becomes increasingly important. This study aims to explore the applicability of lean principles in a service context and to conceptualize how these principles impact service productivity.Design/methodology/approachThis paper presents a conceptual analysis of the six most commonly used lean principles in manufacturing and their applicability to a service context for different types of services. Using this analysis, six propositions are developed to examine the influence of lean on service productivity.FindingsThis study suggests promising synergies, as well as important obstacles, for applying lean principles in services. Standardizing services and increasing reliability in service processes through lean principles can increase efficiency. However, the customer's active role in certain services and, simultaneously, high diversity make the application of lean principles increasingly difficult. Also, customer satisfaction must be considered when improving service productivity, otherwise the positive long‐term effects of a lean approach in service will be absent.Practical implicationsThese findings are useful for organizations aiming to improve their service productivity. Particularly, lean principles are invaluable to increase efficiency and customer satisfaction for services with low diversity and low customer participation. This paper suggests a direction for the proper use of lean principles for different service types, and how efficiency and customer satisfaction are affected through a lean approach.Originality/valueThis study contributes to the research on service productivity and continues the discussion on prototypic characteristics of service and manufacturing orientations.

Lean principles optimize on-time vascular surgery operating room starts and decrease resident work hours

Lean process improvement techniques are used in industry to improve efficiency and quality while controlling costs. These techniques are less commonly applied in health care. This study assessed the effectiveness of Lean principles on first case on-time operating room starts and quantified effects on resident work hours. Standard process improvement techniques (DMAIC methodology: define, measure, analyze, improve, control) were used to identify causes of delayed vascular surgery first case starts. Value stream maps and process flow diagrams were created. Process data were analyzed with Pareto and control charts. High-yield changes were identified and simulated in computer and live settings prior to implementation. The primary outcome measure was the proportion of on-time first case starts; secondary outcomes included hospital costs, resident rounding time, and work hours. Data were compared with existing benchmarks. Prior to implementation, 39% of first cases started on time. Process mapping identified late resident arrival in preoperative holding as a cause of delayed first case starts. Resident rounding process inefficiencies were identified and changed through the use of checklists, standardization, and elimination of nonvalue-added activity. Following implementation of process improvements, first case on-time starts improved to 71% at 6 weeks (P = .002). Improvement was sustained with an 86% on-time rate at 1 year (P < .001). Resident rounding time was reduced by 33% (from 70 to 47 minutes). At 9 weeks following implementation, these changes generated an opportunity cost potential of $12,582. Use of Lean principles allowed rapid identification and implementation of perioperative process changes that improved efficiency and resulted in significant cost savings. This improvement was sustained at 1 year. Downstream effects included improved resident efficiency with decreased work hours.

The lean gap: A review of lean approaches to large-scale software systems development

Lean approaches to product development (LPD) have had a strong influence on many industries and in recent years there have been many proponents for lean in software development as it can support the increasing industry need of scaling agile software development. With it's roots in industrial manufacturing and, later, industrial product development, it would seem natural that LPD would adapt well to large-scale development projects of increasingly software-intensive products, such as in the automotive industry. However, it is not clear what kind of experience and results have been reported on the actual use of lean principles and practices in software development for such large-scale industrial contexts. This was the motivation for this study as the context was an ongoing industry process improvement project at Volvo Car Corporation and Volvo Truck Corporation.The objectives of this study are to identify and classify state of the art in large-scale software development influenced by LPD approaches and use this established knowledge to support industrial partners in decisions on a software process improvement (SPI) project, and to reveal research gaps and proposed extensions to LPD in relation to its well-known principles and practices.For locating relevant state of the art we conducted a systematic mapping study, and the industrial applicability and relevance of results and said extensions to LPD were further analyzed in the context of an actual, industrial case.A total of 10,230 papers were found in database searches, of which 38 papers were found relevant. Of these, only 42 percent clearly addressed large-scale development. Furthermore, a majority of papers (76 percent) were non-empirical and many lacked information about study design, context and/or limitations. Most of the identified results focused on eliminating waste and creating flow in the software development process, but there was a lack of results for other LPD principles and practices.Overall, it can be concluded that research in the much hyped field of lean software development is in its nascent state when it comes to large scale development. There is very little support available for practitioners who want to apply lean approaches for improving large-scale software development, especially when it comes to inter-departmental interactions during development. This paper explicitly maps the area, qualifies available research, and identifies gaps, as well as suggests extensions to lean principles relevant for large scale development of software intensive systems.

Improving product lifecycle management implementations by applying 'lean' principles

Manufacturers are facing increased pressure from external forces. This has led to companies competing for shorter development cycles in order to gain market share. Product lifecycle management (PLM), particularly within complex industries such as the aeronautical industry, is a business activity which may leverage stakeholders to achieve business objectives. PLM implementations however are not meeting timescales and budget expectations, therefore the need to improve efficiency and effectiveness in PLM implementations is required and the use of lean principles to do so is a potential way forward. This paper explores the use of lean principles to improve the efficiency and effectiveness of product lifecycle management (PLM) solutions. A lean PLM deployment methodology has been developed as part of this research, based on surveys of current lean PLM practice and the potential for further gains by holistic use of lean principles is outlined. From the research featured in this paper it has been found that the application of lean principles and subsequently its methods and tools, support the improvement of efficiency and effectiveness within PLM implementations.