Implementation of lean production in hospital operations: case of the oncology Institute Doutor Arnaldo Vieira de Carvalho
DOI:
https://doi.org/10.14488/1676-1901.v18i2.2873Keywords:
Lean Production. Service Operations. Hospital Operations.Abstract
This article aims to analyze the implementation of lean production in the flow of the chemotherapeutic and radiotherapeutic patient, as well as to propose guidelines for the development of lean culture in a hospital operation. The study was classified as qualitative, applied and exploratory, and was performed through a case study in a hospital in the state of São Paulo. The description of the case explains how the process of implementation of lean healthcare in the hospital occurred, evidencing the method and techniques applied. Based on the literature and the case study, it was possible to propose 12 guidelines for the implementation of lean production in hospital operations, which serve as a subsidy to hospital operations that wish to implement lean healthcare by developing improvements in quality and productivity.
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ALLWAY, M.; CORBETT, S. Shifting to lean service: stealing a page from manufacturers playbooks. Journal of Organizational Excellence, v.21, n. 2, p. 45-54, 2002. DOI: 10.1002/npr.10019
ARAÚJO, C. A. S. Fatores a serem gerenciados para o alcance da qualidade para os clientes internos: um estudo em um conjunto de hospitais brasileiros. 2005. 414 f. Tese (Pós-Graduação de Administração) - Universidade Federal do Rio de Janeiro, Rio de Janeiro, 2005.
ARONSSON, H.; ABRAHAMSSON, M.; SPENS, K. Developing lean and agile health care supply chains. Supply Chain Management: an International Journal, v. 16, n. 3, p.176-183, 2011. DOI: 10.1108/13598541111127164
BARLOW, G. L. Just-in-time: implementation within the hotel industry: a case study. International Journal of Production Economics, v. 80, n. 2, p. 155-167, 2002. DOI:doi.org/10.1016/S0925-5273(02)00315-8
BATAGLIA, F. Lean é sinônimo de facilidade em hospitais. Disponível em: <http://www.lean.org.br>. Acesso em: 12 abr. 2013.
BERTANI, T.M. Lean healthcare: recomendações para implantações dos conceitos de produção enxuta em ambientes hospitalares. 2012. 166f. Dissertação (Pós-graduação em Engenharia de Produção)- Escola de Engenharia de São Carlos da Universidade de São Paulo. São Carlos, 2012.
BURGESS, N.; RADNOR, Z. Evaluating lean in healthcare. International Journal of Health Care, Quality Assurance, v. 26, n. 3, p. 220-235, 2013.
BUSHELL, S.; SHELEST, B. Discovering lean thinking at progressive healthcare. The Journal for Quality and Participation, v. 25, n. 2, p. 20-5, 2002. DOI: 10.1108/09526861311311418
CARTER, P. M. et al. Optimizing clinical operations as part of a global emergency medicine initiative in Kumasi, Ghana: application of lean manufacturing principals to low-resource health systems. Academic Emergency Medicine, v. 19, n. 3, p. 338-347, 2012.
DOI: 10.1111/j.1553-2712.2012.01311.x
CAVALLINI, M. E.; BISSON, M. P. Farmácia hospitalar: Um enfoque em sistemas de saúde. 2. ed. Barueri: Manole, 2010.
CLARK, D. M.; SILVESTER, K.; KNOWLES, S. Lean management systems: creating a culture of continuous quality improvement. Journal of Clinical Pathology, v. 66, n. 8, p. 638-643, 2013. DOI: 10.1136/jclinpath-2013-201553
DICKSON, E. W. et al. Use of lean in the emergency department: a case series of 4 hospitals. Annals of Emergency Medicine, v. 54, n. 4, p. 504-510, 2009. DOI: 10.1016/j.annemergmed.2009.03.024
FEINSTEIN, K. W.; GRUNDEN, N.; HARRISON, E. I. A region addresses patient safety. American Journal of Infection Control, v. 30, n. 4, p. 248-51, 2002. DOI: http://dx.doi.org/10.1067/mic.2002.122645
GRABAN, M. Hospitais Lean: melhorando a qualidade, a segurança dos pacientes e o envolvimento dos funcionários. Porto Alegre: Bookman, 2013.
GODINHO FILHO, M. Paradigmas estratégicos de gestão da manufatura configuração, relações com o planejamento e controle da produção e estudo exploratório na indústria de calçados. 2004. 286 f. Tese (Doutorado em Engenharia de Produção) - Universidade Federal de São Carlos, São Paulo, 2004.
HOPP. W. J.; LOVEJOY W. S. Hospital operations: principles of high efficiency health care. Upper Saddle River, NJ: Pearson FT Press, 2013.
JIMMERSON, C. Value stream mapping for healthcare made easy. New York: Productivity Press, 2010.
KOLLBERG, B.; DAHLGAARD, J. J.; BREHMER, P. O. Measuring lean initiatives in health care services: issues and findings. International Journal of Productivity and Performance Management, v. 56, n. 1, p.7-24, 2007. DOI:http://dx.doi.org/10.1108/17410400710717064
LA FORGIA, G. M.; COUTTOLENC, B. F. Desempenho hospitalar no brasil: em busca da Excelência. São Paulo: Singular, 2009.
LAGANGA, L. R. Lean service operations: reflections and new directions for capacity expansion in outpatient clinics. Journal of Operations Management, v. 29, n. 5, p. 422-433, 2011. DOI: 10.1016/j.jom.2010.12.005
LIKER, J. K. O modelo toyota: 14 princípios de gestão do maior fabricante do mundo. Porto Alegre: Bookman, 2008.
LIKER, J. K.; MORGAN, J. M. The Toyota way in services: the case of lean product development. Academy of Management Perspectives, v. 2, n. 20, p. 6-20, 2006. DOI: 10.5465/AMP.2006.20591002
LUONGO, J. Gestão de qualidade em saúde. São Paulo: Rideel, 2011.
MALAGÓN-LODOÑO, G.; MORERA, R. G.; LAVERDE, G. P. Administração hospitalar. 2.ed. São Paulo: Guanabara Koogan, 2000.
PAPADOPOULOS, T.; RADNOR, Z.; MERALI, Y. The role of actor associations in understanding the implementation of lean thinking in healthcare. International Journal of Operations & Production Management, v. 31, n. 1-2, p. 167-191, 2011.
DOI: 10.1108/01443571111104755
PHENG, L. S.; ARAIN, F. M.; FANG, J. W. Y. Applying just-in-time principles in the delivery and management of airport terminal buildings. Built Environment Project and Asset Management, v. 1, n. 1, p. 104-121, 2011. DOI:http://dx.doi.org/10.1108/20441241111143812
PIERCY, N.; RICH, N. Lean transformation in the pure service environment: the case of the call service centre. International Journal of Operations & Production Management, v. 29, n. 1, p. 54-76, 2009. DOI: 10.1108/01443570910925361
RADNOR, Z. J.; HOLWEG, M.; WARING, J. Lean in healthcare: the unfilled promise? Social Science & Medicine, v. 74, n. 3, p. 364-371, 2012. DOI:10.1016/j.socscimed.2011.02.011
SHINGO, S. O Sistema Toyota de Produção do ponto de vista da engenharia de produção. Porto Alegre: Bookman, 1996.
SILVA, E. L.; MENEZES, E. M. Metodologia da pesquisa e elaboração de dissertação. Florianópolis: UFSC, 2005.
SOLIMAN, M. S.; SAURIN, T. A. Uma análise das barreiras e dificuldades em lean healthcare. Produção online, v. 17, n. 2, p. 620-640, 2017.
DOI: http://dx.doi.org/10.14488/1676-1901.v17i2.2605
SOUZA, L. B. Trends and approaches in lean healthcare. Leadership in Health Services, v. 22, n. 2, p. 121-139, 2009. DOI:http://dx.doi.org/10.1108/17511870910953788
SOUZA, V. H. S.; MOZACHI, N. O hospital: manual do ambiente hospitalar. 3. ed. Curitiba: Manual Real, 2009.
SULLIVAN, P. et al. Using lean methodology to improve productivity in a hospital oncology pharmacy. American Journal of Health-System, v.71, n.17, p. 1491-1498, 2014. DOI: 10.2146/ajhp130436
TEICHGRÄBER, U. K.; BUCOURT, M. Applying value stream mapping techniques to eliminate non-value-added waste for the procurement of endovascular stents. European Journal of Radiology, v. 81, n. 1, p. 47-52, 2012. DOI: 10.1016/j.ejrad.2010.12.045
WARING, J. J.; BISHOP, S. Lean healthcare: rhetoric, ritual and resistance. Social Science & Medicine, v. 71, n. 7, p. 1332-1340, 2010. DOI: 10.1016/j.socscimed.2010.06.028
WOMACK, J. P. et al. Going lean in health care. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement, 2005. Disponível em: <http://www.ihi.org>. Acesso em:23 abril 2013.
YASIN, M. M.; WAFA, M. A.; SMALL, M. H. Just-in-time implementation in the public sector. International Journal of Operations & Production Management, v. 21, n. 9, p. 1195-1204, 2001.
DOI:http://dx.doi.org.ez15.periodicos.capes.gov.br/10.1108/EUM0000000005925
YEH, H. et al. Applying lean six sigma to improve healthcare: an empirical study. African Journal of Business Management, v. 5, n. 31, p. 12356-12370, 2011. DOI:http://dx.doi.org.ez15.periodicos.capes.gov.br/10.1108/EUM0000000005925
YIN, R. Estudo de caso: planejamento e método. Porto Alegre: Bookman, 2005.
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