Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

Carlos Zepeda-Lugo, Diego Tlapa, Yolanda Baez-Lopez, Jorge Limon-Romero, Sinue Ontiveros, Armando Perez-Sanchez and Guilherme Tortorella
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Carlos Zepeda-Lugo: Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico
Diego Tlapa: Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico
Yolanda Baez-Lopez: Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico
Jorge Limon-Romero: Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autónoma de Baja California, Ensenada 22860, Mexico
Sinue Ontiveros: Facultad de Ciencias de la Ingeniería, Administrativas y Sociales, Universidad Autónoma de Baja California, Tecate 21460, Mexico
Armando Perez-Sanchez: Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Tijuana 22260, Mexico
Guilherme Tortorella: Department of Systems and Production Engineering, Universidade Federal de Santa Catarina, Florianópolis 88040, Brazil

IJERPH, 2020, vol. 17, issue 15, 1-24

Abstract: Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review is to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve. The review was performed according to PRISMA. We used six databases to search for studies published from 2002 to 2019. Out of 5732 studies, 39 measuring one or more defined outcomes were included. Hospital length of stay (LOS) was measured in 23 studies, 16 of which reported a reduction, turnover time (TOT) decreased in six out of eight studies, while the turnaround time (TAT) and on-time starts (OTS) improved in all five and seven studies, respectively. Moreover, eight out of nine studies reported an earlier discharge time, and the boarding time decreased in all four cases. Meanwhile, the readmission rate did not increase in all nine studies. Lastly, staff and patient satisfaction improved in all eight studies. Our findings show that by focusing on reducing non-value-added activities, LH contributed to improving patient flow and efficiency within inpatient care.

Keywords: inpatient care; lean healthcare; efficiency; patient flow; systematic review; length of stay; turnaround time; turnover time; on-time starts; boarding time; readmission rate; discharge time (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (8)

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