scholarly journals Efficiency through a Lean Healthcare Implementation in a Public Hospital

2019 ◽  
Author(s):  
Luisa Rosas-Hernandez ◽  
Diego Tlapa ◽  
Yolanda Baez-Lopez ◽  
Jorge Limon-Romero ◽  
Armando Perez-Sanchez
Keyword(s):  
Public Hospital ◽  
Waste Reduction ◽  
Value Stream ◽  
Medical Supplies ◽  
Lean Healthcare ◽  
Measure Analysis ◽  
Healthcare Process ◽  
Increasing Demand ◽  
Value Stream Map

Hospitals face challenges to improve efficiency in order to meet an increasing demand for high quality of care and low costs. Industry-based methods such as lean healthcare (LH) are implemented to improve healthcare systems. This study presents a LH implementation following the DMAIC approach (Define-Measure-Analysis-Improve-Control) in a Mexican public hospital, and contributes to the literature by analyzing the relation of waste reduction and sustainability. We focused on improving the medical supply chain from a temporary warehouse (TW) to the operating room (OR). Therefore, we analyzed the value stream including main surgical procedures and their related medical supplies, and identified different causes of inefficiency, which were evaluated and controlled. As a result, five types of waste were reduced through different tools including: value stream map, Kanban, 5’s, among others. Over-processing requests were reduced 15.3%; similarly, defective identification numbers were reduced up to 46.5%, redundant processing was improved by 94.8%, unnecessary inventories were reduced near to 2.8% of the TW inventory, and transportation waste was reduced up to 16.7%. As a consequence, the lead-time for the main supplies was reduced 33 days. Results indicate that LH and DMAIC are effective to reduce waste and highly conducive to improve healthcare process sustainability.

scholarly journals Waste Reduction in Production Processes through Simulation and VSM

2020 ◽  
Vol 12 (8) ◽  
pp. 3291
Author(s):  
Stefania Bait ◽  
Alessandro Di Pietro ◽  
Massimiliano M. Schiraldi
Keyword(s):  
Environmental Indicators ◽  
Waste Reduction ◽  
Corporate Managers ◽  
Value Stream ◽  
Simulation Process ◽  
Production Processes ◽  
Level Of Details ◽  
Optimal Configurations ◽  
Operational Aspect ◽  
Value Stream Map

Corporate managers often face the need to choose the optimal configurations of production processes to reduce waste. Research has shown that simulation is an effective tool among those conceived to support the manager’s decisions. Nevertheless, the use of simulation at the company level remains limited due to the complexity in the design phase. In this context, the Value Stream Map (VSM)—a tool of the Lean philosophy–is here exploited as a link between the strategic needs of the management and the operational aspect of the simulation process in order to approach sustainability issues. The presented approach is divided into two main parts: a set of criteria for expanding the VSM are identified in order to increase the level of details of the represented processes; then, data categories required for the inputs and outputs of each sub-process modeling are defined, including environmental indicators. Specifically, an extended version of the classical VSM (X-VSM), conceived to support process simulation, is here proposed: the X-VSM is used to guide the design of the simulation so that the management decisions, in terms of waste reduction, can be easily evaluated. The proposal was validated on a production process of a large multinational manufacturing company.

scholarly journals Lean Healthcare Tools for Processes Evaluation: An Integrative Review

2021 ◽  
Vol 18 (14) ◽  
pp. 7389
Author(s):  
Letícia Bianchini de Barros ◽  
Letícia de Camargo Bassi ◽  
Laura Passos Caldas ◽  
Alice Sarantopoulos ◽  
Eliete Boaventura Bargas Zeferino ◽  
...  
Keyword(s):  
Health Services ◽  
Continuous Improvement ◽  
Lean Six Sigma ◽  
Value Stream ◽  
Ishikawa Diagram ◽  
Health Area ◽  
Lean Healthcare ◽  
Lean Tools ◽  
And Control ◽  
Value Stream Map

Several health services have used lean healthcare to seek continuous improvement of their processes. Therefore, it is important to investigate the evidence available in the literature about the most used lean tools in the health area to review processes and the main results achieved by the researchers. As an integrative literature review methodology was used, it was conducted in five databases, using the descriptor “quality improvement” and the keyword “Lean Healthcare”. A total of 33 complete articles were selected for analysis. The most recurrent tools were: define, measure, analyze, improve and control (DMAIC); value stream map (VSM); suppliers, inputs, process, outputs, customers analysis (SIPOC), Ishikawa Diagram and 5S. Through the analysis of waste, different interventions were implemented and the main results achieved were reduction in times (processing, waiting, cycle and total), costs, workload and increase in the number of calls. The findings enabled the identification of the main lean tools used in the health area to achieve better results. In particular, we highlight recent studies that have explored the lean six sigma healthcare approach. The results, in addition to contributing to the literature, will also assist managers in choosing the best tool to achieve continuous improvement in hospitals and other health services.

scholarly journals Improving Emergency Department Through Business Process Redesign

2020 ◽  
Vol 24 ◽  
Author(s):  
Ruben Pereira ◽  
Luís Velez Lapão ◽  
Isaias Scalabrin Bianchi ◽  
Daniel Amaral
Keyword(s):  
Business Process ◽  
Public Hospital ◽  
Business Process Management ◽  
Process Management ◽  
Process Redesign ◽  
Individual Interviews ◽  
Life Cycle Stages ◽  
Increasing Demand

The Emergency Departments (ED) of hospitals are poised for continuous improvement due to increasing demand. The ED are places where the efficiency of the services provided can save lives and therefore it should be seen as an area of maximum interest for process optimisation. This research aims at verifying if the application of Business Process Management (BPM) heuristics positively impacts the length of stay (LoS), without deteriorating the quality of the service provided. The methodology that underlies this research is a case study carried out in the ED of a public hospital. The data was gathered from individual interviews, focus groups, direct observation and document analysis. The BPM life cycle stages were followed. In addition, a simulation tool was used, and heuristics were chosen based on Devil’s Quadrangle theory. Three scenarios of the ED were considered. Additionally, three heuristics and any combination of them were also considered. Results show that heuristics positively impact the time variable without affecting the quality of the service, resulting in value gains for the patient. In terms of time consumption, the average LoS in the process was reduced by 22.5%, 15.9%, and 20.9% for each of the considered scenarios, while the maximum LoS was reduced by 29.2%, 36.2% % and 37.4%. Implications from these results were analysed. The novelty of this research is supported by the absence of studies applying BPM heuristics to ED. This research is a step forward to ally BPM heuristics and ED processes.

Improving performance of the hospitalization process by applying the principles of Lean Thinking

2021 ◽  
Vol 33 (7) ◽  
pp. 253-271
Author(s):  
Antonella Fiorillo ◽  
Alfonso Sorrentino ◽  
Arianna Scala ◽  
Vincenzo Abbate ◽  
Giovanni Dell'aversana Orabona
Keyword(s):  
Patient Management ◽  
Performance Indicator ◽  
Length Of Hospital Stay ◽  
Lean Thinking ◽  
Content Type ◽  
Value Stream ◽  
Ishikawa Diagram ◽  
Lean Tools ◽  
Value Stream Map

PurposeThe goal was to improve the quality of the hospitalization process and the management of patients, allowing the reduction of costs and the minimization of the preoperative Length of Hospital Stay (LOS).Design/methodology/approachThe methodology used to improve the quality of the hospitalization process and patient management was Lean Thinking. Therefore, the Lean tools (Value stream map and Ishikawa diagram) were used to identify waste and inefficiencies, improving the process with the implementation of corrective actions. The data was collected through personal observations, patient interviews, brainstorming and from printed medical records of 151 patients undergoing oral cancer surgery in the period from 2006 to 2018.FindingsThe authors identified, through Value Stream Map, waste and inefficiencies during preoperative activities, consequently influencing preoperative LOS, considered the best performance indicator. The main causes were identified through the Ishikawa diagram, allowing reflection on possible solutions. The main corrective action was the introduction of the pre-hospitalization service. A comparative statistical analysis showed the significance of the solutions implemented. The average preoperative LOS decreased from 4.90 to 3.80 days (−22.40%) with a p-value of 0.001.Originality/valueThe methodology allowed to highlight the improvement of the patient hospitalization process with the introduction of the pre-hospitalization service. Therefore, by adopting the culture of continuous improvement, the flow of hospitalization was redrawn. The benefits of the solutions implemented are addressed to the patient in terms of lower LOS and greater service satisfaction and to the hospital for lower patient management costs and improved process quality. This article will be useful for those who need examples on how to apply Lean tools in healthcare.

Social support and health-related quality of life among type 2 DM (T2DM) patients attending a public hospital in Lagos, Nigeria

2019 ◽  
Author(s):  
Olufolake Olabode ◽  
Timothy Omoluru ◽  
Olawunmi Olagundoye ◽  
Akinyele Akinlade ◽  
Henry Akujobi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Public Hospital ◽  
Health Related Quality ◽  
Type 2 Dm ◽  
Related Quality ◽  
Health Related

scholarly journals Recent trends in smartphone-based detection for biomedical applications: a review

2021 ◽  
Vol 413 (9) ◽  
pp. 2389-2406 ◽  
Author(s):  
Soumyabrata Banik ◽  
Sindhoora Kaniyala Melanthota ◽  
Arbaaz ◽  
Joel Markus Vaz ◽  
Vishak Madhwaraj Kadambalithaya ◽  
...  
Keyword(s):  
Biomedical Applications ◽  
Histopathological Examination ◽  
Dark Field ◽  
Portable Devices ◽  
Food Technology ◽  
Wide Range ◽  
Technological Interventions ◽  
Recent Trends ◽  
Increasing Demand

AbstractSmartphone-based imaging devices (SIDs) have shown to be versatile and have a wide range of biomedical applications. With the increasing demand for high-quality medical services, technological interventions such as portable devices that can be used in remote and resource-less conditions and have an impact on quantity and quality of care. Additionally, smartphone-based devices have shown their application in the field of teleimaging, food technology, education, etc. Depending on the application and imaging capability required, the optical arrangement of the SID varies which enables them to be used in multiple setups like bright-field, fluorescence, dark-field, and multiple arrays with certain changes in their optics and illumination. This comprehensive review discusses the numerous applications and development of SIDs towards histopathological examination, detection of bacteria and viruses, food technology, and routine diagnosis. Smartphone-based devices are complemented with deep learning methods to further increase the efficiency of the devices.

scholarly journals Physicochemical evolution and evaluation of groundwater quality in Mougheul area (Southwest of Algeria)

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Saliha Mebarki ◽  
Benali Kharroubi ◽  
Mohammed Amin Kendouci
Keyword(s):  
Physicochemical Parameters ◽  
Calcium Sulfate ◽  
Major Ions ◽  
Groundwater Resources ◽  
Triangular Diagram ◽  
Wilcox Diagram ◽  
Calcium And Magnesium ◽  
Increasing Demand ◽  
Pressure On Water Resources

AbstractIn arid areas, the pressure on water resources and in particular on groundwater resources is on the rise, mainly due to increasing demand and the deterioration of water quality. In this context, the present work aims to follow the annual evolution, between 2009 and 2019 of the physicochemical parameters, and to evaluate the quality of groundwater of the region of Mougheul, by determining the data of pH, TDS, conductivity and the concentrations of major ions ( Ca+2, Mg+2, Na+, K+, Cl−, HCO3−, SO4−2, NO3−) of 07 water points. The results revealed that all the levels of the physicochemical parameters do not exceed the WHO potability standards, except high values were observed at the level of well W6 which exceeds the limits recommended by the WHO (50 mg /l). The diagram of Schöeller and Berkaloff shows that the groundwater has the bicarbonate magnesium facies. The representation of the data on the Piper triangular diagram shows that W6 has the facies chlorinated and calcium sulfate and magnesium and the other water points have the facies bicarbonate calcium and magnesium. SAR values show that the groundwater of Mougheul is excellent for irrigation. The classification according to the Wilcox diagram shows that the groundwater of Mougheul in general is good quality, but the well of W6 water is suitable for irrigation and requires monitoring the evolution of salinity.

Herbs and phytogenic feed additives in poultry nutrition

2023 ◽  
Vol 77 (11) ◽  
pp. 6589-2023
Author(s):  
HALINA MAKAŁA
Keyword(s):  
Animal Welfare ◽  
Feed Additives ◽  
Poultry Meat ◽  
High Demand ◽  
Rearing Conditions ◽  
Poultry Nutrition ◽  
Increasing Demand ◽  
Herbal Mixtures

The aim of the study was to review the results of scientific research on the effect of herbs and phytogenic feed additives used in poultry nutrition on animal welfare, breeding conditions, and the quality of meat. The article explains the importance of feed additives used in poultry nutrition. It discusses the role of herbs and phytogenic feed additives in nutrition in the context of the increasing demand for and consumption of poultry meat. The article also analyzes the influence of herbs and phytogenic feed additives on animal welfare, rearing conditions, and meat quality. The results of research on the effect of herbs and phytogenic feed additives used in poultry nutrition are not unequivocal. In view of the high demand for poultry meat, there is need for continued research on the optimal composition of herbal mixtures in nutrition to obtain good breeding conditions and high quality meat.

Intravenous fluids

1967 ◽  
Vol 5 (4) ◽  
pp. 13-15
Keyword(s):  
Peritoneal Dialysis ◽  
Hospital Pharmacy ◽  
Commercial Production ◽  
Intravenous Fluids ◽  
Operating Theatres ◽  
Increasing Demand

Many hospitals are currently having difficulties in obtaining adequate supplies of i. v. fluids. Staff shortages and increased demand for special sterile bottled solutions for other purposes, for example in operating theatres, for peritoneal dialysis and for haemodialysis, have compelled many hospital pharmacy departments to reduce their output of i. v. fluids. Commercial production of i.v. fluids has not kept pace with the rapidly increasing demand. The quality of i.v. fluids varies considerably:1 pharmacopoeial standards are often not stringently applied, and some of them need revision.

scholarly journals Penjadwalan Tenaga Kebidanan Menggunakan Algoritma Memetika

2018 ◽  
Vol 8 (1) ◽  
pp. 99
Author(s):  
A. Y. Erwin Dodu ◽  
Deny Wiria Nugraha ◽  
Subkhan Dinda Putra
Keyword(s):  
Genetic Algorithm ◽  
Local Search ◽  
Public Hospital ◽  
Memetic Algorithm ◽  
Optimal Schedule ◽  
Scheduling System ◽  
Local Search Methods ◽  
Evolution Algorithm ◽  
Central Sulawesi

The problem of midwife scheduling is one of the most frequent problems in hospitals. Midwife should be available 24 hours a day for a full week to meet the needs of the patient. Therefore, good or bad midwife scheduling result will have an impact on the quality of care on the patient and the health of the midwife on duty. The midwife scheduling process requires a lot of time, effort and good cooperation between some parties to solve this problem that is often faced by the Regional Public Hospital Undata Palu Central Sulawesi Province. This research aimed to apply Memetics algorithm to make scheduling system of midwifery staff at Regional Public Hospital Undata Palu Central Sulawesi Province that can facilitate the process of midwifery scheduling as well as to produce optimal schedule. The scheduling system created will follow the rules and policies applicable in the hospital and will also pay attention to the midwife's preferences on how to schedule them according to their habits and needs. Memetics algorithm is an optimization algorithm that combines Evolution Algorithm  and Local Search method. Evolution Algorithm in Memetics Algorithm generally refers to Genetic Algorithm so that the characteristics of Memetics Algotihm are identical with  Genetic Algorithm characteristics with the addition of Local Search methods. Local Search in Memetic Algorithm aims to improve the quality of an individual so it is expected to accelerate the time to get a solution.

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