Cited by 50Healthcare Operations and Scheduling OptimizationHealthcare Quality and ManagementQuality and Supply Management

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Using Lean tools to reduce patient waiting time

Lot, Luciana Teixeira, Sarantopoulos, Alice, Min, Li Li, Perales, Simone Reges, Boin, Ilka de Fatima Santana Ferreira, Ataide, Elaine Cristina de·2018·Leadership in Health Services

Abstract

Purpose: This paper aims to address problems in patient flow and identify the reasons behind extensive wait time at a public liver transplant outpatient clinic in an education and research hospital through the use of Lean health-care theories. Design/methodology/approach: This paper opted for the application of Lean thinking and action research strategy. Data were collected through personal observations, interviews with users and team brainstorming. A value stream map was developed, improvement possibilities were identified and non-value-added activities were attempted to be eliminated. Findings: Significant problems were identified and improvements were implemented and measured. The major remedial measures were: change the scheduling pattern, create a flow chart and a Kanban visual guide for medical students. In addition, an institutional change in the medical appointment scheduling software collaborated in the reduction of time and in the patient’s displacement. The waiting time was reduced by 4.5 h, and the per cent complete and accurate increased by 50 per cent. Practical implications: The flow was redesigned, and a culture of continuous improvement was introduced. Visiting the place where work was being done, leaders identified and created more value to the process without significant costs. The Gemba Walk was a powerful tool, interacting with people and processes in a Kaizen spirit. Originality/value: Public health services in developing countries are one of the most deprived social needs of good practice. It will be useful for those who need examples about how to apply Lean tools in health care.

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Crossref · 10.1108/lhs-03-2018-0016

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  • Interventions included development and standardization of documents.

    “development and standardization of documents [29,50,51,52,53]”
  • Brazilian authors have also published in international journals, which shows that the results achieved in Brazil have supported research around the world.

    “These Brazilian authors have also published in international journals, which shows that the results achieved in Brazil have supported research around the world [21,29,30,31].”
  • Some authors used more than one design to characterize the study design variable.

    “some authors used more than one design to characterize this variable [29,35,36].”

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References 20 · Cited by 50

Research works printed but not linked: 20

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Metadata

Authors
Lot, L. T., Sarantopoulos, A., Min, L. L., Perales, S. R., Boin, I. D. F. S. F., & Ataide, E. C. D.
Affiliations
Universidade Estadual de Campinas (UNICAMP) (BR)
Venue
Leadership in Health Services
Publisher
Emerald
Published
2018-06-08
Volume
31
Issue
3
Pages
343-351
ISSN
  • 1366-0756 (ISSN-L)
  • 1751-1879
OpenAlex
W2806003162
Cited by
50
References
20
Citations by year
2026: 3 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 8 · 2021: 14 · 2020: 7 · 2019: 6
FWCI
10.32
Type
journal article
Language
en
Open access
closed
Locations
  • Leadership in health services (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Healthcare Operations and Scheduling Optimization
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
  • Social Sciences › Business, Management and Accounting › Management Information Systems › Quality and Supply Management
Keywords
lean healthcare, patient waiting time, patient flow, value stream mapping, non-value-added activities, appointment scheduling, Kanban, Gemba walk, Kaizen, continuous improvement, public health services, medical students
MeSH terms
Ambulatory Care Facilities, Appointments and Schedules, Brazil, Health Services Research, Humans, Software, Time Factors, Waiting Lists, Liver Transplantation, Efficiency, Organizational, Quality Improvement

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