Lean Healthcare: Improving Surgical Process Indicators Through Prioritization Projects

Purpose: Implementing process management methodology through Lean Management and Design Thinking provides a new way to manage surgical blocks, maximize efficiency and adapt to the high variability of demand. This article presents our experience of implementing a set of improvement actions within the surgical process in the context of Lean Healthcare Processes. The project involved a total of 900 healthcare professionals over a 3-year period (2017-2019) and has impacted over 38,000 surgical patients each year at the Vall d'Hebron University Hospital in Barcelona, Spain.The purpose of this article is to present a set of improvement projects within the surgical process and show the indicators that monitor its evolution. These projects have been implemented successfully in a hospital with high surgical complexity and indicate how health care professionals and process engineers can work together as a team to improve healthcare resources. Design/methodology/approach: To evaluate the effectiveness of the actions presented, we propose a series of standardized indicators showing how our findings increase the efficiency of the surgical process. We also indicate Lean projects that can reduce patient waiting times and increase capacity. Below is a management model for the surgical process that considers industrial production criteria such as resource planning, optimizing the use of operating rooms and professionals' time and generating the best surgery combinations.Findings: Projects that have increased efficiency in the surgical block the most have been standardized and converted into a model of action. This is designed to adapt to any level of complexity within the hospital process. The set of improvement projects has been divided into 6 stages: Programming, Material logistics process, pre-surgical stage, intra-surgical stage, post-surgical stage and transversal projects; each affecting a different area of the general hospital (not only the surgical unit). Furthermore, a visual flow chart was designed using the results of the project. Findings from the study have led to a 15% increase in surgical capacity without the need for new resources. The average hospital stay also dropped from 7.2 days to 4.1 days. The flow vision in the care process improves the experience of both patients and health care professionals, who see their participation as part of the whole health care process.Research limitations/implications: the projects were mainly developed at the Vall d'Hebron University Hospital. Although several of these projects have been carried out in other hospitals in Spain by the same team of process engineers, results may be biased when the team provides support within its own process department, compared to when it supports the local team in another hospital temporarily.

Automated summary

Implementing process management methodology through Lean Management and Design Thinking in surgical blocks has proven successful in improving efficiency and adapting to demand variability. This article shares the implementation experience and indicators that monitor the evolution of improvement projects within the surgical process. The projects have positively impacted a high-complexity hospital and demonstrate collaboration between healthcare professionals and process engineers.