Evaluation of the application of continuous improvement based on the Kaizen concept in Emergency Healthcare Units

Ana Carolina Zeferino, Gabriel Nascimento Santos, Thais Lessa Queiroz, José Ricardo Souza Ramos

Resumo


The Brazilian Ministry of Health and the Fluminense Federal University promoted Kaizen in lean thinking implementation projects in 24-hour Emergency Care Units. This research aimed to evaluate the application of Kaizen in both projects looking for patterns, providing valuable information for the design and improvement of future projects. Both projects focused their Kaizen efforts on improving the environment and standardization, with a focus on the use of 5S. The literature shows a more comprehensive approach, making use of Kaizen also to solve recurring problems using methods of analysis and problem solving. For future projects, there should be considered to use 5S within the initial steps for the entire units and to start promoting problem solving Kaizen.


Texto completo:

PDF (English)

Referências


ALBERT Einstein uses Lean Six Sigma to increase quality and satisfaction. Portal Saúde Business, [S. l.], 2012. Available in: https://www.saudebusiness.com/gesto/albert-einstein-utiliza-lean-six-sigma-para-aumentar-qualidade-e-satisfao. Access in: 10 feb. 2023.

BEATTIE, M.; HOOKWAY, G.; PERERA, M.; CALDER, S.; HUNTER-HOWE, C.; WOERDEN, H. van. Improving wait time from referral to opiate replacement therapy in a drug recovery service. BMJ Open Quality, London, v. 7, n. 3, p. 1-7, 2018. DOI: 10.1136/bmjoq-2017-000295. Available in: https://bmjopenquality.bmj.com/content/7/3/e000295.info. Access in: 15 feb. 2023.

BLOUIN-DELISLE, C. H.; DROLET, R.; HAINS, M.; TAILLEUR, L.; ALLAIRE, N.; COULOMBE, M.; VÉZO, A. Improving interprofessional approach using a collaborative lean methodology in two geriatric care units for a better patient flow. Journal of Interprofessional Education and Practice, Omaha, v. 19, 2020. DOI: https://doi.org/10.1016/j.xjep.2020.100332. Available in: https://www.sciencedirect.com/science/article/abs/pii/S240545262030015X. Access in: 21 feb. 2023.

BORGES, G. V.; SANTOS, A. B.; TORRES, L. F.; SILVA, M. B.; SANTOS, G. N.; CALADO, R. D. The benefits of deploying the toyota kata. In: DOLGUI, A.; BERNARD, A.; LEMOINE, D.; CIEMINSKI, G. von; ROMERO, D. (ed.). Advances in production management systems: artificial intelligence for sustainable and resilient production systems: part II. Nantes: Springer International Publishing, 2021. p. 323-332. Available in: https://link.springer.com/chapter/10.1007/978-3-030-85902-2_35. Access in: 5 feb. 2023.

CARNEY, K. P.; CRESPIN, A.; WOERLY, G.; BRETHOUWER, N.; BAUCUM, J.; DISTEFANO, M. C. A front-end redesign with implementation of a novel “intake” system to improve patient flow in a pediatric emergency department. Pediatric Quality & Safety, London, v. 5, n. 2, p. 1-8, 2020. DOI: 10.1097/pq9.0000000000000263. Available in: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190261/. Access in: 21 feb. 2023.

CHAVES, S. M. A. et al. Fast-Track 24-Hour UPA: Analysis of opportunities and continuous improvements through IRAMUTEQ. IFAC-PapersOnLine, [S. l.], v. 55, n. 10, p. 221-226, 2022.

DE AMARAL, L. C.; CALADO, R. D.; VIEIRA, L. W. H.; CHAVES, S. M. DO A. Lean Healthcare in Reducing HAI an Integrative Literature Review. In: DOLGUI, A.; BERNARD, A.; LEMOINE, D.; CIEMINSKI, G. von; ROMERO, D. (ed.). Advances in production management systems: artificial intelligence for sustainable and resilient production systems: part II. Nantes: Springer International Publishing, 2021. p. 351-361. Available in: https://link.springer.com/chapter/10.1007/978-3-030-85902-2_38. Access in: 8 mar. 2023.

ELSHEIKH, A. M.; EMAM, M. S.; ALSHAREEF, S. A. Bridging the gap between documents and practice in medication management “documents vitalization”. Business Process Management Journal, Bingley, v. 23, n. 4, p. 830-841, 2017. DOI: https://doi.org/10.1108/BPMJ-02-2017-0030. Available in: https://www.emerald.com/insight/content/doi/10.1108/BPMJ-02-2017-0030/full/html. Access in: 8 mar. 2023.

FERREIRA, D. M. C.; SAURIN, T. A. A complexity theory perspective of kaizen: a study in healthcare. Production Planning and Control, Oxfordshire, v. 30, n. 16, p. 1337-1353, 2019. DOI: https://doi.org/10.1080/09537287.2019.1615649. Available in: https://www.tandfonline.com/doi/abs/10.1080/09537287.2019.1615649. Access in: 10 mar. 2023.

FILLINGHAM, D. Can lean save lives?. Leadership in Health Services, [S. l.], v. 20, n. 4, p. 231-241, 2007. DOI: 10.1108/17511870710829346. Available in: https://pubmed.ncbi.nlm.nih.gov/20698096/. Access in: 18 jan. 2023

FITZPATRICK, J. L.; SANDERS, J. R.; WORTHEN, B. R. Program evaluation: alternative approaches and practical guidelines. 4. ed. Boston: Pearson, 2011.

HITTI, E. A.; EL-EID, G. R.; TAMIN, H.; SALEH, R.; SALIBA, M.; NAFFA, L. Improving emergency department radiology transportation time: a successful implementation of lean methodology. BMC Health Services Research, New York, v. 17, n. 1, 2017. DOI: 10.1186/s12913-017-2488-5. Available in: https://pubmed.ncbi.nlm.nih.gov/28870249/. Access in: 15 jan. 2023

IMAI, M. Kaizen: the key to Japan’s competitive success. New York: McGraw-Hill Education, 1986.

KELENDAR, H.; FAISAL, M.; MCINTOSH, B.; MOHAMMED, M. A. The use of lean methodology in healthcare settings in developing countries: a narrative review. British Journal of Health Care Management, London, v. 26, n. 6, 2020. DOI: https://doi.org/10.12968/bjhc.2019.0095. Available in: https://www.magonlinelibrary.com/doi/abs/10.12968/bjhc.2019.0095. Access in: 21 jan. 2023.

KNECHTGES, P.; DECKER, M. C. Application of kaizen methodology to foster departmental engagement in quality improvement. Journal of the American College of Radiology, Reston, v. 11, n. 12, p. 1126-1130, 2014. DOI: 10.1016/j.jacr.2014.08.027. Available in: https://pubmed.ncbi.nlm.nih.gov/25444067/. Access in: 26 jan. 2023.

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, Bingley, v. 56, n. 1, p. 7-24, 2006. DOI: https://doi.org/10.1108/17410400710717064. Available in: https://www.emerald.com/insight/content/doi/10.1108/17410400710717064/full/html. Access in: 7 mar. 2023

KOVACEVIC, M.; JOVICIC, M.; DJAPAN, M.; ZIVANOVIZ-MAKUZIC, I. Lean thinking in healthcare: review of implementation results. International Journal for Quality Research, Kragujevac, v. 10, n. 1, p. 219-230, 2016. DOI: 10.18421/IJQR10.01-12. Available in: https://www.proquest.com/openview/0c5b0e73af74c7cf9100633d995b0921/1?pq-origsite=gscholar&cbl=5154742. Access in: 15 feb. 2023.

LAMM, M. H.; ECKEL, S.; AMERINE, L. B. Using lean principles to improve outpatient adult infusion clinic chemotherapy preparation turnaround times. American Journal of Health-System Pharmacy, Kettering, v. 72, n. 13, p. 1138-1146, 2015. DOI: https://doi.org/10.2146/ajhp140453. Available in: https://academic.oup.com/ajhp/article-abstract/72/13/1138/5111393?redirectedFrom=fulltext. Access in: 18 feb. 2023.

LEAN-DRIVEN improvements slash wait times, drive up patient satisfaction scores. ED Management, Morrisville, v. 24, n. 7, p. 79-81, 2012. Available in: https://pubmed.ncbi.nlm.nih.gov/22838052/. Access in: 11 jan. 2023.

LEAN NAS EMERGÊNCIAS. São Paulo: Lean nas Emergências, 2018. Available in: https://www.leannasemergencias.com.br. Access in: 25 jan. 2023.

LODGE, A.; BAMFORD, D. New development: using lean techniques to reduce radiology waiting times. Public Money and Management, London, v. 28, n. 1, p. 49-52, 2008. DOI: 10.1111/j.1467-9302.2008.00618.x. Available in: https://www.tandfonline.com/doi/citedby/10.1111/j.1467-9302.2008.00618.x?scroll=top&needAccess=true&role=tab. Access in: 25 feb. 2023

LORDELO, S. A. V.; NOGUEIRA, S. M. S.; FARIAS FILHO, J. R. de; COSTA, H. G.; BARBOSA, C. L.; CALADO, R. D. Kaizen and healthcare: a bibliometric analysis. In: DOLGUI, A.; BERNARD, A.; LEMOINE, D.; CIEMINSKI, G. von; ROMERO, D. (ed.). Advances in production management systems: artificial intelligence for sustainable and resilient production systems: part II. Nantes: Springer International Publishing, 2021. p. 314-322. Available in: https://link.springer.com/chapter/10.1007/978-3-030-85902-2_34. Access in: 10 mar. 2023.

MANOS, A.; SATTLER, M.; ALUKAL, G. Make healthcare lean. Quality Progress, Milwaukee, v. 39, n. 7, p. 24-30, 2006. Available in: http://faculty.mercer.edu/burtner_j/documents/qpmanosmakehealthcarelean.pdf. Access in: 15 feb. 2023.

MAZZOCATO, P.; STENFORS-HAYES, T.; THIELE SCHWARZ, U. von; HASSON, H.; NYSTROM, M. E. Kaizen practice in healthcare: a qualitative analysis of hospital employees’ suggestions for improvement. BMJ OPEN, London, v. 6, n. 7, 2016. DOI: 10.1136/bmjopen-2016-012256. Available in: https://pubmed.ncbi.nlm.nih.gov/27473953/. Access in: 11 feb. 2023.

MEDINA-LEÓN, S. V.; MEDINA-PALOMERA, A.; GONZALEZ-ANGELES, A.; ROGERS, P.; GIL-SAMANIEGO-RAMOS, M.; CEBALLOS-CORRAL, J.; NUNO-MORENO, V. Framework for patient flow improvement. Research Journal of Applied Sciences, Engineering and Technology, New York, v. 8, n. 3, p. 410-422, 2014. DOI: http://dx.doi.org/10.19026/rjaset.8.987. Available in: https://maxwellsci.com/jp/mspabstract.php?doi=rjaset.8.987. Access in: 15 jan. 2023.

MOUSAVI ISFAHANI, H.; TOURANI, S.; SEYEDIN, H. Features and results of conducted studies using a lean management approach in emergency department in hospital: a systematic review. Bulletin of Emergency and Trauma, Shiraz, v. 7, n. 1, p. 9-20, 2019. DOI: 10.29252/beat-070102. Available in: https://pubmed.ncbi.nlm.nih.gov/30719461/. Access in: 25 jan. 2023.

PHILLIPS, J.; HEBISH, L. J.; MANN, S.; CHING, J. M.; BLACKMORE, C. C. Engaging frontline leaders and staff in real-time improvement. Joint Commission Journal on Quality and Patient Safety, Oxford, v. 42, n. 4, p. 170-178, 2016. DOI: 10.1016/s1553-7250(16)42021-0. Available in: https://pubmed.ncbi.nlm.nih.gov/27025577/. Access in: 8 feb. 2023.

PINTO, C. F.; COELHO, S. M.; CALADO, R. D.; SILVA, M. B. Access improvement using lean healthcare for radiation treatment in a public hospital. IFAC Proceedings Volumes, [S. l.], v. 46, n. 24, p. 247–253, 2013. DOI: https://doi.org/10.3182/20130911-3-BR-3021.00048. Available in: https://www.sciencedirect.com/science/article/pii/S1474667016321966?via%3Dihub. Access in: 5 feb. 2023.

REIS, M. E. D. M. dos; ABREU, M. F. de; BRAGA NETO, O. de O.; VIERA, L. E. V.; TORRES, L. F.; CALADO, R. D. DMAIC in improving patient care processes: replication and lessons learned in context of healthcare. IFAC PapersOnLine, Laxenburg, v. 55, n. 10, p. 549-554, 2022. DOI: https://doi.org/10.1016/j.ifacol.2022.09.451. Available in: https://www.sciencedirect.com/science/article/pii/S2405896322017414. Access in: 8 feb. 2023.

REIS, M.; VIERA, L.; AMARAL, L.; FARIAS FILHO, J.; TEIXEIRA, A.; CALADO, R. D. Motivators to application of DMAIC in patient care processes. In: DOLGUI, A.; BERNARD, A.; LEMOINE, D.; CIEMINSKI, G. von; ROMERO, D. (ed.). Advances in production management systems: artificial intelligence for sustainable and resilient production systems: part II. Nantes: Springer International Publishing, 2021. p. 269-279. Available in: https://link.springer.com/chapter/10.1007/978-3-030-85902-2_29#:~:text=The%20main%20motivators%20for%20the,in%20user%20and%20team%20satisfaction. Access in: 3 mar. 2023.

SANTOS, A. B.; CALADO, R. D.; ORLANDO FILHO, O.; BOURGUIGNON, S. C. Application of the enterprise diagnosis method in healthcare: an evaluation study in three emergency care units in the state of São Paulo - Brazil. Revista Meta: Avaliação, Rio de Janeiro, v. 13, n. 41, p. 884-900, out./dez. 2021. DOI: https://doi.org/10.22347/2175-2753v13i41.3755. Available in: https://revistas.cesgranrio.org.br/index.php/metaavaliacao/article/view/3755. Access in: 3 mar. 2023.

SPEAR, S.; BOWEN, H. K. Decoding the DNA of the Toyota production system. Harvard Business Review, Boston, v. 77, n. 5, p. 96-106, 1999. Available in: https://hbr.org/1999/09/decoding-the-dna-of-the-toyota-production-system. Access in: 3 mar. 2023.

SUAREZ-BARRAZA, M. F.; MIGUEL-DAVILA, J. A. Kaizen-Kata, a problem-solving approach to public service health care in Mexico: a multiple-case study. International Journal of Environmental Research and Public Health, Basel, v. 17, n. 9, 2020. DOI: https://doi.org/10.3390/ijerph17093297. Available in: https://www.mdpi.com/1660-4601/17/9/3297. Access in: 8 mar. 2023.

WOMACK, J. P.; JONES, D. T. Lean thinking: banish waste and create wealth in your corporation. Journal of the Operational Research Society, London, v. 48, n. 11, p.1148-1150, 1997. DOI:10.1038/sj.jors.2600967. Available in: https://www.tandfonline.com/toc/tjor20/48/11?nav=tocList. Access in: 5 feb. 2023.




DOI: http://dx.doi.org/10.22347/2175-2753v0i0.3806

Bookmark and Share


Direitos autorais 2023 Fundação Cesgranrio

Licença Creative Commons
Este obra está licenciado com uma Licença Creative Commons Atribuição-NãoComercial 4.0 Internacional.

Principios Norteadores para o Avaliador

Guiding Principles for Evaluators American Evaluation Association (AEA)

Com o proposito de guiar o trabalho dos profissionais de avaliação e assegurar a etica de sua atuacao, a American Evaluation Association (AEA) - Associacao Profissional de Avaliadores - estabeleceu cinco principios norteadores aqui resumidos:

1.  Indagacao Sistematica, no que se refere à capacidade de coletar dados utilizando tecnicas apropriadas e comunicando metodos e abordagens com a devida transparencia para permitir acesso e critica.

2.  Competencia, no que se refere a demonstrar atuacao competente perante os envolvidos no processo avaliativo e desenvolver continuamente sua capacidade para alcancar o mais alto nivel de desempenho possivel.

3.  Integridade/Honestidade, no que se refere a assegurar honestidade e integridade ao longo de todo o processo avaliativo, negociando com os envolvidos e interessados na avaliação e buscando esclarecer e orientar procedimentos que venham provocar distorcoes ou indevidas utilizacoes.

4.  Respeito pelas pessoas, no que se refere ao respeito pela seguranca, dignidade e auto-valorizacao dos envolvidos no processo avaliativo, atuando sempre com etica profissional, evitando riscos e prejuizos que possam afetar os participantes para assegurar, o melhor possivel, o respeito às diferencas e o direito social de retorno dos resultados, aos envolvidos.

5.  Responsabilidade pelo bem estar geral e público, no que se refere a levar em consideracao a diversidade de interesses e valores que possam estar relacionados ao público em geral,buscando responder nao somente às expectativas mais imediatas, mas tambem às implicacoes e repercussoes mais amplas e, nesse sentido, disseminar a informacao sempre que necessario.

Indexado em:

  1. Miguilim - Diretório das revistas científicas eletrônicas brasileiras

  2. DOAJ - Directory of Open Access Journals

  3. EBSCO - Information Services

  4. Edubase

  5. Google Scholar

  6. Latindex - Sistema regional de información en línea para revistas científicas de América Latina, el Caribe, España y Portugal

  7. LivRe! - Portal do CNEN - Comissão Nacional de Energia Nuclear do Ministério de Ciência, Tecnologia e Inovação

  8. OEI - Organizacion de Estados Iberoamericanos (Madri, Espanha, CREDI)

  9. RCAAP - Repositorio Cientifico de Acesso Aberto de Portugal

  10. REDIB - Red Iberoamericana de Innovación y Conocimiento Científico

  11. Scopus - A maior base de dados de abstracts e citacao de literatura revisada por pares:periodicos cientificos, livros e anais

 

Scimago

SJR : Scientific Journal Rankings

SCImago Journal & Country Rank
  
  

Meta: Aval., Rio de Janeiro, ISSN 2175-2753.