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Managing inpatient bed setup: an action-research approach using lean technical practices and lean social practices

精益制造 背景(考古学) 价值流映射 改善 过程管理 授权 运营管理 公立医院 劳动力 业务 计算机科学 医学 护理部 工程类 生物 经济增长 古生物学 经济 法学 政治学
作者
Luciana Paula Reis,June Marques Fernandes,Sérgio Evangelista Silva,Carlos Augusto de Carvalho Andreosi
出处
期刊:Journal of Health Organisation and Management [Emerald (MCB UP)]
卷期号:37 (2): 213-235 被引量:3
标识
DOI:10.1108/jhom-09-2021-0365
摘要

This article aims to introduce a guide to improving hospital bed setup by combining lean technical practices (LTPs), such as kaizen and value stream mapping (VSM) and lean social practices (LSPs), such as employee empowerment.Action research approach was employed to analyze the process of reconfiguration of bed setup management in a Brazilian public hospital.The study introduces three contributions: (1) presents the use of VSM focused specifically on bed setup, while the current literature presents studies mainly focused on patient flow management, (2) combines the use of LSPs and LTPs in the context of bed management, expanding current studies that are focused either on mathematical models or on social and human aspects of work, (3) introduces a practical guide based on six steps that combine LSPs and LSPs to improve bed setup management.The research focused on the analysis of patient beds. Surgical beds, delivery, emergency care and intensive care unit (ICU) were not considered in this study. In addition, the process indicators analyzed after the implementation of the improvements did not contemplate the moment of the COVID-19 pandemic. Finally, this research focused on the implementation of the improvement in the context of only one Brazilian public hospital.The combined use of LSPs and LTPs can generate considerable gains in bed setup efficiency and consequently increase the capacity of a hospital to admit new patients, without the ampliation of the physical space and workforce.The improvement of bed setup has an important social character, whereas it can generate important social benefits such as the improvement of the admission service to patients, reducing the waiting time, reducing hospitalization costs and improving the hospital capacity without additional physical resources. All these results are crucial for populations, their countries and regions.While the current literature on bed management is more focused on formal models or pure human and social perspectives, this article brings these two perspectives together in a single, holistic framework. As a result, this article points out that the complex bed management problem can be efficiently solved by combining LSPs and LTPs to present theoretical and practical contributions to the important social problem of hospital bed management.
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