Lean in healthcare: A comprehensive review

•We aim to provide a comprehensive review of Lean in healthcare.•Lean is an improvement approach increasingly applied in healthcare.•Notwithstanding the growing body of knowledge some issues remain underexplored.•Evaluation of more “system wide approach” in its implementation is needed. Lean seems t...

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Veröffentlicht in:	Health policy (Amsterdam) Jg. 119; H. 9; S. 1197 - 1209
Hauptverfasser:	D’Andreamatteo, Antonio, Ianni, Luca, Lega, Federico, Sargiacomo, Massimo
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Ireland Elsevier Ireland Ltd 01.09.2015
Schlagworte:	Continuous quality improvement Delivery of Health Care - organization & administration Delivery of Health Care - standards Health policy Healthcare Hospitals Humans Internal Medicine Investments Lean Lean Six Sigma Lean thinking Measurement Operational excellence Organizational Innovation Productivity Quality Improvement - organization & administration Quality of Health Care - organization & administration Review Revolution Success Surgery United States Lean Operational excellence Continuous quality improvement Lean thinking Healthcare Review Lean Six Sigma
ISSN:	0168-8510, 1872-6054
Online-Zugang:	Volltext
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Abstract	•We aim to provide a comprehensive review of Lean in healthcare.•Lean is an improvement approach increasingly applied in healthcare.•Notwithstanding the growing body of knowledge some issues remain underexplored.•Evaluation of more “system wide approach” in its implementation is needed. Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of “system wide approach” are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts.
AbstractList	Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. Background: Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Method: Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. Findings: 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of 'system wide approach' are still low in number. Conclusion: Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. [Copyright Elsevier Ltd.] •We aim to provide a comprehensive review of Lean in healthcare.•Lean is an improvement approach increasingly applied in healthcare.•Notwithstanding the growing body of knowledge some issues remain underexplored.•Evaluation of more “system wide approach” in its implementation is needed. Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one. Comprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data. 243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of “system wide approach” are still low in number. Even though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. BACKGROUNDLean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in healthcare. Accordingly, Lean healthcare has been developing into a major strand of research since the early 2000s. The aim of this work is to present a comprehensive overview of the main issues highlighted by research on implementation of Lean in a complex contest such as the healthcare one.METHODComprehensive literature review was conducted in order to identify empirical and theoretical articles published up to September 2013. Thematic analysis was performed in order to extract and synthesis data.FINDINGS243 articles were selected for analysis. Lean is best understood as a means to increase productivity. Hospital is the more explored setting, with emergency and surgery as the pioneer departments. USA appears to be the leading country for number of applications. The theoretical works have been focused mainly on barriers, challenges and success factors. Sustainability, framework for measurement and critical appraisal remain underestimated themes. Evaluations of "system wide approach" are still low in number.CONCLUSIONEven though Lean results appear to be promising, findings so far do not allow to draw a final word on its positive impacts or challenges when introduced in the healthcare sector. Scholars are called to explore further the potentiality and the weaknesses of Lean, above all as for the magnitude of investments required and for the engagement of the whole organization it represents increasingly strategic choice, whilst health professionals, managers and policy makers could and should learn from research how to play a pivotal role for a more effective implementation of lean in different health contexts. Highlights • We aim to provide a comprehensive review of Lean in healthcare. • Lean is an improvement approach increasingly applied in healthcare. • Notwithstanding the growing body of knowledge some issues remain underexplored. • Evaluation of more “system wide approach” in its implementation is needed.
Author	D’Andreamatteo, Antonio Ianni, Luca Lega, Federico Sargiacomo, Massimo
Author_xml	– sequence: 1 givenname: Antonio surname: D’Andreamatteo fullname: D’Andreamatteo, Antonio email: adandreamatteo@gmail.com organization: Department of Management and Business Administration, University “G. d’Annunzio”, Via Pindaro, 42, 65127 Pescara, Italy – sequence: 2 givenname: Luca surname: Ianni fullname: Ianni, Luca email: lianni@unich.it organization: Department of Management and Business Administration, University “G. d’Annunzio”, Via Pindaro, 42, 65127 Pescara, Italy – sequence: 3 givenname: Federico surname: Lega fullname: Lega, Federico email: federico.lega@unibocconi.it organization: Department of Policy Analysis and Public Management, CeRGAS Public Management & Policy SDA - Bocconi University, Via Roentgen, 1, 20136 Milan, Italy – sequence: 4 givenname: Massimo surname: Sargiacomo fullname: Sargiacomo, Massimo email: msargiacomo@unich.it organization: Department of Management and Business Administration, University “G. d’Annunzio”, Via Pindaro, 42, 65127 Pescara, Italy
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/25737260$$D View this record in MEDLINE/PubMed
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Snippet	•We aim to provide a comprehensive review of Lean in healthcare.•Lean is an improvement approach increasingly applied in healthcare.•Notwithstanding the... Highlights • We aim to provide a comprehensive review of Lean in healthcare. • Lean is an improvement approach increasingly applied in healthcare. •... Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and adopted in... BACKGROUNDLean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and... Background: Lean seems to be the next revolution for a better, improved, value-based healhcare. In the last 15 years Lean has been increasingly adapted and...
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SubjectTerms	Continuous quality improvement Delivery of Health Care - organization & administration Delivery of Health Care - standards Health policy Healthcare Hospitals Humans Internal Medicine Investments Lean Lean Six Sigma Lean thinking Measurement Operational excellence Organizational Innovation Productivity Quality Improvement - organization & administration Quality of Health Care - organization & administration Review Revolution Success Surgery United States
Title	Lean in healthcare: A comprehensive review
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