Implementation of Lean Healthcare Approaches in a Hospital's Surgical Block

Abstract

Over the last decades, there has been a growing demand for healthcare services, driven by increased life expectancy, population ageing and the prevalence of chronic diseases. In this context, there is an increasing need to make hospital systems more robust and efficient. To achieve this, hospital managers have increasingly adopted Lean methodologies, focusing primarily on identifying and eliminating waste, making operations and processes more efficient. The application of these methodologies in the healthcare sector is known as Lean Healthcare. Research in this area has gained growing interest since the late 20th century, resulting in a clear enhancement of hospital system sustainability and service quality. However, a significant gap has been identified regarding the observation of processes and the implementation of concrete tools in hospital units, which could directly contribute to the improvement of the healthcare network. This research aimed to diagnose and analyse the current state of the processes and activities associated with the operating room of a hospital unit. It also explored the application of Lean Healthcare tools. The project followed the Action Research methodology, applying a practical and collaborative approach to analyse, identify, suggest and implement process improvements, promoting interdisciplinarity between engineering and hospital operations management. This proximity to a real-world context strengthens scientific knowledge in the field of process standardisation, highlighting Action Research as a valid scientific methodology capable of adding value both to institutions and, simultaneously, to the scientific community. Through the data analysis and in loco observation of more than 60 surgeries, it was possible to model preoperative, intraoperative and postoperative processes. This enabled the diagnosis of improvement opportunities. The results revealed that surgeries were frequently delayed due to issues related to medical resource availability. Additionally, operating rooms exhibited low occupancy rates. In response, the research team proposed revised scheduling strategies, implemented 5S audits, process standardization, control checklists and Single-Minute Exchange of Die (SMED) practices. These interventions led to a reduction in non-conformities and errors, including a decrease of over 40 percentage points in non-conformities related to the availability of medical devices. Although there is still a long way to go in Lean Healthcare research, this investigation contributes to a more efficient and robust healthcare network, implementing Lean Healthcare in the surgery department to deliver safer and higher-quality services with the patient at the centre of continuous improvement efforts.