Applying Lean in Process Innovation in Healthcare: The Case of Hip Fracture

Int J Environ Res Public Health. 2020 Jul 22;17(15):5273. doi: 10.3390/ijerph17155273.

Abstract

Academic literature and practitioners acknowledge that there is a need to improve efficiency and service quality in the healthcare industry. In Spain, osteoporotic fractures represent a great cost in socio-economic and morbi-mortality terms, hip fracture being the surgical pathology with the second highest consumption of resources. The research questions that govern this study concern the use of Lean principles to identify waste, and an evaluation of the application of an innovative approach in the hip fracture surgery process. A research design based on a case study and action research was developed. Findings relate to (i) the identification of the main types of waste or muda (being the most frequent delay, transportation, over-processing and defects); (ii) the analysis of existing processes based on a Lean approach (identifying opportunities for improvement as a reduction of the number of steps and participants, improving communication, automation, standardization, etc.); and (iii) the application of an innovative process based on the Lean approach and action research in the healthcare industry. This research provides insights for academia, practitioners, management, and society: waste identification and process redesign helps to continue the improvement of operations, increase efficiency, reduce costs, and enhance services, providing benefits to patients, families, hospital employees, and the healthcare system.

Keywords: healthcare; hip fracture integrated care pathway; lean; process innovation; quality improvement.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Delivery of Health Care
  • Female
  • Health Resources
  • Hip Fractures*
  • Humans
  • Male
  • Osteoporotic Fractures
  • Spain