Padronização de kits de material cirúrgico para tratamentos de coluna utilizando a abordagem Lean Healthcare approach

Luana Coelho de Morais, Stella Jacyszyn Bachega, Naiara Faiad Sebba Calife, Dalton Matsuo Tavares

Resumo


Os kits contendo material cirúrgico selecionado podem reduzir atrasos, custos, erros e proporcionar segurança para a equipe médica e para o paciente. O objetivo da pesquisa era dimensionar os pacotes necessários para dois tipos de tratamento da coluna usando ferramentas do Lean Healthcare como suporte. O ciclo PDCA foi usado como um método de solução de problemas. Na etapa ‘Plan’, avaliou-se a situação atual e a necessidade de mudança por meio do Mapeamento do Fluxo de Valor, em relação à situação atual e futura. Na etapa ‘Do’, foi desenvolvido um plano de melhoria das mudanças, com o auxílio da abordagem 5S. Na etapa ‘Check’ foram utilizadas as ferramentas Kaizen, Trabalho Padronizado e Gestão Visual, para propor a implementação das mudanças. Na etapa ‘Act’, foi sugerido o acompanhamento das ações. Isso elimina as atividades que não agregam valor à visão do paciente ou do cliente do processo.


Palavras-chave


Lean Healthcare; Kit Cirúrgico; Produção Enxuta.

Texto completo:

PDF (English)

Referências


Adebanjo, D., Laosirihongthong, T., & Samaranayake, P. (2016). Prioritizing lean supply chain management initiatives in healthcare service operations: a fuzzy AHP approach. Production Planning & Control, 27 (12), 953-966. doi: https://doi.org/10.1080/09537287.2016.1164909.

Alves, A. C., Gonçalves, A. M., Fernandes, J. M., Vaz, I., Teixeira, S., Sousa, I., Pereira, J. J., & Dória-Nóbrega, S. (2016). Combined tools for Surgical Case Packages contents and cost optimization: a preliminary study. Procedia Computer Science, 100, 393-398. doi: https://doi.org/10.1016/j.procs.2016.09.174

Amran, M. D. M., Januddi, F., Nuraina, S., Ikbar, A. W. M, & Khairanum, S. (2020). The barriers in lean healthcare implementation. Test Engineering and Management, 82 (1-2), 1972-1981.

Ballou, R. H. (2007). Business logistics/supply chain management. India: Pearson Education.

Boronat, F., Budia, A., Broseta, E., Ruiz-Cerdá, J. L., & Vivas-Consuelo, D. (2018). Application of Lean Healthcare methodology in a urology department of a tertiary hospital as a tool for improving efficiency. Actas Urológicas Españolas (English Edition), 42 (1), 42-48. doi: https://doi.org/10.1016/j.acuroe.2017.11.008.

Bryman, A. (1989). Research methods and organization studies. London: Uniwin Hyman.

Byrnes, J. N., Schmitt, J., Tommaso, C., & Occhino, J. A. (2017). Cost reduction techniques in the operating suite: Surgical tray optimization. American Journal of Obstetrics & Gynecology, 216(3), Supplement, S616, March 01. doi: https://doi.org/10.1016/j.ajog.2016.12.119.

Chen, M., & Lu, Z. (2014). Effects of PDCA Applied to Medical Record Quality Management. Chinese Medical Record English Edition, 2(8), 372-375. doi: https://doi.org/10.3109/23256176.2014.992175

Cichos, K. H., Hyde, Z. B., Mabry, S. E., Ghanem, E. S., Brabston, E. W., Hayes, L. W., McGwin Jr. G., & Ponce, B. A. (2019). Optimization of Orthopedic Surgical Instrument Trays: Lean Principles to Reduce Fixed Operating Room Expenses. The Journal of Arthroplasty, 34, 238-2840. doi: https://doi.org/10.1016/j.arth.2019.07.040.

Collar, R. M., Shuman, A. G., Feiner, S., Mcgonegal, A. K., Heidel, N., Duck, M., Mclean, S. A., Billi, J. E., Healy, D. W., & Bradford, C. R. (2012). Lean management in academic surgery. Journal of the American College of Surgeons, 214(6), 928-936. doi: https://doi.org/10.1016/j.jamcollsurg.2012.03.002.

Costa, L. B., & Godinho, M., Filho. (2016). Lean healthcare: review, classification and analysis of literature. Production Planning & Control 27 (10): 823-836. doi: https://doi.org/10.1080/09537287.2016.1143131.

Costa, L. B., Godinho, M., Filho, Rentes, A. F., Bertani, T. M., & Mardegan, R. (2015). Lean healthcare in developing countries: evidence from Brazilian hospitals. The International Journal of Health Planning and Management, 32 (1), e99-e120. doi: https://doi.org/10.1002/hpm.2331.

Creswell, J. W. (2014). Research design: Qualitative, quantitative and mixed methods approaches. Newbury Park, CA: Sage Publications.

Crosby, L., Lortie, E., Rotenberg, B., & Sowerby, L. (2019). Surgical Instrument Optimization to Reduce Instrument Processing and Operating Room Setup Time. Otolaryngology-Head and Neck Surgery, 1-5. doi: https://doi.org/10.1177/0194599819885635.

Curatolo, N., Lamouri, S., Huet, J. C., & Rieutord, A. (2013). A Critical Analysis of Lean Approach in Hospital. Business Process Management Journal, 20(3), 433-454. doi: https://doi.org/10.1108/BPMJ-04-2013-0051.

D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A comprehensive review. Health Policy, 119(9), 1197-1209. doi: https://doi.org/10.1016/j.healthpol.2015.02.002.

Dobrzykowski, D. D., Mcfadden, K. L., & Vonderembse, M. A. (2016). Examining pathways to safety and financial performance in hospitals: A study of lean in professional service operations. Journal of Operations Management, 42-43(1), 39-51. doi: https://doi.org/10.1016/j.jom.2016.03.001.

Drotz, E., & Poksinska, B. (2014). Lean in healthcare from employees’ perspectives. Journal of Health Organization and Management, 28(2), 177-195. doi: https://doi.org/10.1108/JHOM-03-2013-0066.

Farrelly, J. S., Clemons, C., Witkins, S., Hall, W., Christison-Lagay, E. R., Ozgediz, D. E., Cowles, R. A., Stitelman, D. H., & Caty, M. G. (2017). Surgical tray optimization as a simple means to decrease perioperative costs. Journal of Surgical Research, 220, 320-326. doi: https://doi.org/10.1016/j.jss.2017.06.029.

Farrokhi, F. R., Gunther, M., Williams, B., & Blackmore, C. C. (2015). Application of lean methodology for improved quality and efficiency in operating room instrument availability. Journal for Healthcare Quality. 37(5), 277-286. doi: https://doi.org/10.1111/jhq.12053.

Giraldo, A., Mothersell, W. M., & Motwani, J. (2015). The need for implementing lean in healthcare organizations. International Journal Productivity and Quality Management, 16(2), 211-230. doi: https://doi.org/10.1504/IJPQM.2015.071240.

Graban, M. (2011). Lean hospitals: improving quality, patient safety, and employee satisfaction. New York: CRC Press.

Grosz, B. J. (1996). Collaborative Systems (AAAI-94 Presidential Address). AI magazine, 17(2), 67-85. doi: https://doi.org/10.1609/aimag.v17i2.1223

Hendry, C. (2012). Human resource management: a strategic approach to employment. London: Routledge.

Henrique, D. B., Rentes, A. F., & Godinho, M., Fillho. (2016). A new value stream mapping approach for healthcare environments. Production Planning & Control, 27(1), 24-48. doi: https://doi.org/10.1080/09537287.2015.1051159.

Hicks, C., McGovern, T., Prior, G., & Smith, I. (2015). Applying lean principles to the design of healthcare facilities. International Journal of Production Economics, 170(Part B), 677-686. doi: https://doi.org/10.1016/j.ijpe.2015.05.029.

Holden, R. J., Eriksson, A., Andreasson, J., Williamsson, A., & Dellve, L. (2015). Healthcare workers' perceptions of lean: A context-sensitive, mixed methods study in three Swedish hospitals. Applied Ergonomics, 47(1), p. 181-192. doi: https://doi.org/10.1016/j.apergo.2014.09.008.

Improta, G., Cesarelli, M., Montuori, P., Santillo, L. C., & Triassi, M. (2017). Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy). Journal of Evaluation in Clinical Practice, 24(2), 338-346. doi: https://doi.org/10.1111/jep.12844.

Jackson, T. L. (Ed.). (2012). Kaizen workshops for lean healthcare. CRC Press.

Johnson, J. E., Smith, A. L., & Mastro, K. A. (2012). From Toyota to the bedside: nurses can lead the lean way in health care reform. Nursing administration quarterly, 36(3), 234-242. doi: https://doi.org/10.1097/ NAQ.0b013e318258c3d5.

Joosten, T., Bongers, I., & Janssen, R. (2009). Application of lean thinking to health care: issues and observations. International journal for quality in health care, 21(5), 341-347. doi: https://doi.org/10.1093/intqhc/mzp036.

Lindskog, P., Hemphälä, J., & Eriksson, A. (2017). Lean tools promoting individual innovation in healthcare. Creativity and Innovation Management, 26(2), 175-188. doi: https://doi.org/10.1111/caim.12201.

Liu, X., Zhu, Y., Peng, K., Zhou, C., Liu, M., Liu, S. C., & Tu, C. (2014). Application of PDCA Method in Quality Management of Running Medical Records at the Department of Orthopedics. Chinese Medical Record English Edition, 2(3), 112-115. doi: https://doi.org/10.3109/23256176.2014.910906.

Lunardini, D., Arington, R., Canacari, E. G., Gamboa, K., Wagner, K., & Mcguire, K. J. (2014). Lean principles to optimize instrument utilization for spine surgery in an academic medical center: an opportunity to standardize, cut costs, and build a culture of improvement. Spine, 39(20), 1714-1717. doi: https://doi.org/10.1097/BRS.0000000000000480.

Machado, V. C., & Leitner, U. (2010). Lean tools and lean transformation process in health care. International Journal of Management Science and Engineering Management, 5(5), 383-392. doi: https://doi.org/10.1080/17509653.2010.10671129.

Mannon, M. (2014). Lean healthcare and quality management: The experience of ThedaCare. Quality Management Journal, 21(1), 7-10. doi: https://doi.org/10.1080/10686967.2014.11918371

Marchand, K.B., Taylor, K.B., Salem, H.S., Mont, M.A., & Marchand, R.C. (2020). Surgical Tray Optimization and Efficiency: The Impact of a Novel Sealed Sterile Container and Instrument Tray Technology. Surg Technol Int, Nov 27;37: sti37/1375. Advance online publication. PMID: 33245139.

Martins, R. A. (2012). Abordagens Quantitativa e Qualitativa. In P. A. C. Miguel (Org.). Metodologia de pesquisa em engenharia de produção e gestão de operações (pp. 47-63). Rio de Janeiro: Elsevier.

Ministério da Saúde. (2015). Despacho n.º 1400-A/2015: Anexo - Plano Nacional para a Segurança dos Doentes 2015-2020. Diário da República, 2(28), 3882-(2)-3882-(10). Retrieved December 04, 2020, from https://dre.pt/application/file/66457154

Ministério da Saúde. (2016). Manual de boas práticas de gestão das Órteses, Próteses e Materiais Especiais (OPME). Retrieved November 05, 2020, from http://bvsms.saude.gov.br/bvs/publicacoes/manual_praticas_ gestao_proteses_materiais_especiais.pdf.

Montella, E., Di Cicco, M. V., Ferraro, A., Centobelli, P., Raiola, E., Triassi, M., & Improta, G. (2016). The application of Lean Six Sigma methodology to reduce the risk of healthcare–associated infections in surgery departments. Journal of Evaluation in Clinical Practice, 23(3), 530-539. doi: https://doi.org/10.1111/jep.12662.

Moraros, J., Lemstra, M., & Nwankwo, C. (2016). Lean interventions in healthcare: do they actually work? A systematic literature review. International Journal for Quality in Health Care, 28(2), 150–165. doi: https://doi.org/10.1093/intqhc/mzv123.

Poksinska, B. B., Fialkowska-Filipek, M., & Engström, J. (2016). Does Lean healthcare improve patient satisfaction? A mixed-method investigation into primary care. BMJ Quality & Safety, 26(2), 85-86. doi: https://doi.org/10.1136/bmjqs-2015-004290.

Rutledge, J., Xu, M., & Simpson, J. (2015). Application of the Toyota Production System Improves Core Laboratory operation. American Journal of Clinical Pathology, 133(1), 24-31. doi: https://doi.org/10.1309/AJCPD1MSTIVZI0PZ.

Schonberger, R. J. (2018). Reconstituting lean in healthcare: From waste elimination toward ‘queue-less’ patient-focused care. Business Horizons, 61(1), 13-22. doi: https://doi.org/10.1016/j.bushor.2017.09.001.

Sugianto, J. Z., Stewart, B., Ambruzs, J. M., Arista, A., Park, J. Y., Cope-Yokoyama, S., & Luu, H. S. (2015). Applying the Principles of Lean Production to Gastrointestinal Biopsy Handling: From the Factory Floor to the Anatomic Pathology Laboratory. Laboratory Medicine, 46(3), 259–264. doi: https://doi.org/10.1309/LMJCUFUN0LT8C6DB.

Tay, H. L. (2016). Lean Improvement Practices: Lessons from Healthcare Service Delivery Chains. IFAC-PapersOnLine, 49(12), 1158-1163. doi: https://doi.org/10.1016/j.ifacol.2016.07.660.

Tay, H. L., Singh, P. J., Bhakoo, V., & Al-Balushi, S. (2017). Contextual factors: assessing their influence on flow or resource efficiency orientations in healthcare lean projects. Operations Management Research, 10 (3-4), 118–136. doi: https://doi.org/10.1007/s12063-017-0126-3.

Tortorella, G., Dun, D. H., & Almeida, A. G. (2020). Leadership behaviors during lean healthcare implementation: a review and longitudinal study. Journal of Manufacturing Technology Management, 31(1), 193-215. doi: https://doi.org/10.1108/JMTM-02-2019-0070.

Van Rossum, L., Aij, K. H., Simons, F. E., Eng, N. van der, & Have, W. D. ten. (2016). Lean healthcare from a change management perspective: The role of leadership and workforce flexibility in an operating theatre. Journal of Health Organization and Management, 30(3), 475-493. doi: https://doi.org/10.1108/JHOM-06-2014-0090.

Waldhausen, J. H., Avansino, J. R., Libby, A., & Sawin, R. S. (2010). Application of lean methods improves surgical clinic experience. Journal of pediatric surgery, 45(7), 1420-1425. doi: https://doi.org/10.1016/j.jpedsurg.2009.10.049

Wang, X. (2014). Application of PDCA Method in Medical Record Archiving Management. Chinese Medical Record English Edition, 2(1), 22-26. doi: https://doi.org/10.3109/23256176.2014.897487.

Wannemuehler, T. J., Elghouche, A. N., Kokoska, M. S., Deig, C. R., & Matt, B. H. (2015). Impact of L ean on surgical instrument reduction: Less is more. The Laryngoscope, 125(12), 2810-2815. doi: https://doi.org/10.1002/lary.25407. Epub 2015 Jun 24.

Worth, J., Shuker, T., Keyte, B., Luckman, J., Ohaus, K., Verble, D., & Nickel, T. (2012). Perfecting patient journeys. Lean Enterprise Institute.

Yin, R. K. (2015). Case study research: Design and Methods, Applied social research methods series. London: Sage Publications.

Zadeh, R. S., Shepley, M. M., & Waggener, L. T. (2012). Rethinking efficiency in acute care nursing units: Analyzing nursing unit layouts for improved spatial flow. HERD: Health Environments Research & Design Journal, 6(1), 39-65. doi: https://doi.org/10.1177/193758671200600103.




DOI: https://doi.org/10.5585/exactaep.2021.18071

Direitos autorais 2021 Exacta

Licença Creative Commons
Esta obra está licenciada sob uma licença Creative Commons Atribuição - Não comercial - Compartilhar igual 4.0 Internacional.

Tempo médio entre a submissão e primeira resposta de avaliação: 120 dias

Exacta – Engenharia de Produção

e-ISSN: 1983-9308
ISSN: 1678-5428
www.revistaexacta.org.br

Exacta  ©2022 Todos os direitos reservados.

Este obra está licenciada com uma Licença 
Creative Commons Atribuição-NãoComercial-CompartilhaIgual 4.0 Internacional