How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level
Lean Thinking and clinical pathways are commonly used concepts to improve healthcare. However, little is known on how to use Lean Thinking for the optimization of pathways or the quantification of both concepts. This study aims to create a framework to analyze pathways with Lean Thinking on a system...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/11/18/2488 |
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| author | Joanna R. G. Vijverberg Marc B. V. Rouppe van der Voort Paul B. van der Nat Machteld J. Mosselman Sander Rigter Douwe H. Biesma Frits van Merode |
| author_facet | Joanna R. G. Vijverberg Marc B. V. Rouppe van der Voort Paul B. van der Nat Machteld J. Mosselman Sander Rigter Douwe H. Biesma Frits van Merode |
| author_sort | Joanna R. G. Vijverberg |
| collection | DOAJ |
| description | Lean Thinking and clinical pathways are commonly used concepts to improve healthcare. However, little is known on how to use Lean Thinking for the optimization of pathways or the quantification of both concepts. This study aims to create a framework to analyze pathways with Lean Thinking on a system level, by quantifying the seven wastes, flow and pull. A systematic literature review was performed. Inclusion criteria were the focus of the article on a well-defined group of patients and studied a pathway optimization with Lean Thinking. Data were extracted on measured outcomes, type of intervention and type of researched pathway. Thirty-six articles were included. No articles described the implementation of the Lean Thinking philosophy or studied the development of their people and partners (“4 P” model). Most articles used process optimization tools or problem-solving tools. The majority of the studies focused on process measures. The measures found in the review were used as input for our suggested framework to identify and quantify wastes, flow, and pull in a clinical pathway. The proposed framework can be used to create an overview of the improvement potential of a pathway or to analyze the level of improvement after an enhancement is introduced to a pathway. Further research is needed to study the use of the suggested quantifications. |
| first_indexed | 2024-03-10T22:42:52Z |
| format | Article |
| id | doaj.art-e8b2068f2a9a4631a342d06cf82592a6 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T22:42:52Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-e8b2068f2a9a4631a342d06cf82592a62023-11-19T10:55:38ZengMDPI AGHealthcare2227-90322023-09-011118248810.3390/healthcare11182488How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System LevelJoanna R. G. Vijverberg0Marc B. V. Rouppe van der Voort1Paul B. van der Nat2Machteld J. Mosselman3Sander Rigter4Douwe H. Biesma5Frits van Merode6Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The NetherlandsDepartment of Juiste Zorg, Juiste Plaats, Juiste Kosten, St. Antonius Hospital, 3435 CM Nieuwegein, The NetherlandsDepartment of Value Improvement, St. Antonius Hospital, 3435 CM Nieuwegein, The NetherlandsDepartment of Juiste Zorg, Juiste Plaats, Juiste Kosten, St. Antonius Hospital, 3435 CM Nieuwegein, The NetherlandsDepartment of Anesthesiology and Intensive Care, St. Antonius Hospital, 3435 CM Nieuwegein, The NetherlandsDepartment of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsCare and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The NetherlandsLean Thinking and clinical pathways are commonly used concepts to improve healthcare. However, little is known on how to use Lean Thinking for the optimization of pathways or the quantification of both concepts. This study aims to create a framework to analyze pathways with Lean Thinking on a system level, by quantifying the seven wastes, flow and pull. A systematic literature review was performed. Inclusion criteria were the focus of the article on a well-defined group of patients and studied a pathway optimization with Lean Thinking. Data were extracted on measured outcomes, type of intervention and type of researched pathway. Thirty-six articles were included. No articles described the implementation of the Lean Thinking philosophy or studied the development of their people and partners (“4 P” model). Most articles used process optimization tools or problem-solving tools. The majority of the studies focused on process measures. The measures found in the review were used as input for our suggested framework to identify and quantify wastes, flow, and pull in a clinical pathway. The proposed framework can be used to create an overview of the improvement potential of a pathway or to analyze the level of improvement after an enhancement is introduced to a pathway. Further research is needed to study the use of the suggested quantifications.https://www.mdpi.com/2227-9032/11/18/2488lean thinkingclinical pathwayquantificationimprovement potential |
| spellingShingle | Joanna R. G. Vijverberg Marc B. V. Rouppe van der Voort Paul B. van der Nat Machteld J. Mosselman Sander Rigter Douwe H. Biesma Frits van Merode How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level Healthcare lean thinking clinical pathway quantification improvement potential |
| title | How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level |
| title_full | How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level |
| title_fullStr | How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level |
| title_full_unstemmed | How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level |
| title_short | How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level |
| title_sort | how to use lean thinking for the optimization of clinical pathways a systematic review and a proposed framework to analyze pathways on a system level |
| topic | lean thinking clinical pathway quantification improvement potential |
| url | https://www.mdpi.com/2227-9032/11/18/2488 |
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