Lean healthcare: proposição de uma ferramenta de gestão visual para gerenciamento de leitos hospitalares com base nos conceitos kanban

Abstract

Bed management in hospital regulatory sectors is challenging and complex in health institutions. The use of electronic systems and the lean healthcare philosophy, focused on continuous process improvement and waste elimination in the health area, are relevant to facilitate processes, overcoming the difficulties of systematization and access to information. Among the lean tools is kanban, which is widely used in health for managing hospital beds, controlling stocks and organizing patient flows. However, there are no systematized and validated models for managing beds in hospitals internal regulatory sectors. A reference method is needed to improve the interaction between the care areas, health professionals and the internal regulatory sectors of a hospital, making planning, control and management of beds more efficient. In this context, the objective of this research was to propose a visual management framework based on the kanban concept for managing hospital beds. This is an applied, qualitative, technological development, observational and exploratory research. The study was conducted in a university hospital in the interior of São Paulo in three stages: 1) evaluation of the current tool for hospital bed management; 2) development of a prototype for hospital bed management; and 3) validation of the prototype. DMAIC (define; measure; analyse; improve; control) was used as a methodological framework for the development of the research. The prototype of the visual management framework developed is of medium fidelity and provides data for real-time visualization of: bed status, patient waiting times for beds, and decision-making tools for the care team and internal regulatory sectors. The prototype was presented and validated by professionals from the internal regulatory sectors. The results of the research are expected to facilitate the implementation of the proposed prototype and have a positive impact on the care provided to patients. In addition, the development of new projects to improve care processes, applying the principles and tools of the lean philosophy, is powerful for making health and hospitals more efficient. As a limitation, the difficulty of developing electronic/digital systems that depend on information from the system of the hospital of study.