THE LEAN METHODOLOGY APPLIED TO HEALTHCARE INSTITUTIONS: A SYSTEMATIC LITERATURE REVIEW

Resumo

SINCE HEALTH SYSTEMS HAVE DUE COMPLEXITY, BOTH IN PROCESSES AND IN MANAGEMENT, LEAN
HEALTHCARE, DERIVED FROM THE LEAN PHILOSOPHY, IMPROVES PROCESSES IN THEIR ENTIRETY, WITH A VIEW
TO A GRADUAL RISE IN QUALITY THAT GENERATE BENEFITS IN THE CARE PROVIDED. THE OBJECTIVE OF THE
STUDY WAS TO VERIFY, THROUGH ORIGINAL STUDIES, THE APPLICABILITY OF THE LEAN HEALTHCARE
METHODOLOGY AS A WAY OF IMPROVING PROCESSES IN HEALTH INSTITUTIONS, IDENTIFYING POSTIMPLEMENTATION CHANGES. THROUGH A QUALITATIVE AND DESCRIPTIVE SYSTEMATIC LITERATURE REVIEW
CONDUCTED USING THE PRISMA METHODOLOGY, WITH RESEARCH CARRIED OUT IN THE CAPES, AND IN
THE PUBMED AND SCIELO DATABASES. THE INITIAL SEARCH HAD 77 STUDIES, AFTER APPLYING THE
INCLUSION CRITERIA BEING NATIONAL (PORTUGUESE), INTERNATIONAL (ENGLISH) STUDIES AND STUDIES THAT
CONTAIN THE WORD LEAN IN THE TITLE, 27 OF THE STUDIES DID NOT MEET THESE CRITERIA, THEN WAS APPLIED
THOSE OF EXCLUSION THAT WERE STUDIES NOT FOUND IN FULL, DUPLICATE STUDIES, STUDIES THAT DO NOT
HAVE LEAN HEALTHCARE AS A FOCUS AND NON-ORIGINAL STUDIES, WHERE 42 STUDIES MET THESE CRITERIA,
REACHING A TOTAL OF 8 SELECTED STUDIES. EVEN SO, THE SEARCH STRATEGY WAS CARRIED OUT IN THE
REFERENCES OF THE SELECTED STUDIES BASED ON THE INCLUSION AND EXCLUSION CRITERIA, WHERE IT WAS
POSSIBLE TO SELECT FIVE STUDIES IN WHICH THE FINAL DATABASE WAS CONSTITUTED IN 13 STUDIES, WITHOUT
TIME LIMITATION SO THERE WAS NO ELIMINATION OF STUDIES THAT THEY BELIEVE TO BE IMPORTANT FOR THE
DEVELOPMENT OF THE RESEARCH. THE STUDIES CONVERGE IN THEIR OBJECTIVES IN UNDERSTANDING AND
IMPROVING OPERATIONAL PROCESSES USING THE IMPLEMENTATION OF LEAN METHODOLOGY IN HEALTH
SYSTEMS. THE MAIN CONCLUSIONS IN THESE STUDIES WERE SIGNIFICANT CHANGES IN THE SECTORS
COVERED, OF WHICH 12 WERE STUDIES FOCUSED ON THE PATIENT, WITH LEAD TIME REDUCTION AND
IMPROVEMENT IN ITS FLOW. IN ADDITION, IT OBTAINED A REDUCTION IN QUEUES AND A FOCUS ON CARE AND
MANAGEMENT PROCESSES, INCREASING THE SATISFACTION OF THE TEAM, BEING POSSIBLE TO NOTE THAT
LEAN AFFECTS EMPLOYEES MAINLY IN A POSITIVE WAY. FROM THE 13 STUDIES ANALYZED, IT WAS VERIFIED
THE AUTHORS' SEARCH TO BRING IMPROVEMENTS AND CHANGES THROUGH THE LEAN METHOD WITHIN THE
SCOPE OF HEALTH WITH A FOCUS ON PATIENTS, EMPLOYEES AND PROCESS FLOW. IN THIS WAY, IT WAS
POSSIBLE TO VERIFY THAT, WITH THE LEAN HEALTHCARE IMPLEMENTATION, THERE WAS A SIGNIFICANT
INFLUENCE. IN ADDITION TO VERIFYING THAT THERE ARE LIMITATIONS IN THE STUDIES THAT ARE OF A SINGLE
CASE, LIMITATION OF RESOURCES USED FOR THEIR IMPLEMENTATION, AND FOR BEING A RELATIVELY NEW
PHILOSOPHY. THE STUDIES ALSO SUGGEST A DEEPENING OF RESEARCH IN ITS EXPANSION OF DATA AND IN OTHER AREAS SUCH AS ADMINISTRATION AND INVOLVING CONTINUOUS IMPROVEMENT PROJECTS IN FAVOR OF LEAN PRODUCTION, IN ADDITION TO HAVING MORE EXPRESSIVE SAMPLES.