Lean management in health institutions: Example of Firat University Hospital General Surgery Department

In today's world where competition is rapidly increasing, institutions in both public and private sectors tend to increase their performance by using scarce resources efficiently. Efficient use of resources means no waste. The concept of waste is now associated with lean. Although the use of lean concept started in automotive sector, it was then used extensively in manufacturing sector. With the lean production activities in the manufacturing sector, wastes are determined in the process and lean techniques are applied to eliminate the wastes. In this way, products that meet the value definition of customers are offered at any time and place, processes are accelerated, costs are reduced, and production amounts, profits, employee and customer satisfaction are increased. The equivalent of lean production that is used commonly in manufacturing sector is lean management in service sector. Lean management activities, which have recently been implemented in the service sector, have a limited resource and practice. Since the service is intangible, immeasurable and dynamic, the number of studies that are conducted is limited. These studies are expected to increase over time. Institutions that want to abandon traditional management procedures and adopt lean management should first undergo cultural change. Management and employees should also believe in this change. In this study, the applicability of lean management in health institutions was investigated. Fırat University Hospital General Surgery Department was chosen as the application area of the study. First of all, satisfaction levels of outpatients and inpatients and their employees were determined. Then, value flow mapping studies in health institutions were examined and research was made on lean management and lean techniques. Health care institutions that desire to implement lean management should firstly define the value definitions of the people they provide services with. What is meant by the definition of value is that the expectation of the person being served and her/his perception of it are the same. Those who receive services from health institutions primarily expect to be diagnosed accurately, to be treated correctly in case of need, not to wait between these diagnosis and treatment processes, to be greeted with a friendly and solicitous staff and to receive service in a clean and spacious environment. Waiting is one of 7 waste types. Value stream mapping that is one of the lean management techniques to determine wastage is a visual tool. Accordingly, current and future state value flow maps were drawn for the service families selected from the outpatients of the General Surgery Policlinic. Value stream mapping and information and material flow are presented visually. It is more visible to determine the waste points with the current state value flow maps. Furthermore, periods that create added value and do not create added value are determined. Following the determination of wastage, lean solution suggestions were developed to eliminate these wastes. Future state value flow maps were drawn in line with the developed lean solution suggestions and these suggestions were shown on the maps. With the implementation of these recommendations, it is thought that waiting and costs will decrease and productivity, profit, performance and patient-employee satisfaction will increase.