Application of lean thinking in the healthcare sector

Lean thinking has begun to be adopted in the healthcare organization since the problems as tight healthcare budget, increase on demand, evidence of poor performance with fatal medical errors put the value, the quality and safety in health service delivery at risk. Prior research has shown that lean thinking is approached as a difficult subject to be deployed in hospitals since it originated from the manufacturing sector. And then, the majority of a healthcare organization are still conservative about the use of lean healthcare even though it is gaining increased attention. So, this study aims to facilitate the inclusion of lean thinking into the healthcare structure, to identify value-adding processes and to remove waste from the system. Izmir Medical Park hospital's internal medicine clinic is the place where the research has been carried out. Besides, the process of the clinic has been analyzed from the time the patient gets into the hospital until he/she is discharged or get into admission. Based on the review of the literature on the principles of lean thinking and the application of lean healthcare in the hospitals, a roadmap for creating a lean process model was used to guide the implementation. With the observation of the flow of the patient and the measurement phases, semi-structured interviews were then conducted with certain process owners in order to understand the current state of the process and elaborate the future one. The analysis of the current and future states of the internal medicine's process demonstrated that almost 90% reduction on the waste of waiting has been observed. It is the major non-value adding an activity in the whole process. With the walking distance of certain patients shortened, the time spent by the patient through internal medicine is also reduced. These results indicate that lean thinking highlights its effectiveness in improving the process and is compatible with the healthcare environment by following a clear path with the help of the major process improvement tools. On this basis, it is advantageous that healthcare organization promotes within the establishments the problem-solving skills as necessary in completing lean implementation because it is related to the continuous improvement principle. This research does not cover this last principle as a whole since it is a long term vision and is supposed to be the journey. So further research is needed then to focus on the factors that could help to sustain lean thinking alive in the establishments who have started the journey.