Lean interventions in healthcare: do they actually work? A systematic literature review

Our study found that Lean interventions have: no statistically significant association with patient satisfaction and health outcomes; a negative association with financial costs and worker satisfaction and potential, yet inconsistent, benefits on process outcomes like patient flow and safety

John Moraros; Mark Lemstra; Chijioke Nwankwo

2016

Scholarcy highlights

  • Healthcare systems are at a cross roads
  • Lean thinking was first developed in the automotive and manufacturing industries but it has recently expanded to the healthcare sector
  • We identified a total of 1056 peer-reviewed articles of which 164 were removed as duplicates, 768 were removed due to lack of relevance to healthcare and 76 were removed because they did not meet the inclusion criteria
  • This study found no impact of Lean on 30-day mortality rate post-hospital discharge
  • The findings of our systematic review suggest that Lean interventions have: no statistically significant association with patient satisfaction and health outcomes, a negative association with financial costs and worker satisfaction and potential yet inconsistent benefits on process outcomes like patient flow and safety
  • Three outcomes showed statistically significant positive outcomes of Lean including: staff washing or disinfecting their hands, staff checking ID bands and patients given safety brochures
  • While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date does not support this claim
  • The question remains whether continuing to heavily invest in Lean is bringing us closer to or taking us further away from a much needed, viable, long-term solution to an increasingly problematic and unsustainable healthcare delivery system

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