TY - JOUR
T1 - How to Use Lean Thinking for the Optimization of Clinical Pathways
T2 - A Systematic Review and a Proposed Framework to Analyze Pathways on a System Level
AU - Vijverberg, Joanna R.G.
AU - Rouppe van der Voort, Marc B.V.
AU - van der Nat, Paul B.
AU - Mosselman, Machteld J.
AU - Rigter, Sander
AU - Biesma, Douwe H.
AU - van Merode, Frits
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/9/7
Y1 - 2023/9/7
N2 - Lean Thinking and clinical pathways are commonly used concepts to improve healthcare. However, little is known on how to use Lean Thinking for the optimization of pathways or the quantification of both concepts. This study aims to create a framework to analyze pathways with Lean Thinking on a system level, by quantifying the seven wastes, flow and pull. A systematic literature review was performed. Inclusion criteria were the focus of the article on a well-defined group of patients and studied a pathway optimization with Lean Thinking. Data were extracted on measured outcomes, type of intervention and type of researched pathway. Thirty-six articles were included. No articles described the implementation of the Lean Thinking philosophy or studied the development of their people and partners (“4 P” model). Most articles used process optimization tools or problem-solving tools. The majority of the studies focused on process measures. The measures found in the review were used as input for our suggested framework to identify and quantify wastes, flow, and pull in a clinical pathway. The proposed framework can be used to create an overview of the improvement potential of a pathway or to analyze the level of improvement after an enhancement is introduced to a pathway. Further research is needed to study the use of the suggested quantifications.
AB - Lean Thinking and clinical pathways are commonly used concepts to improve healthcare. However, little is known on how to use Lean Thinking for the optimization of pathways or the quantification of both concepts. This study aims to create a framework to analyze pathways with Lean Thinking on a system level, by quantifying the seven wastes, flow and pull. A systematic literature review was performed. Inclusion criteria were the focus of the article on a well-defined group of patients and studied a pathway optimization with Lean Thinking. Data were extracted on measured outcomes, type of intervention and type of researched pathway. Thirty-six articles were included. No articles described the implementation of the Lean Thinking philosophy or studied the development of their people and partners (“4 P” model). Most articles used process optimization tools or problem-solving tools. The majority of the studies focused on process measures. The measures found in the review were used as input for our suggested framework to identify and quantify wastes, flow, and pull in a clinical pathway. The proposed framework can be used to create an overview of the improvement potential of a pathway or to analyze the level of improvement after an enhancement is introduced to a pathway. Further research is needed to study the use of the suggested quantifications.
KW - clinical pathway
KW - improvement potential
KW - lean thinking
KW - quantification
U2 - 10.3390/healthcare11182488
DO - 10.3390/healthcare11182488
M3 - Article
SN - 2227-9032
VL - 11
JO - Healthcare
JF - Healthcare
IS - 18
M1 - 2488
ER -