IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i15p9018-d870802.html
   My bibliography  Save this article

Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review

Author

Listed:
  • Diego Tlapa

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autonoma de Baja California, Ensenada 23080, Mexico)

  • Guilherme Tortorella

    (Department of Mechanical Engineering, The University of Melbourne, Melbourne, VIC 3010, Australia)

  • Flavio Fogliatto

    (Industrial Engineering Department, Universidade Federal do Rio Grande do Sul, Porto Alegre 90010-150, Brazil)

  • Maneesh Kumar

    (Cardiff Business School, Cardiff University, Cardiff CF5 2YB, UK)

  • Alejandro Mac Cawley

    (Departamento de Ingeniería Industrial y de Sistemas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile)

  • Roberto Vassolo

    (IAE Business School, Universidad Austral, Buenos Aires B1630FHB, Argentina)

  • Luis Enberg

    (Departamento de Ingeniería Industrial y de Sistemas, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile)

  • Yolanda Baez-Lopez

    (Facultad de Ingeniería, Arquitectura y Diseño, Universidad Autonoma de Baja California, Ensenada 23080, Mexico)

Abstract

Despite the increasing utilization of lean practices and digital technologies (DTs) related to Industry 4.0, the impact of such dual interventions on healthcare services remains unclear. This study aims to assess the effects of those interventions and provide a comprehensive understanding of their dynamics in healthcare settings. The methodology comprised a systematic review following the PRISMA guidelines, searching for lean interventions supported by DTs. Previous studies reporting outcomes related to patient health, patient flow, quality of care, and efficiency were included. Results show that most of the improvement interventions relied on lean methodology followed by lean combined with Six Sigma. The main supporting technologies were simulation and automation, while emergency departments and laboratories were the main settings. Most interventions focus on patient flow outcomes, reporting positive effects on outcomes related to access to service and utilization of services, including reductions in turnaround time, length of stay, waiting time, and turnover time. Notably, we found scarce outcomes regarding patient health, staff wellbeing, resource use, and savings. This paper, the first to investigate the dual intervention of DTs with lean or lean–Six Sigma in healthcare, summarizes the technical and organizational challenges associated with similar interventions, encourages further research, and promotes practical applications.

Suggested Citation

  • Diego Tlapa & Guilherme Tortorella & Flavio Fogliatto & Maneesh Kumar & Alejandro Mac Cawley & Roberto Vassolo & Luis Enberg & Yolanda Baez-Lopez, 2022. "Effects of Lean Interventions Supported by Digital Technologies on Healthcare Services: A Systematic Review," IJERPH, MDPI, vol. 19(15), pages 1-23, July.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9018-:d:870802
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/15/9018/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/19/15/9018/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Eva K. Lee & Hany Y. Atallah & Michael D. Wright & Eleanor T. Post & Calvin Thomas & Daniel T. Wu & Leon L. Haley, 2015. "Transforming Hospital Emergency Department Workflow and Patient Care," Interfaces, INFORMS, vol. 45(1), pages 58-82, February.
    2. Mohammad Asif Salam & Sami A. Khan, 2016. "Value creation through lean management: a case study of healthcare service operations," International Journal of Services and Operations Management, Inderscience Enterprises Ltd, vol. 25(3), pages 275-293.
    3. Agnetis, Alessandro & Bianciardi, Caterina & Iasparra, Nicola, 2019. "Integrating lean thinking and mathematical optimization: A case study in appointment scheduling of hematological treatments," Operations Research Perspectives, Elsevier, vol. 6(C).
    4. Hung-Wen Tsai & Su-Wen Huang & Yin-Lurn Hung & Yu-Shan Hsu & Chien-Chung Huang, 2021. "Use of the Smart Lean Method to Conduct High-Quality Integrated Perioperative Management Prior to Hospitalization," IJERPH, MDPI, vol. 18(24), pages 1-16, December.
    5. Baril, Chantal & Gascon, Viviane & Miller, Jonathan & Côté, Nadine, 2016. "Use of a discrete-event simulation in a Kaizen event: A case study in healthcare," European Journal of Operational Research, Elsevier, vol. 249(1), pages 327-339.
    6. Bergey, Meredith R. & Goldsack, Jennifer C. & Robinson, Edmondo J., 2019. "Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team," Social Science & Medicine, Elsevier, vol. 235(C), pages 1-1.
    7. Dimitris Mourtzis, 2020. "Simulation in the design and operation of manufacturing systems: state of the art and new trends," International Journal of Production Research, Taylor & Francis Journals, vol. 58(7), pages 1927-1949, April.
    8. D’Andreamatteo, Antonio & Ianni, Luca & Lega, Federico & Sargiacomo, Massimo, 2015. "Lean in healthcare: A comprehensive review," Health Policy, Elsevier, vol. 119(9), pages 1197-1209.
    9. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    10. Shivam Gupta & Sachin Modgil & Angappa Gunasekaran, 2020. "Big data in lean six sigma: a review and further research directions," International Journal of Production Research, Taylor & Francis Journals, vol. 58(3), pages 947-969, February.
    11. Cláudia Pinho & Luis Mendes, 2017. "IT in lean-based manufacturing industries: systematic literature review and research issues," International Journal of Production Research, Taylor & Francis Journals, vol. 55(24), pages 7524-7540, December.
    12. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    13. Syed Salleh & Praveen Thokala & Alan Brennan & Ruby Hughes & Andrew Booth, 2017. "Simulation Modelling in Healthcare: An Umbrella Review of Systematic Literature Reviews," PharmacoEconomics, Springer, vol. 35(9), pages 937-949, September.
    14. Mazen Hassanain & Mohammed Zamakhshary & Ghada Farhat & Ahmed Al-Badr, 2017. "Use of Lean methodology to improve operating room efficiency in hospitals across the Kingdom of Saudi Arabia," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(2), pages 133-146, April.
    15. Cagatay Tasdemir & Rado Gazo, 2018. "A Systematic Literature Review for Better Understanding of Lean Driven Sustainability," Sustainability, MDPI, vol. 10(7), pages 1-54, July.
    16. Maria Pia Ciano & Patrick Dallasega & Guido Orzes & Tommaso Rossi, 2021. "One-to-one relationships between Industry 4.0 technologies and Lean Production techniques: a multiple case study," International Journal of Production Research, Taylor & Francis Journals, vol. 59(5), pages 1386-1410, March.
    17. Chaloner Chute & Tara French, 2019. "Introducing Care 4.0: An Integrated Care Paradigm Built on Industry 4.0 Capabilities," IJERPH, MDPI, vol. 16(12), pages 1-17, June.
    18. Carlos Zepeda-Lugo & Diego Tlapa & Yolanda Baez-Lopez & Jorge Limon-Romero & Sinue Ontiveros & Armando Perez-Sanchez & Guilherme Tortorella, 2020. "Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review," IJERPH, MDPI, vol. 17(15), pages 1-24, August.
    19. Sven-Vegard Buer & Marco Semini & Jan Ola Strandhagen & Fabio Sgarbossa, 2021. "The complementary effect of lean manufacturing and digitalisation on operational performance," International Journal of Production Research, Taylor & Francis Journals, vol. 59(7), pages 1976-1992, April.
    20. Miguel Ortiz-Barrios & Juan-José Alfaro-Saiz, 2020. "An integrated approach for designing in-time and economically sustainable emergency care networks: A case study in the public sector," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-28, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Diego Tlapa & Ignacio Franco-Alucano & Jorge Limon-Romero & Yolanda Baez-Lopez & Guilherme Tortorella, 2022. "Lean, Six Sigma, and Simulation: Evidence from Healthcare Interventions," Sustainability, MDPI, vol. 14(24), pages 1-25, December.
    2. Bertha Leticia Treviño-Elizondo & Heriberto García-Reyes & Rodrigo E. Peimbert-García, 2023. "A Maturity Model to Become a Smart Organization Based on Lean and Industry 4.0 Synergy," Sustainability, MDPI, vol. 15(17), pages 1-24, September.
    3. Daniele La Forgia & Gaetano Paparella & Rahel Signorile & Francesca Arezzo & Maria Colomba Comes & Gennaro Cormio & Antonella Daniele & Annarita Fanizzi & Agnese Maria Fioretti & Gianluca Gatta & Miri, 2022. "Lean Perspectives in an Organizational Change in a Scientific Direction of an Italian Research Institute: Experience of the Cancer Institute of Bari," IJERPH, MDPI, vol. 20(1), pages 1-15, December.
    4. Seokho Ahn & Jaesung Kim & Seok Chan Jeong & Myungil Kim & Cheolyoung Kim & Dongki Park, 2022. "Stress Distribution Analysis of Threaded Implants for Digital Dentistry," IJERPH, MDPI, vol. 19(19), pages 1-14, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Diego Tlapa & Ignacio Franco-Alucano & Jorge Limon-Romero & Yolanda Baez-Lopez & Guilherme Tortorella, 2022. "Lean, Six Sigma, and Simulation: Evidence from Healthcare Interventions," Sustainability, MDPI, vol. 14(24), pages 1-25, December.
    2. Carlos Zepeda-Lugo & Diego Tlapa & Yolanda Baez-Lopez & Jorge Limon-Romero & Sinue Ontiveros & Armando Perez-Sanchez & Guilherme Tortorella, 2020. "Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review," IJERPH, MDPI, vol. 17(15), pages 1-24, August.
    3. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    4. Su Keng Tan & Wai Keung Leung & Alexander Tin Hong Tang & Roger A Zwahlen, 2017. "Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-20, October.
    5. Alessandro Concari & Gerjo Kok & Pim Martens, 2020. "A Systematic Literature Review of Concepts and Factors Related to Pro-Environmental Consumer Behaviour in Relation to Waste Management Through an Interdisciplinary Approach," Sustainability, MDPI, vol. 12(11), pages 1-50, May.
    6. Jacob Elnaggar & Fern Tsien & Lucio Miele & Chindo Hicks & Clayton Yates & Melisa Davis, 2019. "An Integrative Genomics Approach for Associating Genetic Susceptibility with the Tumor Immune Microenvironment in Triple Negative Breast Cancer," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 15(1), pages 1-12, February.
    7. Hyun Kim & Navneet Kaur Baidwan & David Kriebel & Manuel Cifuentes & Sherry Baron, 2018. "Asthma among World Trade Center First Responders: A Qualitative Synthesis and Bias Assessment," IJERPH, MDPI, vol. 15(6), pages 1-14, May.
    8. Giuseppe La Torre & Remigio Bova & Rosario Andrea Cocchiara & Cristina Sestili & Anna Tagliaferri & Simona Maggiacomo & Camilla Foschi & William Zomparelli & Maria Vittoria Manai & David Shaholli & Va, 2023. "What Are the Determinants of the Quality of Systematic Reviews in the International Journals of Occupational Medicine? A Methodological Study Review of Published Literature," IJERPH, MDPI, vol. 20(2), pages 1-12, January.
    9. Frank Peinemann & Ulrich Grouven & Nicolaus Kröger & Carmen Bartel & Max H Pittler & Stefan Lange, 2011. "First-Line Matched Related Donor Hematopoietic Stem Cell Transplantation Compared to Immunosuppressive Therapy in Acquired Severe Aplastic Anemia," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-16, April.
    10. Jonathan Kingsley & Aisling Bailey & Nooshin Torabi & Pauline Zardo & Suzanne Mavoa & Tonia Gray & Danielle Tracey & Philip Pettitt & Nicholas Zajac & Emily Foenander, 2019. "A Systematic Review Protocol Investigating Community Gardening Impact Measures," IJERPH, MDPI, vol. 16(18), pages 1-12, September.
    11. Wei-Wei Chen & Feng Wang & Rui-Hua Xu, 2013. "Platinum-Based Versus Non-Platinum-Based Chemotherapy as First Line Treatment of Inoperable, Advanced Gastric Adenocarcinoma: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-8, July.
    12. Giovanni Vinti & Valerie Bauza & Thomas Clasen & Kate Medlicott & Terry Tudor & Christian Zurbrügg & Mentore Vaccari, 2021. "Municipal Solid Waste Management and Adverse Health Outcomes: A Systematic Review," IJERPH, MDPI, vol. 18(8), pages 1-26, April.
    13. Hanna Górska-Warsewicz, 2022. "Consumer or Patient Determinants of Hospital Brand Equity—A Systematic Literature Review," IJERPH, MDPI, vol. 19(15), pages 1-36, July.
    14. André Ramalho & João Serrano & Rui Paulo & Pedro Duarte-Mendes & António Rosado & João Petrica, 2021. "Emerging Qualitative Research Trends (2010–2021) on Sedentary Behaviour among Older Adults: A Systematic Literature Review Protocol," IJERPH, MDPI, vol. 18(21), pages 1-8, November.
    15. S. Rajsic & H. Gothe & H. H. Borba & G. Sroczynski & J. Vujicic & T. Toell & Uwe Siebert, 2019. "Economic burden of stroke: a systematic review on post-stroke care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 107-134, February.
    16. Sibonokuhle Ndlovu, 2023. "Preparedness and Response to COVID-19 Disruptions and Learning Challenges for Students with Disabilities in South Africa: A Systematic Review," Sustainability, MDPI, vol. 15(2), pages 1-17, January.
    17. João Carlos Belloti & Aldo Okamura & Jordana Scheeren & Flávio Faloppa & Vinícius Ynoe de Moraes, 2019. "A systematic review of the quality of distal radius systematic reviews: Methodology and reporting assessment," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-12, January.
    18. Abbas Mardani & Dalia Streimikiene & Edmundas Kazimieras Zavadskas & Fausto Cavallaro & Mehrbakhsh Nilashi & Ahmad Jusoh & Habib Zare, 2017. "Application of Structural Equation Modeling (SEM) to Solve Environmental Sustainability Problems: A Comprehensive Review and Meta-Analysis," Sustainability, MDPI, vol. 9(10), pages 1-65, October.
    19. Luísa Bandeira Lopes & João Albernaz Neves & João Botelho & Vanessa Machado & José João Mendes, 2021. "Regenerative Endodontic Procedures: An Umbrella Review," IJERPH, MDPI, vol. 18(2), pages 1-17, January.
    20. Bernice Redley & Tracy Douglas & Mari Botti, 2020. "Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(9-10), pages 1477-1487, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9018-:d:870802. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.