Improvements in the obstetric center of a public hospital: a case study of the use of Lean Healthcare tools

Authors

DOI:

https://doi.org/10.47456/bjpe.v10i2.44242

Keywords:

Lean Healthcare, Waste, Tools

Abstract

The Brazilian health system faces challenges in providing services. Focusing on Lean Healthcare, hospital management seeks improvements in relation to process efficiency and the quality of services provided, reducing waste. The research focuses on analyzing and improving the processes of the Obstetric Center (OC) of a hospital in Feira de Santana, using Lean Healthcare. The study aims to identify waste that affects the length of stay of patients in the OC and propose improvements. The research, classified as descriptive and exploratory, was conducted in a case study format and applied Value Stream Mapping (MFV), to identify waste, classify it and suggest improvements. Waste in patient flow, such as unnecessary waiting and movement, was identified, resulting in proposals for changes in processes and organizational culture. Performance indicators, such as length of stay, were defined to monitor results. It is expected that the proposed improvements, combined with the training of professionals on Lean, will reduce the length of stay in the OC by 37%, improving the efficiency and quality of care. The study highlights the importance of continuous improvement of healthcare processes to ensure a more effective and safe service.

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Author Biographies

Willma Bastos Ribeiro Oliveira, Universidade Federal do Recôncavo da Bahia

I am currently studying Production Engineering at the Federal University of Recôncavo da Bahia (UFRB), in Feira de Santana. I have a Bachelor's degree in Energy and Sustainability, from the same educational institution, and I have a Logistics Technician diploma from the National Industrial Learning Service (SENAI). I was the Financial Coordinator of the Bahian Nucleus of Production Engineering Students (NUBEEP) and Administrative/Financial Director of EngTemp JR. Currently, I am part of the Lean Healthcare project, working in the Applied Research part at a hospital in the city where I live.

Camille Pereira Guimarães , Universidade Federal do Recôncavo da Bahia

He has experience in the area of ​​Production Engineering, with an emphasis on Production Engineering. Fellow researcher for the Lean Healthcare scientific initiation project. Acts as CEO of Engtemp Jr, a junior consulting and engineering company

Maria Clara Sampaio Gonçalves, Universidade Federal do Recôncavo da Bahia

Student of the Interdisciplinary Bachelor's Degree in Energy and Sustainability (BES), with an emphasis on Production Engineering, at the Federal University of Recôncavo da Bahia (UFRB). Currently a scholarship holder for Initiation in Technological Development and Innovation (PIBITI) in the Lean Healthcare research project applied to the healthcare area of ​​Feira de Santana and a volunteer in the WIE IEEE affinity group at UFRB.

Andressa Clara Barbosa de Araujo, Universidade Federal da Bahia

Master's student in the Industrial Engineering Program (PEI) at the Federal University of Bahia (UFBA). He has a Bachelor's degree in Production Engineering from the Federal University of Recôncavo da Bahia (2023) and a Bachelor's degree in Interdisciplinary in Energy and Sustainability from the Federal University of Recôncavo da Bahia (2022). During his graduation, he was a Fellow in Initiation in Technological Development and Innovation of the Lean Healthcare project applied to the healthcare area of ​​Feira de Santana (2022-2023), a Fellow in Scientific Initiation of the Lean Healthcare project applied to the healthcare area of ​​Feira de Santana (2021 - 2022) and Scholarship in scientific initiation of the research project Study of the preparation of biodegradable polymers using agricultural waste (2017 - 2018).

Cristiane Agra Pimentel, Universidade Federal do Recôncavo da Bahia

Currently a professor at the Federal University of Recôncavo da Bahia (UFRB) in Feira de Santana on the Production Engineering course, senior member of the IEEE. He has 12 years of experience in the metallurgical industrial area. Expertise developed in the areas of quality, production system (lean), audits and certifications. Internal and external auditor of the Integrated Management System (ISO 9001, ISO 14001 and ISO IEC 17025) and Green Belt. During her master's degree she worked with the implementation of ISO standards in the public service, highlighting the accreditation of the Biomaterials laboratory of the Northeast CERTBIO in the ISO/IEC 17025 standard, and during her doctorate she worked with the development of materials for application as biomaterials. Currently leading the Lean Healthcare research project focusing on the healthcare area at BA and the Impacts of AI on education, in addition to working on issues related to female performance in exact sciences. Recipient of the 2021 IEEE Undergraduate Teaching Award, IEEE WIE 2021 and 2022 Honorable Mention- Inspiring Member of the Year Award and 2021 Outstanding Branch Counselor Branch Chapter Advisor Award. As of 2024, he is a member of the IEEE R9 Industry Engagement Committee and is Vice Chair of the WIE northeast section.

References

Andriani, I. & Ignácio, P. (2019). Aplicação de Ferramentas Lean Healthcare em Serviços de Saúde de Hemodiálise. Anais do ENEGEP - Encontro Nacional de Engenharia de Produção, São Paulo, SP, Brasil, 29, 18p. Recuperado de https://abepro.org.br/biblioteca/TN_STO_290_1634_37823.pdf DOI: https://doi.org/10.14488/ENEGEP2019_TN_STO_290_1634_37823

Brito, M. P., de. (2018). Aplicação de técnicas de gestão avançada Lean Healthcare para otimizar o fluxo de pacientes do pronto-socorro de um hospital universitário público de Belo Horizonte (Dissertação de mestrado), Universidade Federal de Minas Gerais. Minas Gerais, MG, Brasil. Recuperado de https://abepro.org.br/biblioteca/TN_STO_290_1634_37823.pdf

Boronat, F., Budia, A., Broseta, E., Ruiz-Cerdá, J. L., & Vivas-Consuelo, D. (2018). Aplicación de la metodología Lean healthcare en un servicio de urología de un hospital terciario como herramienta de mejora de la eficiencia. Actas Urol Esp., 42(1), 42-48. https://doi.org/10.1016/j.acuro.2017.03.009 DOI: https://doi.org/10.1016/j.acuro.2017.03.009

Campos, R., Oliveira, L. C. Q., Silvestre, B. S., & Ferreira, A. S. (2005). A ferramenta 5S e suas implicações na gestão da qualidade total. In: XII Simpósio de Engenharia de Produção - SIMPE, São Paulo, SP, Brasil. p. 1-12. Recuperado de https://www.simpep.feb.unesp.br/anais/anais_12/copiar.php?arquivo=Campos_R_A%20FERRAMENTA%205S%20E%20SUAS.pdf

Castello, R. V. (2022). Lean healthcare: um caminho para melhorias de gestão e serviços de saúde. (Dissertação de Mestrado) - Universidade Federal de Uberlândia. Uberlândia, MG, Brasil.

DOI http://dx.doi.org/10.14393/ufu.di.2022.222. DOI: https://doi.org/10.14393/ufu.di.2022.222

Consul, J. T. (2015). Aplicação de Poka Yoke em processos de caldeiraria. Porto Alegre: Production, 25(3), 678-690. https://doi.org/10.1590/0103-6513.084012 DOI: https://doi.org/10.1590/0103-6513.084012

Coutinho, F. M. J. & Aquino, J. T., de. (2016). Os 5s como diferencial competitivo para o sistema de gestão da qualidade: estudo de caso de uma empresa de aços longos. Gestão.Org, 13(2), 176-186. Recuperado de https://periodicos.ufpe.br/revistas/index.php/gestaoorg/article/view/22077

D'Andreamatteo, A. Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A comprehensive review. Health Policy, v. 119, 1197-1209.

https://doi.org/10.1016/j.healthpol.2015.02.002 DOI: https://doi.org/10.1016/j.healthpol.2015.02.002

Deguirmendjian, S. C. (2016). Lean Healthcare: aplicação do diagrama de espaguete em uma

unidade de emergência. (Dissertação de mestrado), Universidade Federal de São Carlos, São Carlos, SP, Brasil. Repositório Institucional da UFSCar. Recuperado de

https://repositorio.ufscar.br/handle/ufscar/7405

Freitas, W. R. S. & Jabbour, Charbel, J. C. (2011). Utilizando Estudo de Caso(s) como Estratégia de Pesquisa Qualitativa: boas práticas e sugestões. Estudo & Debate, 18(2), 07-22. Recuperado de http://www.meep.univates.br/revistas/index.php/estudoedebate/article/view/560/550

Ferreira, S. B., Fiorotto, H. N., & Brilinger, C. O. (2021). Implantação da Metodologia Lean Healthcare no Pronto-Socorro de um Hospital Público: impactos no gerenciamento de leitos (Monografia), Congresso Internacional em Saúde, Joinville, SC, Brasil, 8, 14p. Recuperado de https://publicacoeseventos.unijui.edu.br/index.php/conintsau/article/view/19307

Gil, A. C. (2010). Como Elaborar Projetos de Pesquisa. 41-42, São Paulo: Atlas. Recuperado de https://files.cercomp.ufg.br/weby/up/150/o/Anexo_C1_como_elaborar_projeto_de_pesquisa-antonio_carlos_gil.pdf

Godoy, A. S. (1995). Pesquisa Qualitativa: tipos fundamentais. Revista de Administração de Empresas, 35(3), 20-29.

https://doi.org/10.1590/S0034-75901995000300004 DOI: https://doi.org/10.1590/S0034-75901995000300004

Graban, M. (2013). Hospitais Lean. Editora Bookman, 2 ed. Recuperado de https://livrariapublica.com.br/livros/hospitais-lean-mark-graban/

Instituto Brasileiro de Geografia e Estatística. (2022). Síntese dos indicadores sociais: Uma análise das condições de vida da população brasileira. Recuperado de https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/33484-despesas-com-saude-em-2019-representam-9-6-do-pib#:~:text=As%20despesas%20relativas%20%C3%A0%20sa%C3%BAde,da%20Sa%C3%BAde%2C%20iniciada%20em%202010.

Juventino, K. S. J., Barbara, E., Silva, M., da, & Pimentel, C. A. (2021). Lean nas Emergências: análise comparativa da implementação em cinco hospitais brasileiros. Revista de Administração Hospitalar e Inovação em Saúde - RAHIS, 18(3). https://doi.org/10.21450/rahis.v18i3.7097 DOI: https://doi.org/10.21450/rahis.v18i3.7097

Lean Institute Brasil. (2019). Lean na saúde. Recuperado de https://www.lean.org.br/workshop/110/lean-na-saude.aspx

Lenzi, F. C., Kiesel, M. D., & Zucco, F. D. (2010). Ação empreendedora: como desenvolver e administrar seu negócio com excelência. São Paulo: Gente.

Magalhães A. L. P., Erdmann, A. L., Silva, E. L., & Santos, J. L. G. (2016). Lean thinking in health and nursing: an integrative literature review. Latino-Americana de Enfermagem, 24:e2734. http://dx.doi.org/10.1590/1518-8345.0979.2734 DOI: https://doi.org/10.1590/1518-8345.0979.2734

Marion, J. C., Dias, R., & Traldi, M. C. (2002). Monografia para os cursos de administração, contabilidade e economia. São Paulo: Atlas.

Oliveira, E. L., Jr. (2017). Pesquisa científica na graduação: um estudo das vertentes temáticas e metodológicas dos TCCs. 25 f. (Trabalho de Conclusão de Curso). Faculdade de Ciências Integradas do Pontal, Universidade Federal de Uberlândia, Ituiutaba, Brasil. Recuperado de https://repositorio.ufu.br/handle/123456789/20939

Organização Nacional de Acreditação. (2024). Certificações concedidas. Recuperado de https://www.ona.org.br.

Penha, H. H. R. (2017). Lean Healthcare: avaliação da aplicação do diagrama de espaguete em uma unidade pediátrica. (Dissertação de Mestrado), Universidade Federal de São Carlos - UFSCar, São Carlos, SP, Brasil. Recuperado de https://repositorio.ufscar.br/bitstream/handle/ufscar/9406/DissHHRP.pdf?sequence=1&isAllowed=y

Pinho, T. R. (2016). Lean Healthcare: uma revisão da realidade nacional. (Dissertação de Mestrado). Universidade da Beira Interior. Covilhã, Portugal. Recuperado de https://ubibliorum.ubi.pt/handle/10400.6/5345?locale=en

Ribas, T. (2023). Kanban: O que é, como funciona e como adotar? Recuperado de https://thomazribas.com/agile/kanban.

Rodrigues, A. C. O. (2015). Adoção dos Princípios Lean na Saúde: estudo de caso em um hospital geral. (Projeto de Graduação), Faculdade de Tecnologia Departamento de Engenharia de Produção, Universidade de Brasília, Brasília, Brasil. Recuperado de https://bdm.unb.br/bitstream/10483/13664/1/2015_AnaCristinadeOliveiraRodrigues.pdf

Rodrigues, A. C. O. & Affonso, A., Neto. (2017). Aplicação do Lean no setor de saúde: estudo de caso em um hospital geral. Journal of Lean Systems, 2(2), 46-67. Recuperado de https://ojs.sites.ufsc.br/index.php/lean/article/view/1635

Rother, M. & Snook, J. (2003). Aprendendo a enxergar mapeando o fluxo de valor para agregar valor e eliminar desperdício. São Paulo: Lean Institute Brasil.

Santandreu, O. M., Mascarell, C. S., & Sabater, J. J. G. (2021). A Model for the Implementation ofLean Improvements in Healthcare Environments as Applied in a Primary Care Center. International Journal of Environmental Research and Public Health, Spain, 18, 28-76. https://doi.org/10.3390/ijerph18062876 DOI: https://doi.org/10.3390/ijerph18062876

Santos, M. C., do & Balsanelli A. P. (2021). Implementação do Lean Healthcare em serviços de saúde hospitalares. Revista de enfermagem on line - UFPE, 15, 1-18. https://doi.org/10.5205/1981-8963.2021.247422 DOI: https://doi.org/10.5205/1981-8963.2021.247422

Shingo, S. (1986). Zero Quality Control: Source Inspection and the Poka-Yoke System. Massachusetts: Productivity Press.

Vieira, F. S. (2020). Direito à Saúde no Brasil: seus contornos, judicialização e a necessidade da macrojustiça. Instituto de Pesquisa Econômica Aplicada. Brasília: IPEA. 01-74. Recuperado de https://repositorio.ipea.gov.br/bitstream/11058/9714/1/TD_2547.pdf

Vieira, L. C. N., Menezes, M. O., Pimentel, C. A., & Juventino, G. K. S. (2020). Lean Healthcare no Brasil: uma revisão bibliométrica. São Paulo: Gestão Sistema de Saúde. Recuperado de https://doi.org/10.5585/rgss.v9i3.16882 DOI: https://doi.org/10.5585/rgss.v9i3.16882

Xavier, A. S., Silva, A. A., de, Sabino, E. R., Feitosa, A. D., Ribeiro, T. S., & Jenuário, T. L. S. (2018). Emprego da metodologia seis sigma na melhoria de processos: um estudo bibliométrico. Cap. 5, 15- 25. Belo Horizonte: Poisson. Recuperado de https://www.poisson.com.br/livros/lean/volume1/Sistemas_Lean_vol1.pdf DOI: https://doi.org/10.14488/ENEGEP2017_TN_STO_238_376_33880

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Published

2024-05-07

How to Cite

Oliveira, W. B. R., Guimarães , C. P., Gonçalves, M. C. S., Araujo, A. C. B. de, & Pimentel, C. A. (2024). Improvements in the obstetric center of a public hospital: a case study of the use of Lean Healthcare tools. Brazilian Journal of Production Engineering, 10(2), 182–195. https://doi.org/10.47456/bjpe.v10i2.44242

Issue

Vol. 10 No. 2 (2024): Regular Issue (April - June) *Publication Articles Continuous Flow*

Section

QUALITY ENGINEERING

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