Gestão de Operações Hospitalares: um framework de indicadores baseado em Lean Healthcare

The previously issues related to hospital management, such as increased hospital costs and demand, inefficiencies in processes, low productivity and patient dissatisfaction, demands for improvements in management approaches. These improvements can lead to a change of Hospital Operations Management with the application of process improvement techniques such as Lean Healthcare, business process management models, simulation technologies and automatic collection of process information. This project aims to develop a Lean Healthcare Indicators Framework for Hospital OM, enabling the improvement of KPI using adaptable OM tools. The specific objectives are: O1: Identify the main OM factors influencing Lean Healthcare KPIs - addressing GAP1 described in the state-of-the-art section. O2: Create OM generic patients’ process flow models for emergency departments, surgical services, and outpatient consultation, adaptable to different hospitals’ contexts – GAP2. O3: Create prototypes of these process models that can be used for simulation purposes in different contexts – GAP3. O4: Create prototypes for automatic collection of process information based on patients’ flows – GAP4. Illustrative O1 examples of OM factors are the availability of beds, MD, nurses, patients, materials, and equipment. An illustration of KPIs would be staffing ratio per bed, Average length of stay, and Waiting time. The O2 will allow to create starting points of adaptable models to be used in different contexts. As an example, if a generic BPMN model for patient flow in ED exists, it could be used for different ED contexts adapted to the existing OM factors (e.g. resources, materials, equipment). O3 will allow to create more detailed simulation models (e.g. using Simio) based on the previous generic process models. These detailed models may be used for improvement processes or for designing new systems. As one of the main gaps identified in the literature is the inexistence of detailed information of processes in hospital environments, this project proposes to apply automatic methods and systems to collect data from patients (e.g. using indoor localization systems) that allow to make a detailed characterisation of patients’ flow. These objectives are important to overcome society important difficulties with healthcare management and improve the patients experience by, as an example, increasing its overall satisfaction or reducing the waiting times. It will also allow to develop and/or integrate different technologies, not yet used in these contexts, for the improvement of HOM. Moreover, these are gaps identified in recent literature, as showed in the state-of-the-art section. There are recent scientific studies that show the need for a better understanding of KPIs (GAP1), for the development of more comprehensive models (GAP2), applicable to diverse and wide-ranging contexts (GAP2/3), and the need for more generic simulation systems (GAP3) using detailed information automatically collected (GAP4). Related to GAP4, the proposal has an additional innovation point, as it is focused on the collection of patients’ flow, and using that information to characterize and improve the process. This framework, and these objectives will be pursued with collaboration of the stakeholders, including health professionals, managers, researchers and patients. Furthermore, these stakeholders will contribute for the evaluation of the overall project in different hospitals.