Aplicació del model Lean Healthcare en la gestió de blocs quirúrgics: model Vall d'Hebron de gestió quirúrgica

Sales Coll, Marc
The purpose of this thesis is to investigate, analyze and interpret the results of a series of interventions applied in the surgical area with the aim of increasing the productivity and efficiency of the care activity. A methodology for implementing planning and execution processes in the healthcare environment based on Lean Management is presented. From the study of the literature on facilitators and barriers in this type of implantation together with the experience acquired in a Hospital of high complexity as it is Vall d'Hebron, and in the frame of the methodology Action Research, present the different steps to consider in a comprehensive improvement project in order to maintain a Lean Transformation over time. For each stage, the key points to consider and possible contingency points are presented. The Lean tools that have been applied to a total of 80 improvement projects successfully implemented at the Hospital as part of the Surgical Process are also illustrated with examples. The conclusion is to establish a roadmap for conducting Lean-based improvement projects, and to fill the current gap that exists between a large number of theoretical proposals that have not been implemented or maintained in the medium term, and the sustainability over time of the projects developed by the Hospital's improvement teams. It shows the experience of more than 3 years of work between the phases of constitution of the teams of improvement, training of the professionals in Lean and realization of the maps of process, detect the value of each action from the point of view of the patient (VSM), up to the prioritization of opportunities, implementation and verification of the results obtained, laying the foundations for the sustainability of these projects and continuous improvement. The economic impact resulting from the implementation of improvement projects on the surgical process is also analyzed, which at the end of the study meant an annual operating saving of more than € 8.5 million after applying different concepts related to the improvement of patient flow management, the management of information among professionals and the improvement of the logistics circuits of materials. ​
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