Managing inpatient bed setup: an action-research approach using lean technical practices and lean social practices
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 31 January 2023
Issue publication date: 18 April 2023
Abstract
Purpose
This article aims to introduce a guide to improving hospital bed setup by combining lean technical practices (LTPs), such as kaizen and value stream mapping (VSM) and lean social practices (LSPs), such as employee empowerment.
Design/methodology/approach
Action research approach was employed to analyze the process of reconfiguration of bed setup management in a Brazilian public hospital.
Findings
The study introduces three contributions: (1) presents the use of VSM focused specifically on bed setup, while the current literature presents studies mainly focused on patient flow management, (2) combines the use of LSPs and LTPs in the context of bed management, expanding current studies that are focused either on mathematical models or on social and human aspects of work, (3) introduces a practical guide based on six steps that combine LSPs and LSPs to improve bed setup management.
Research limitations/implications
The research focused on the analysis of patient beds. Surgical beds, delivery, emergency care and intensive care unit (ICU) were not considered in this study. In addition, the process indicators analyzed after the implementation of the improvements did not contemplate the moment of the COVID-19 pandemic. Finally, this research focused on the implementation of the improvement in the context of only one Brazilian public hospital.
Practical implications
The combined use of LSPs and LTPs can generate considerable gains in bed setup efficiency and consequently increase the capacity of a hospital to admit new patients, without the ampliation of the physical space and workforce.
Social implications
The improvement of bed setup has an important social character, whereas it can generate important social benefits such as the improvement of the admission service to patients, reducing the waiting time, reducing hospitalization costs and improving the hospital capacity without additional physical resources. All these results are crucial for populations, their countries and regions.
Originality/value
While the current literature on bed management is more focused on formal models or pure human and social perspectives, this article brings these two perspectives together in a single, holistic framework. As a result, this article points out that the complex bed management problem can be efficiently solved by combining LSPs and LTPs to present theoretical and practical contributions to the important social problem of hospital bed management.
Keywords
Acknowledgements
The authors would like to thank the Federal University of Ouro Preto (UFOP/Brazil) (www.ufop.br), Foundation for Research Support of the State of Minas Gerais (FAPEMIG, grand number APQ-00951-22), Coordination for the Improvement of Higher Education Personnel (CAPES) and National Council for Scientific and Technological Development (CNPq), for the support and funding during the development of the research. The authors also would like to thank the editors of the Journal and their reviewers, who contributed to the improvement of this article.
Citation
Reis, L.P., Fernandes, J.M., Silva, S.E. and Andreosi, C.A.d.C. (2023), "Managing inpatient bed setup: an action-research approach using lean technical practices and lean social practices", Journal of Health Organization and Management, Vol. 37 No. 2, pp. 213-235. https://doi.org/10.1108/JHOM-09-2021-0365
Publisher
:Emerald Publishing Limited
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