A influência do Lean Healthcare para gestão hospitalar

Marcos Lucas de Oliveira, Lizandra Garcia Lupi Vergara

Resumo


O estudo da ergonomia envolve a verificação dos fatores que influenciam no desempenho do sistema produtivo e causam consequências aos trabalhadores. Dessa forma, procuram reduzir a fadiga, estresse, erros e acidentes proporcionando saúde, segurança e satisfação aos empregados, durante a sua interação com o sistema produtivo. Esse estudo objetivou identificar quais são as variáveis que intervém nos processos de operacionalização de sistemas complexos que utilizam os princípios da filosofia lean healthcare. A metodologia utilizada foi de natureza aplicada, com o uso de entrevistas focalizadas por meio de questionários. Os resultados do estudo apontam que os hospitais investigados possuem uma baixa implementação da filosofia lean e não há uma aferição da implementação com o aumento do nível de segurança laboral. Conclui-se que, de modo geral, a gestão hospitalar ainda está com cerne nos procedimentos operacionais e não com foco no paciente. Ademais, evidencia-se que os avanços no elo da gestão hospitalar no setor público, no sul do Brasil, são baixos e os métodos de gestão são, portanto classificados como tradicionais e/ou obsoletos.

Palavras-chave


Ergonomia. Engenharia de resiliência. Sistemas complexos. Hospitais públicos. Lean healthcare.

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Referências


AL-ARAIDAH, O., et al. Lead-time reduction utilizing lean tools applied to healthcare: the inpatient pharmacy at a local hospital, Journal for Healthcare Quality, v. 32, p. 59-66, 2010.

ANDRADE, A. L.; SELEME, A.; RODRIGUES, L. H.; SOUTO, R. Pensamento sistêmico: caderno de campo: o desafio da mudança sustentada nas organizações e na sociedade. Porto Alegre, Brasil: Bookman, 2006.

AZADEH, A. et al. A unique algorithm for the assessment and improvement of job satisfaction by resilience engineering : Hazardous labs. International Journal of Industrial Ergonomics, v. 49, p. 68–77, 2015.

AZADEH, A.; ZARRIN, M. An intelligent framework for productivity assessment and analysis of human resource from resilience engineering , motivational factors , HSE and ergonomics perspectives. Safety Science, v. 89, p. 55–71, 2016.

AZADEH, A; ROUDI, E.; SALEHI, V. Optimum design approach based on integrated macro-ergonomics and resilience engineering in a tile and ceramic factory. Safety Science, v. 96, p. 62–74, 2017.

BACK, J. et al. Resilience markers for safer Systems and organisations. Computer safety, reliability, and security, p. 99-112, 2008.

BARDIN, L. Análise de conteúdo. Lisboa: Edições 70, 1977.

CAGLIANO, A. C.; GRIMALDI, S.; RAFELE, C. A systemic methodology for risk management in healthcare sector. Safety Science, v. 49 (5), p. 695-708, 2011.

COSTA, L. B. M.; GODINHO FILHO, M. Lean healthcare: review, classification and analysis of literature. Production Planning and Control, v. 27, n. 10, p. 823-836, 2016.

D’ANDREAMATTEO, A. et al. Lean in Healthcare: a comprehensive review. Health Policy, v. 119, p.1197-1209, 2015.

DE SOUZA, L. B; PIDD, M. Exploring the barriers to lean health care implementation. Public Money & Managemen, v. 31, n. 1, p. 59-66, 2011.

DEKKER, S. et al. Complicated, complex, and compliant: best practice in obstetrics. Cogn Technol Work, Applied Ergonomics, v. 15, p. 189–95, 2013.

DICKSON, E. W., ET. AL. Application of Lean Manufacturing Techniques in the Emergency Department, Journal of Emergency Medicine, v. 37(2), p.177-182, 2008.

DINH, L.T. et al. Resilience engineering of industrial processes: principles and contributing factors. Journal of Loss Prevention in the Process Industries, v. 25 (2), p. 233–241, 2012.

DOMINGUES, M.; BATISTA, A. L. F.; TATO, D. M. International Journal of Mining Science and Technology Engineering complex systems applied to risk management in the mining industry. International Journal of Mining Science and Technology, v. 27, n. 4, p. 611–616, 2017.

ÉRDI, P. Complexity explained. Berlin: Springer, 2008.

FERNANDES, P. R.; HURTADO, A. L. B.; BATIZ, E. C. Ergonomics management with a proactive focus. Procedia Manufacturing, v. 3, n. Ahfe, p. 4509–4516, 2015.

FURNISS, D., et al. A resilience markers framework for small teams. Reliability Engineering & System Safety, v. 96 (1), p. 2–10, 2011.

GIL, A. C. Como Elaborar Projetos de Pesquisa. São Paulo. 5º Ed. Editora: Atlas. 2010.

HAENKE, R.; STICHLER, J.F.; Applying lean six sigma for innovative change to the post-anesthesia care unit. Journal of Nursing Administration, v. 45, n. 4, p. 185-187. 2015.

HENDRICK, H.W. Applying ergonomics to systems: Some documented “lessons learned”. Applied Ergonomics, v. 39, n. 4, p. 418-426, 2008.

HENDRICK, H.W. Ergonomics in organizational design and management. Ergomics, v 34, n. 6, p. 743-756, 1991.

HETTINGER, L. J. et al. Modelling and simulation of complex sociotechnical systems: envisioning and analysing work environments. Ergonomics, v. 58, p. 600–14, 2015.

HOLDEN, R. J. et al. Healthcare workers’ perceptions of lean: A context-sensitive, mixed methods study in three Swedish hospitals. Applied Ergonomics, v. 47, p. 181–192, 2015.

HOLLNAGEL, E. Prologue: the scope of resilience engineering. Resilience engineeringin practice: a guidebook, Farnham, UK: Ashgate, p.19-29, 2011.

HOUCHENS, N.; KIM, S. C. The Application of Lean in the Healthcare Sector: Theory and Practical Examples, In Wickramasinghe et al., Lean Thinking for Healthcare, Springer New York, p. 43-53, 2014.

JACOBSON, M. J. et al. Designs for learning about climate change as a complex system. Learning and Instruction, v. 52, p. 1–14, 2017.

JOHNSON, N. Simply complexity: a clear guide to complexity theory. Oxford: One-World; 2010.

KAPLAN, G.; PATTERSON S. Seeking perfection in healthcare: A case study in adopting Toyota Production System methods. Healthcare executive, v. 23, pp.16-21, 2008.

KIM, C. S.; et al. Lean health care: what can hospitals learn from a world-class automaker?, Journal of Hospital Medicine. v. 1, n. 3, 191–199, 2006.

KURTZ, C. F.; SNOWDEN, D. J. The new dynamics of strategy: sense-making in acomplex-complicated world. IBM Journal of Research & Development, v.42, p.462–83, 2003.

MANS, R.; W. VAN, D. E. A; VANWERSCH, R. J. Process Mining in Healthcare: Evaluating and Exploiting Operational Healthcare, Processes, 2015.

MARCONI, M. A.; LAKATOS, E. M. Fundamentos da metodologia científica. São Paulo: Altas, 2010.

MIGUEL, C. P. A. Metodologia de Pesquisa em Engenharia de Produção. Rio de Janeiro: Elsevier, 2010.

MINTZBERG, H. Managing the myths of health care, World Hosp. Health Serv. Journal International Hospital Federation, v 48, n. 3, p. 4–7, 2012.

MOLDOVAN, F. New Approaches and Trends in Health Care. Procedia Manufacturing, v. 22, p. 947–951, 2018.

MONTERO, R. Los fundamentos teóricos de la práctica de la gestión de la seguridad bajo escrutinio, en Protección & Seguridad, v. 59 (350), p. 6-14, 2013.

NARAYANAMURTHY, G.; GURUMURTHY, A. Is the hospital lean? A mathematical model for assessing the implementation of lean thinking in healthcare institutions. Operations Research for Health Care, v. 18, p. 84–98, 2018.

NARAYANAMURTHY, G.; GURUMURTHY, A. Leanness assessment: a literature review. International Journal of Operations & Production Management, v. 36 (10), p. 1115–1160, 2016.

OLIVEIRA, M.L.; JORDÃO, C.; VERGARA, L.G.L. Fatores biomecânicos: uma análise do trabalho dos enfermeiros. Saber Humano, v. 9, n. 14, p. 154-166, 2019.

PAVARD, B., DUGDALE, J. A Tutorial on Complexity in Social Sciences. Disponível em: http://www.irit.fr/COSI. Acesso em: 20, set. 2018.

PINTO, J. P. Pensamento Lean: A filosofia das organizações vencedoras. Lisboa: Lidel, 2009.

POKSINSKA, B. B.; FIALKOWSKA-FILIPEK, M.; ENGSTRÖM, J. Does Lean healthcare improve patient satisfaction? A mixed-method investigation into primary care. BMJ Quality and Safety, v. 26, n. 2, p. 95–103, 2018.

RADNOR, Z. Implementing Lean in Health Care: Making the link between the approach, readiness and sustainability. International Journal of Industrial Engineering and Management, v.2(1), p.1-12, 2011.

RENIERS, G.; SORENSEN, K.; KHAN, F. Amyotte P.Resilience of chemical industrial areas through attenuationbased security. Reliability Engineering & System Safety, v. 131, p. 94–101, 2014.

RIGHI, A. W.; SAURIN, T. A.; WACHS, P. A. systematic literature review of resilience engineering: Research areas and a research agenda proposal. Reliability Engineering and System Safety, v. 141, p. 142–152, 2015.

ROJAS, E. et al. Process mining in healthcare: A literature review. Journal of Biomedical Informatics, v. 61, p. 224–236, 2016.

SAURIN, T. A. et al. The design of scenario-based training from the resilience engineering perspective: A study with grid electricians. Accident Analysis and Prevention, v. 68, p. 30–41, 2014.

SNOWDEN, D. F.; BOONE, M. E. A leader’s framework for decision making: wise executives tailor their approach to fit the complexity of the circumstances they face. Harvard Business Review, p. 69–76, 2007.

SOLIMAN, M.; SAURIN, T. A. Lean production in complex socio-technical systems: A systematic literature review. Journal of Manufacturing Systems, v. 45, p. 135–148, 2017a.

SOLIMAN, M.; SAURIN, T. A. Uma análise das barreiras e dificuldades em lean healthcare. Revista Produção Online, v.17, n. 2, p. 620-640, 2017b.

SOUZA, B. L.; PIDD, M. Exploring the barriers to lean health care implementation. Public Money & Management, v. 31 (1), p. 59-66, 2011.

SOUZA, L.; SOUZA. Trends and approaches in lean healthcare. Leadership in health services, v. 22(2), p. 121-139, 2009.

TRIST, E. The evolution of socio-technical systems: a conceptual framework and action research program. In: Occasional Paper No. 2. Ontario, CA: Ontario Quality of Working Life Centre; 2017.

WACHS, P. et al. Resilience skills as emergent phenomena : A study of emergency departments in Brazil and the United States. Applied Ergonomics, v. 56, p. 227–237, 2016.

WALKER, G.H. et al. Translating concepts of complexity to the field of ergonomics. Ergonomics, v. 53, p. 1175–86, 2010.

WAN, J. et al. How attachment influences users willingness to donate to content creators in social media: A sociotechnical systems perspective. Information & Management, v. 54, n. 7, p. 837–850, 2017.

WELLMAN, J.; HAGAN, P.; JEFFRIES, H. Leading the Lean Healthcare Journey. New York: Taylor and Francis Group, 2011.

YOUNG, T. et al. Using industrial processes to improve patient care. BMJ, vol. 328, p. 162–164, 2004.




DOI: https://doi.org/10.18815/sh.2020v10n17.433

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