Modeling the flows of high risk patients with COVID-19 in Matanzas with a Lean approach

Authors

Keywords:

integrated management, patients flow, COVID-19, Lean approach

Abstract

Introduction: in the context of the pandemic, the efficient management of the patients flow with a focus on their trajectory is crucial. In this sense, the Lean approach allows to increase the performance of the health care system, eliminating activities that do not generate value for the patient.

Objective: to carry out an integral analysis of the high risk patients flow with COVID-19 in Matanzas, using the Lean approach.

Materials and methods: a quantitative methodology, structured in four stages was implemented for the integrated management of the flow of high risk patients with COVID-19, using the Lean approach.  This methodology integrates tools for the selection of experts, process representation, structural analysis and value flow maps. It was applied during the period of highest incidence of the pandemic in Matanzas (May 1st to August 1st 2021).

Results: deficiencies related to the flows of high risks patients with COVID-19 in Matanzas were identified. A comprehensive analysis of the flows was carried out in order to make a proposal for improvements with a Lean approach. The proposal guaranteed an optimization of 1 500 minutes per service cycle, with an efficiency of 85.86% of the total time of each cycle (treatment stage), and 59.38% of the waiting times between them.

Conclusions: Lean tools allow a comprehensive analysis of the patients’ flow, in addition to showing a route for their management, focused on the trajectory and not on the occupation of the resource.

Downloads

Download data is not yet available.

References

1. Malca Saavedra KY. Caso de estudio: atención de pacientes en sala quirúrgica [tesis en Internet]. Lima: Universidad de Piura; 2020 [citado 04/10/2022]. Disponible en: https://pirhua.udep.edu.pe/handle/11042/4547

2. Carnota Lauzán O. La irrupción de la gerencia en las organizaciones sanitarias del sector público. Rev Cubana Sal Públ [Internet]. 2016 [citado 04/10/2022];42(4):596-627. Disponible en: https://www.scielosp.org/article/rcsp/2016.v42n4/596-627

3. Chavarro Carvajal DA, Venegas Sanabria LC, Caicedo Correa SM, et al. Retos de la atención a las personas mayores con COVID-19 a nivel hospitalario. Asoc Colomb Gerontol Geriatr [Internet]. 2020 [citado 04/10/2022];34(1):81-6. Disponible en: http://hdl.handle.net/10554/53617

4. Sarmentero Bon I, Sánchez Suárez Y, Rodríguez Sánchez Y, et al. Bibliometría sobre cultura organizacional en el sector de la salud, ante la Covid-19. Universidad y Sociedad [Internet]. 2022 [citado 05/01/2023];14(S6):427-36. Disponible en: https://rus.ucf.edu.cu/index.php/rus/article/download/3474/3418

5. Sánchez Suárez Y, Gómez Pérez M, Maynoldi Pino K, et al. Contribución al perfeccionamiento del proceso de gestión de ingreso de pacientes con covid-19. Rev Cubana Administración Pública y Empresarial [Internet]. 2021 [citado 04/10/2022];5(3):e181. Disponible en: https://apye.esceg.cu/index.php/apye/article/view/181

6. Dawoodbhoy FM, Delaney J, Cecula P, et al. AI in patient flow: applications of artificial intelligence to improve patient flow in NHS acute mental health inpatient units. Heliyon [Internet]. 2021 [citado 04/10/2022];7(5):e06993. Disponible en: http://doi.org/10.1016/j.heliyon.2021.e06993

7. Dauncey SJ, Kelly PA, Baykov D, et al. Rhythmicity of patient flow in an acute medical unit: relationship to hospital occupancy, 7-day working and the effect of COVID-19. QJM: monthly journal of the Association of Physicians [Internet]. 2021 [citado 04/10/2022];114(11):773-9. Disponible en: http://doi.org/10.1093/qjmed/hcaa334

8. Berg E, Weightman AT, Druga DA. Emergency Department Operations II: Patient Flow. Emerg Med Clin North Am [Internet]. 2020 [citado 04/10/2022];38(2):323-37. Disponible en: http://doi.org/10.1016/j.emc.2020.01.002

9. Vali M, Salimifard K, Gandomi AH, et al. Application of job shop scheduling approach in green patient flow optimization using a hybrid swarm intelligence. Comput Ind Eng [Internet]. 2022 [citado 15/11/2022];172:108603. Disponible en: http://doi.org/10.1016/j.cie.2022.108603

10. Hulshof PJ, Kortbeek N, Boucherie RJ, et al. Taxonomic classification of planning decisions in health care: a structured review of the state of the art in OR/MS. Health systems [Internet]. 2012 [citado 04/10/2022];1:129-75. Disponible en: https://link.springer.com/article/10.1057/hs.2012.18

11. Blouin Delisle CH, Drolet R, Hains M, et al. Improving interprofessional approach using a collaborative lean methodology in two geriatric care units for a better patient flow. J Interprofessional Educ Pract [Internet]. 2020 [citado 04/10/2022];19:100332. Disponible en: http://doi.org/10.1016/j.xjep.2020.100332

12. Duarte Forero E, Camacho Oliveros MÁ. Planeación de la capacidad hospitalaria: un enfoque desde el flujo de pacientes con Dinámica de Sistemas. INGE CUC [Internet]. 2020 [citado 04/10/2022];16(1):217-33. Disponible en: http://doi.org/10.17981/ingecuc.16.1.2020.16

13. Martínez Sánchez P, Martínez Flores J, Nuño De La Parra P, et al. Mejora en el tiempo de atención al paciente en una unidad de urgencias gineco-obstétricas mediante la aplicación de Lean Manufacturing. Rev Lasallista Investig [Internet]. 2016 [citado 04/10/2022];13(2):46-56. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1794-44492016000200006

14. Zambrano Cancañón CE, Lao León YO, Moreno Pino MR. El pensamiento lean desde la manufactura hasta la salud: una revisión de la literatura. Corr Cient Méd [Internet]. 2019 [citado 04/10/2022];23(3). Disponible en: https://revcocmed.sld.cu/index.php/cocmed/article/download/3234/1454

15. Giron Huerta E. Lean healthcare-sex sigma vinculado a triage para servicios de urgencias en el hospital Ángeles en Puebla, México [tesis en Internet]. Puebla: Universidad Iberoamericada; 2021 [citado 04/10/2022]. Disponible en: https://hdl.handle.net/20.500.11777/5107

16. Hassan Marrero N. Mejora de la gestión del flujo de pacientes en el Hospital Clínico Quirúrgico Docente Faustino Pérez Hernández [tesis]. Matanzas: Universidad de Matanzas; 2018.

17. Sánchez Suárez Y, Marqués León M, Hernández Nariño A, et al. Análisis estructural de la gestión de flujo de pacientes con coronavirus en Cuba. Ing Ind [Internet]. 2021 [citado 04/10/2022];42(3):29-41. Disponible en: http://scielo.sld.cu/scielo.php?pid=S1815-59362021000300029&script=sci_arttext&tlng=en

18. Díaz-Canel Bermúdez M, Núñez Jover J. Gestión gubernamental y ciencia cubana en el enfrentamiento a la COVID-19. An Acad Cienc Cuba [Internet]. 2020 [citado 04/10/2022];10(2). Disponible en: http://revistaccuba.sld.cu/index.php/revacc/article/view/881

19. Leyva Caballero R, Bonal Ruiz R. Voluntad política e intersectorialidad para el enfrentamiento a la COVID-19 en Cuba. Rev haban cienc méd [Internet]. 2020 [citado 04/10/2022];19(2):e3241. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1729-519X2020000200017&lng=es

20. Delgado Fazackerley N, Gisbert Soler V, Pérez Bernabéu E, et al. Lean manufacturing como herramientas de mejora en la atención hospitalaria [Internet]. Alicante: Área de Innovación y Desarrollo, S.L.; 2020 [citado 04/10/2022]. Disponible en: https://dialnet.unirioja.es/descarga/libro/861145.pdf

Published

2023-08-09

How to Cite

1.
Sánchez-Suárez Y, Marqués-León M, Hernández-Nariño A, Santos-Pérez O. Modeling the flows of high risk patients with COVID-19 in Matanzas with a Lean approach. Rev Méd Electrón [Internet]. 2023 Aug. 9 [cited 2025 Jan. 9];45(4):e5136. Available from: https://revmedicaelectronica.sld.cu/index.php/rme/article/view/5136

Issue

Section

Research article

Similar Articles

You may also start an advanced similarity search for this article.