scholarly journals Features and Results of Conducted Studies Using a Lean Management Approach in Emergency Department in Hospital: A Systematic Review

2019 ◽  
Vol 7 (1) ◽  
pp. 9-20 ◽  
Author(s):  
Haleh Mousavi Isfahani ◽  
Sogand Tourani ◽  
Hesam Seyedin
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Management Approach ◽  
Lean Management

Lean management approach in hospitals: a systematic review

2019 ◽  
Vol 10 (1) ◽  
pp. 161-188 ◽  
Author(s):  
Haleh Mousavi Isfahani ◽  
Sogand Tourani ◽  
Hesam Seyedin
Keyword(s):  
Systematic Review ◽  
Six Sigma ◽  
Meta Analysis ◽  
Developed Countries ◽  
Lean Six Sigma ◽  
Management Approach ◽  
Lean Management ◽  
Lean Thinking ◽  
Meaningful Improvement ◽  
Content Type

Purpose In the recent few years, the Lean management has made significant improvements in providing quality service to patients in many health-care centers. Thus, this study aims to systematically review features and results of conducted studies using a lean management approach in hospitals. Design/methodology/approach In this systematic review, eight databases, including PubMed, Web of Knowledge, Google Scholar, Scopus, Iranmedex, SID, Magiran and Medlib, were searched using keywords including “Lean principles,” “Lean Six Sigma,” “Lean Process SID,” “Lean thinking,” “Lean Methodology,” “Toyota Production System lean processing,” “lean techniques” and “hospital,” as well as their Persian equivalents. Required data were extracted using an extraction table and were analyzed using content analysis method. Findings Out of 967 identified articles, 48 articles were included in the study. Most of the studies have been conducted in developed countries such as America, Britain, The Netherlands and Canada. The highest number of studies has been conducted in the overall hospital and emergency departments. Lean Six Sigma and Lean methodology were the most frequent terms used for lean management. The five-phase Six Sigma methodology was one of the most important methods used for the implementation of the Lean management. Performing the process at the first time (timing) and length of stay had the highest frequencies among indicators assessed in the studies. All indicators assessed in the studies have improved after the implementation of Lean management. Among 150 assessed indicators, 69 were meaningfully improved (p < 0.05) and 12 indicators did not have a meaningful improvement (p > 0.05) and 69 indicators did not show any meaningful changes. Practical implications A number of implications are drawn out to aid academics, practitioners and policymakers in improving knowledge and skills. The elimination of production wastes is the most important principle of Lean thinking and paying attention to the clients and increasing the value. This will significantly improve quality of services to the patients and reduce costs and losses through preventing wastes. Suitable metrics in Lean management need to be established. A move to placing greater emphasis on understanding the contexts in which theory is implemented is another application. Research/limitation The limitation of this study is selection of studies in English and Persian language, excluding gray literatures and unpublished studies and relying on a relatively limited number of databases for the identification of potentially eligible studies. In addition, because of the enormous heterogeneity in the methods and results of the studies, performing a meta-analysis in this study was not possible. Originality/value The results of this study show that there were many dispersions and heterogeneities in the way of implementation and content of Lean management in hospitals.

Elderly patientsʼ experiences of care in the emergency department: a systematic review

2010 ◽  
Vol 8 (Supplement) ◽  
pp. 1-25
Author(s):  
Lim Siew Hoon ◽  
Sandra Mackey ◽  
He Hong-Gu
Keyword(s):  
Systematic Review ◽  
Emergency Department

scholarly journals Injuries and frequent use of emergency department services: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040272
Author(s):  
Catherine Laferté ◽  
Andréa Dépelteau ◽  
Catherine Hudon
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Cohort Studies ◽  
Eligibility Criteria ◽  
Geriatric Population ◽  
Physical Injuries ◽  
Frequent Use ◽  
Different Types ◽  
Ed Visits ◽  
Return Visits

ObjectiveTo review all studies having examined the association between patients with physical injuries and frequent emergency department (ED) attendance or return visits.DesignSystematic review.Data sourceMedline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO databases were searched up to and including July 2019.Eligibility criteriaEnglish and French language publications reporting on frequent use of ED services (frequent attendance and return visits), evaluating injured patients and using regression analysis.Data extraction and synthesisTwo independent reviewers screened the search results, and assessed methodological quality using the Joanna Briggs Institute tool for prevalence studies. Results were collated and summarised using a narrative synthesis. A sensitivity analysis was performed to evaluate the repercussions of removing a study that did not meet the quality criteria.ResultsOf the 2184 studies yielded by this search, 1957 remained after the removal of duplicates. Seventy-eight studies underwent full-text screening leaving nine that met the eligibility criteria and were included in this study: five retrospective cohort studies; two prospective cohort studies; one cross-sectional study; and one case-control study. Different types of injuries were represented, including fractures, trauma and physical injuries related to falls, domestic violence or accidents. Sample sizes ranged from 200 to 1 259 809. Six studies included a geriatric population while three addressed a younger population. Of the four studies evaluating the relationship between injuries and frequent ED use, three reported an association. Additionally, of the five studies in which the dependent variable was return ED visits, three articles identified a positive association with injuries.ConclusionsPhysical injuries appear to be associated with frequent use of ED services (frequent ED attendance as well as return ED visits). Further research into factors including relevant youth-related covariates such as substance abuse and different types of traumas should be undertaken to bridge the gap in understanding this association.

scholarly journals Factors influencing emergency department observation time following anaphylaxis: a systematic review

CJEM ◽  
2021 ◽  
Author(s):  
David Simard ◽  
Vanessa Bouchard ◽  
Annie Plourde ◽  
Sébastien Lefebvre ◽  
Antoine Herman-Lemelin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Observation Time ◽  
Factors Influencing

Emergency department interventions for homelessness: a systematic review

CJEM ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 111-122 ◽  
Author(s):  
Evan A. Formosa ◽  
Vanessa Kishimoto ◽  
Ani Orchanian-Cheff ◽  
Kaitlin Hayman
Keyword(s):  
Systematic Review ◽  
Emergency Department
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