Implantação do Sistema Lean Healthcare no Pronto Socorro do Hospital de Clínicas da Universidade Federal de Uberlândia: Estudo de Caso

Abstract

Objective: To analyze the implementation process of Lean in Emergencies at the Hospital de Clínicas of the Federal University of Uberlândia (HC-UFU), evaluating, in addition to the activities that were developed, possible failures that occurred and seeking to identify possibilities for correction and improvement. Method: During a period of 36 months, hospital indicators referring to one year before implantation (T1 - from April 2017 to March 2018), one year during implantation (T2 - from April 2018 to March 2019) and one year after the implementation of Lean in Emergencies (Q3 - from April 2019 to March 2020). Hospital indicators were retrieved from the HC-UFU statistics sector, and those corresponding to 10 variables were analyzed: Male and Female hospitalization, Male and Female discharge, Male and Female transfer, Male death < 24 hours and Female death < 24 hours, Male Death >24h and Female Death >24h and general occupancy rate. The Lean in Emergencies scores (NEDOCS and LOS) were only analyzed in the period in which the team was able to register and were used only to demonstrate trends over time. Results: The analysis of the behavior of the indicators did not demonstrate effectiveness related to the implementation of the Lean Healthcare system in the emergency sector. The reasons for failure may be related to the discontinuity in project monitoring, the lack of involvement of the clinical staff and alignment with the needs of the staff training academy, the difficulty of understanding the project by local public entities and the geographic region where it is located. inserted by the hospital and by users of the health system who were not properly informed about the development and objectives of the project. These aspects must be considered in future management processes that may be implemented in the hospital. Despite the result of implementing Lean in the emergency sector not having reached the expected goals, a fact that, at first. In reality, the study showed windows of opportunity for future action on points that can improve the hospital management process and which should be tested in future experiments. Conclusion: The methodology followed for the implementation of Lean in the Emergency sector did not produce improvement in hospital indicators