Title: A qualitative analysis of Lean implementation in Brazilian surgical centres: a multiple-case study

Authors: Paulo Renato De Sousa; Marcelo Werneck Barbosa; Gerson Tontini; Aloísio Rosado Filho; Maria Madalena Macedo Pires Ferreira

Addresses: Fundação Dom Cabral, Avenida Princesa Diana 760 Alphaville Lagoa dos Ingleses, Nova Lima, 34 018 006, Brazil ' Facultad de Administración y Negocios, Universidad Autónoma de Chile, Pedro de Valdivia, 425 – Providencia – Santiago, Chile ' FURB – Regional University of Blumenau, R. Antônio da Veiga, 140 – Itoupava Seca, Blumenau – SC, 89030-903, Brazil ' Hospital São Domingos, Av. Jerônimo de Albuquerque, 540 – Bequimão, São Luís, MA, 65060-645, Brazil ' Hospital São Domingos, Av. Jerônimo de Albuquerque, 540 – Bequimão, São Luís, MA, 65060-645, Brazil

Abstract: Different studies have been published in recent years describing the experiences of adopting Lean thinking in healthcare institutions. However, the analysis of Lean implementations in hospitals located in emerging economies is lacking. Besides, Lean implementations are usually reported based on a single case study. This study analyses Lean adoption in four Brazilian surgical centres, using a multiple-case approach using semi-structured interviews. Results suggest that Lean implementation reduces the duration of operations and the time the patient stays in the hospital, improves the punctuality of procedures, reduces losses, errors, materials' usage, preparation time, and increases collaborators' satisfaction. Primary challenges to implementing Lean include changes to organisational culture and involvement of multidisciplinary teams. By using a multiple-case design, it is possible to compare different outcomes and more confidently generalise these results to other surgical centres. We expect this study stimulates the implementation and analysis of Lean adoption in other emerging economies.

Keywords: Lean; surgical centre; operating rooms; Lean healthcare; Brazilian health system; process improvement; continuous improvement; quality of care; waste elimination; Lean culture.

DOI: 10.1504/IJHTM.2021.119164

International Journal of Healthcare Technology and Management, 2021 Vol.18 No.3/4, pp.168 - 185

Received: 13 Sep 2020
Accepted: 10 Mar 2021
Published online: 26 Nov 2021 *

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