Lean management tools applied to hospital facilities: The case of an operative unit of intensive care

This paper presents the results of a simulation study that has involved a public Facility Healthcare, in particular an operative unit of intensive care. This unit represents the core of a healthcare facility where patients with abnormal vital signs as a result of diseases of the medical or surgical treatment of trauma are greeted. The approach proposed in this research work begins with the study and analysis of the processes that take place within the unit of intensive care; after that tools and methods of lean management are applied by using a Modeling & Simulation based approach. The work illustrates the improvement obtained with the application of Kanban technique and the 5S method. To this end, a simulation model of the intensive care unit considering the main processes and activities has been developed. Main goal of simulation was to see to which extent the operative unit is improved after the changes implemented through lean management tools and methods. The simulation model highlights the delays due to poor internal organization and the improvements achieved by redesigning the flows, minimizing the pathways and reengineering the layout of the operative unit. The results obtained by using the simulation model have been transferred to the real system with a relevant increase of the intensive care unit performances (giving a quantitative measure of the value added to care and wellness of patients).