Dados do Trabalho

Título

THE USE OF THE "LEAN" METHODOLOGY FOR IMPROVEMENTS AND SAFETY IN PATIENTS' PROCESSES IN AN ONCOLOGY OUTPATIENT CLINIC.

Introdução

The term "Lean" in the area of health is defined as the maximization of value for the client through an efficient and waste-free process. This approach seeks to provide services that respect the needs of patients, prioritizing and ensuring the safety of the process ¹ ². In addition, it seeks to identify and eliminate waste in processes such as: failures, overproduction, transportation, waiting, inventory, movement, excessive processing and human potential, aiming to add value to the business and patient.

Objetivo

This study aimed to identify waste, map weaknesses and barriers found in the process within the oncology outpatient clinic, in a large private hospital.

Método

The tools of the Lean Method of Process Mapping and Health Risks (FMEA), "Suplier-Input-Process-Output-Customer" (SIPOC) and Day In Life Of (DILO) were applied, considering appointments (n=6,461) and chemotherapies (n=1,919), based on the average number of appointments between 2017 and 2019.

Resultado

With the SIPOC, the input and output of the processes, the activities and those responsible were identified. Improvement actions were identified with the use of the FMEA. According to DILO, 23% of the time was spent on activities of low value and slowness in the system, 71% spent due to errors in the process, and 60.98% spent on activities that add value. After revision of flows, adjustments in the physical structure, balancing of employees' activities and processes, it was possible to reduce the time with activities of low aggregated value and slowness of the system to 15%, time spent due to errors in the process to 30% and increased time for activities that add value to 71.39%. During these adjustments, it was identified the need for a care coordinator to assist in the barriers to the initiation and continuity of treatment and to facilitate the cancer patient’s journey in the institution. It was inserted the project of the nurse navigator to help the patient to go through his journey, mainly at the beginning of the process.

Conclusão

The Lean methodology provided an increase in productivity, team efficiency, quality of service, patient satisfaction, greater process safety, reduction in waiting time for care, in addition to identifying new working models of professionals who can contribute to the patient’s journey during their treatment.

Palavras-chave

Lean; oncology; processes

Área

Oncologia - Políticas Públicas, Acesso, Farmacoeconomia e Gestão em Saúde