How to Use Lean Thinking for the Optimization of Clinical Pathways: A Systematic Review and a Proposed Framework to...

Area of Science:

• Healthcare Management
• Process Optimization
• Systems Engineering

Background:

• Lean Thinking and clinical pathways are established healthcare improvement methodologies.
• Limited understanding exists on integrating Lean Thinking for pathway optimization and quantifying these concepts.
• A systematic approach is needed to analyze and improve clinical pathways using Lean principles.

Purpose of the Study:

• To develop a framework for system-level analysis of clinical pathways using Lean Thinking.
• To quantify the seven wastes, flow, and pull within healthcare pathways.
• To provide a tool for assessing improvement potential and post-enhancement effectiveness.

Main Methods:

• A systematic literature review was conducted to identify relevant studies.
• Inclusion criteria focused on patient groups, pathway optimization, and Lean Thinking.
• Data extraction included measured outcomes, interventions, and pathway types.

Main Results:

• Thirty-six articles were included in the review.
• No studies addressed the full Lean Thinking philosophy or the "4 P" model (people, partners, process, and performance).
• Most studies utilized process or problem-solving tools, with a focus on process measures.

Conclusions:

• The identified measures can inform a framework for quantifying wastes, flow, and pull in clinical pathways.
• The proposed framework aids in evaluating a pathway's improvement potential and the impact of enhancements.
• Further research is recommended to validate the proposed quantification methods.