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Table 2 Comparison of application of lean management in manufacturing and health-care organization

From: The impact of changes in intensive care organization on patient outcome and cost-effectiveness—a narrative review

Type of problem Manufacturing organization Health-care organization Implication for intensive care
Overproduction Producing ahead of need Unnecessary treatment and overuse of diagnostic testing Clear treatment goals and end-of-life decision guidelines
Waiting Operators standing idle waiting for other workers or machines to finish Patient waits for an appointment, for test results, for a bed, for discharge paperwork Clear admission and discharge guidelines
Transport Moving parts and products unnecessarily Taking patients to and from tests, moving patients from one room to another Diagnostic tests being performed at bed side
Over Processing Performing unnecessary or incorrect activities Unnecessary forms, asking the same patient the same question more than once, charting everything instead of charting by exception Digital system Preventing re-enter of patient data Patient centric rounding
Inventory Having more than the minimum stock necessary Overstocked drugs that expire, under stocked surgical supplies that lead to delays while staff search for them Pooling of inventories within the hospital or even within the region just in time
Motion Making workers look for parts, tools, documents, etc Searching for supplies, forms, drugs Correct and logic labelling of all supplies, forms, and drugs
Defects Inspection, rework, and scrapping parts that do not meet standards Making and correcting errors, checking for errors Clear protocols including feedback mechanisms and e-alerts
Talent Waste Failure to listen to employee ideas for improvement Using highly trained individuals to do jobs that could be performed by less expensive personnel, failure to listen to employee ideas for improvement Focus on ICU physician and ICU nurse specific tasks and outsource tasks such as washing patients, paperwork, and move tasks down from ICU physician to ICU nurse when possible