ObjectiveTo analyze the application status of Kanban management in medical service management at home and abroad and to provide a reference for lean medical management practice in China.MethodsUsing the bibliometric method, in China National Knowledge Infrastructure, Wanfang Database, CQVIP Journal Database, Springer Link, Embase and PubMed, we used “Kanban” and “Kanban management” as Chinese search terms, “Kanban system” and “two-bin system” as English search terms to search for literature published from 2009 to 2019. The number of articles published, institutions, authors, citation frequencies, key words, Kanban usage, and improved areas where Kanban was applied in were statistically described and analyzed.ResultsA total of 219 articles were retrieved. Of the 14 articles included in the study, 12 articles were published from 2015 to 2019, 8 articles were published by hospitals, and 9 articles were cited more than or equal to 3 times. The key words were basically the combinations of Kanban and related topics in the field of medical service management, such as quality control and improvement, ward service, high-quality care and process evaluation; 11 articles used Kanban alone. Kanban was used in medicine supply chain management, ward bed management, and material inventory management abroad; and was used in medicine management, emergency room patient management, medical staff performance management, operating room equipment management, and high-quality medical service management in China.ConclusionsKanban as a lean management method was introduced into the domestic medical field late, and the current research development is not balanced. Asa visual management tool, Kanban needs to be extended in the medical field. As a lean improvement tool, Kanban has positive significance in improving medical quality and patient satisfaction. It is suggested that researchers should not be limited to the existing applied research, and can study the application of Kanban in different medical service fields in combination with different lean management tools according to the actual situation of the hospital.
ObjectiveTo analyze the application status and existing problems of value stream mapping (VSM) in improving medical services at home and abroad, so as to provide decision evidence for hospitals to apply VSM to improve medical services.MethodsUsing “value stream mapping” and “value stream” as search terms, we searched PubMed, Embase, China National Knowledge Infrastructure, CQVIP Journal Database and Wanfang Database (2009-2019), and collected relevant literature on the application of VSM to improve medical services at home and abroad. We conducted bibliometric analysis after confirming the literature according to the inclusion criteria. The standardization of application of VSM was also evaluated.ResultsOf the 299 articles retrieved, 13 studies fulfilled the inclusion criteria. The publication time of the literature was distributed between 2013 and 2019. Of the 8 foreign articles included, the regions to which the first author belonged were 4 in the United States, 1 in Ireland, Norway, Lebanon and Indonesia respectively. Of the 5 included domestic articles, the regions to which the first author belonged were 2 in Zhejiang and Shanghai respectively, and 1 in Guangdong. Of the foreign literature, 5 articles did not clearly state the sample size observed when drawing VSM, 5 articles incomplete drawing elements of VSM, and 3 articles did not show VSM. Of the domestic literature, 2 articles did not clearly state the sample size observed when drawing VSM, 3 articles had incomplete drawing elements of VSM, and 1 article did not show VSM.ConclusionsVSM is relatively more used in high-income and upper-middle income countries. The medical service improvement issues for which VSM is applied are relatively single. The standardization of the application of VSM in domestic and foreign literature needs to be improved overall.
Objective To analyze the application of lean healthcare management in optimizing services in foreign operating rooms, and provide a theoretical reference for further optimizing service processes in domestic operating rooms with lean healthcare management. Methods PubMed and Web of Science databases were searched literature about lean healthcare management in optimizing foreign hospital operating room service process. The search period was from the establishment of databases to November 2024. The number of publications, publishing institutions, authors, citation frequencies, keywords, the use of lean management tools and the improvement status were analyzed.Results A total of 71 literatures were included. Among them, 17 literatures were published from 2008 to 2014, and the number of related literatures increased significantly since 2015, with 54 literatures published by 2024; 9 literatures were published by universities and 62 literatures were published by hospitals. In terms of the distribution of countries and regions where the literatures were published, there were 34 literatures from the United States, 12 from the United Kingdom, 5 from Italy, 4 from Switzerland, and 3 from Canada. The keywords basically presented the combination ofthemes related to operating room management and lean healthcare management improvement fields, such as lean six sigma, quality improvement, and operating room efficiency. The five lean tools with the highest frequency of occurrence in the 71 included literatures were value stream mapping, fishbone diagram, A3 report, PDCA cycle management, and 5S. Conclusions There is an imbalance in the development of lean healthcare management research, with the number of publications in developed countries being far higher than that in developing countries. Lean healthcare management is conducive to improving surgical safety, work efficiency, and patient-doctor satisfaction. Lean healthcare management should further adapt to the actual situation, unify the lean management indicators in operating rooms, conduct cross-departmental cooperation, maximize the effectiveness of lean improvement tools, and achieve modern medical management.