Structuring a Performance Measurement System in surgical centers to support Lean Healthcare initiatives

Author(s)

Túlio Figaro Ulhôa

• Document type: Master's Dissertation
• Press: São Carlos.
• Institution: Universidade de São Paulo (USP). Escola de Engenharia de São Carlos (EESC/SBD)
• Defense date: 2019-04-26

Examining board members

Luiz Cesar Ribeiro Carpinetti; Moacir Godinho Filho; Heloisa Helena Oliveira Martins Shih

• Advisor: Kleber Francisco Espôsto

Abstract

The use of Lean can improve production in order to increase process efficiency and quality. Systems, such as hospitals, have been using an approach named Lean Healthcare to create more value to their services delivered to patients, to reduce process wastes and to increase quality of care. In this setting, improvement opportunities in surgical centers and operating rooms, which are responsible for a relevant volume of hospital procedures and a significant share of revenue and costs structure, can be identified. In this context, performance measurement, as well as performance indicators management, have been shown as a tough task, and studies highlighted its relevance in Lean healthcare initiatives, which could support process improvement and provide relevant decision making based on precise and reliable information. From this premise, this research proposes the structuring of a Performance Measurement System (PMS) to support Lean practices introduction in surgical centers. This PMS was supported by a conceptual model based on eight requirements coming from theoretical aspects, such as literature reviews about the relationship of surgical centers management with Lean and performance measurement practices. The conceptual model made it possible to exemplify the requirements through a case study in a surgical center of a Brazilian hospital. Based on this case, practical aspects were observed and used to ground the proposed PMS, such as the development of five performance indicators categories (surgical volume, surgical processes, financial sustainability, resource management and stakeholders) and Lean practices tests (such as value stream mapping and visual management boards). Then, a PMS framework was structured, joining theoretical and practical aspects of the research, in order to align and to promote measurement, improvement and management of a surgical center\'s operations and strategies. Besides the framework, a six-phase implementation guide was developed, in order to support future replications of this PMS. It is expected that this research supports theoretical and practical studies in healthcare operations management, in order to improve the current practices and promote benefits for future research. (AU)

• FAPESP's process: 17/04702-0 - Structuring a Performance Measurement System in Surgery Centers to support Lean Healthcare innitiatives.
• Grantee: Túlio Fígaro Ulhoa
• Support Opportunities: Scholarships in Brazil - Master