Lean healthcare application for patient flow analysis in Cardiology department

The thesis is aiming at strengthening the effects of implementation of lean principles when applied in healthcare context. In the first chapter will be presented a big picture of Italian healthcare system, in order to define main features of the industry taken into consideration, especially challenges and criticalities that are constantly pushing innovation and improvement in the healthcare environment. In the second chapter the key concepts and values of lean thinking will be described, highlighting how lean philosophy modifies company’s attitude toward improvements and changes, enhancing optimization of resources and the reduction of all possible source of waste, through the entire values stream. In this context, several lean tools will be presented in order to understand practical application of the principles and the results expected from the adoption of each tool in the different contexts. In the third chapter the general managerial philosophy will be declined in healthcare settings, since this specific sector differs from other industries and business models for several features. It has to be considered that worldwide healthcare is facing a period of reduction of investments and expenditure, while aging population and increase of unhealthy lifestyles is increasing overtime the demand for healthcare services. This set the basis for a perfect matching of lean applications and healthcare sector; some successful examples will be explained to demonstrate the effectiveness of purely production theory in healthcare sector. In the fourth chapter, Simulation Modelling will be presented, since this tool is frequently used to test effectiveness of Lean principles. In this case, simulation modelling allows to provide a simplified computer-based representation of the model considered, avoiding risks and reducing costs of implementation; this aspect is crucial when dealing with funds shortage context as healthcare, since experimentation of different scenarios through a simulation software will not increase risks in the evaluation of impacts of possible changes. Analogies between lean principles and simulation modelling will be underlined, reporting evidences of mutual benefit of joint application. In the fifth chapter will be presented the core of thesis, which is an application, implemented in the Cardiology ward of Maria Vittoria Hospital of Turin. The project aims at optimizing one of the most frequent invasive procedural process performed inside the ward, through the application of lean principles. A complete description of the process will be presented, reporting main criticalities and source of intervention. Finally, the results of the analysis will be discussed, proposing some solutions and implementations of the current state of the Department.