Information and Knowledge Management using ArcGIS ModelBuilder

Review of Lean Method Application for Improvement in
Health Information Systems
Soudabeh Khodambashi and Maryati Mohd Yusof
UKM University, Bangi, Malaysia
s.khodambashi@gmail.com
mmy@ftsm.ukm.my
Abstract: Medical care is undergoing considerable change due to the application of information technology and
management tools and techniques. Health Information Systems (HIS) are used extensively in healthcare to
enhance data processing. Various tools and techniques including quality management methods are available to
improve efficiency of HIS. Lean method has become relatively popular in improving clinical process cycle and
work flow, eliminating non-value added activities known as waste. By applying Lean that optimizes clinical work
flow, we can gain safe, efficient and high quality care as well as cost reduction. The aim of this paper is to
investigate the application of Lean method and its effectiveness in healthcare. We also focus on several Lean
techniques, its major implementation steps as well as the requirements for implementing Lean in healthcare. The
focus would be on implementation of Lean on clinical process related to HIS. The paper also highlights critical
success factor for healthcare organization to consider when implementing Lean method.
Keywords: lean method, health information system, value stream mapping, clinical work flow
1. Introduction
Health Information Systems (HIS) are used extensively in healthcare organizations to support various
conventional data processing tasks. They are also used for scheduling, automating nurse stations,
monitoring intensive care patients, and providing preliminary diagnoses. The simplest HIS collects
and processes data (Yusof et al., 2008b). The application of information technology in healthcare
highlights significant potentials and benefits, particularly with regard to innovations in improving both
clinical and administrative processes.
A number of quality management methods have been extensively employed in order to improve
health care quality since the last decade. For example, in optimizing clinical workflow as one of the
critical factor of HIS adoption, Lean method would be a better choice (Schweikhart and Dembe, 2009,
Yusof et al., 2008a). Health care organizations adopt Lean in their clinical processes. Some of the
public healthcare systems are planning to use Lean or have already adopted it for improving safety
and quality of healthcare (Holden, 2010, Jones and Mitchell, 2006). It was reported that 53% of the
current hospitals, implemented Lean method (Holden, 2010).
The aim of this paper is to represent the key findings of a literature review on adoption of Lean
method in clinical practices. This paper focuses on Lean concept, tools that would be useful and
applicable in healthcare, and some of the critical success factors for Lean implementation.
2. Lean method
Lean concept was introduced from Toyota Production System and it was first implemented in a US
auto manufacturing. Lean is a quality improvement tool which uses quantitative methods for tracking
data to reach the stated goals by documenting progress to improve quality and reduce costs
(DelliFraine et al., 2010). Lean aims to improve efficiency by eliminating non-value added activities
that is known as waste (Schweikhart and Dembe, 2009).
In Lean method, all steps and activities which add value will be maintain by eliminating intermediate
steps, time, and people (Poppendieck, 2002). This goal could be achieved by reducing delivery cycle
or shortening delivery batches without adding additional cost (Hines et al., 2004). Lean concept has
been divided into five categories that are value, value stream, flow, pull, and perfection (Staats et al.,
2010).
Some of the tools and methods in Lean include Value Stream Mapping, Kaizen (short-cycle continues
improvement, Work Standardization, 5S, cellular manufacturing, inventory management, root cause
analysis, A3 report, Poka-yoke (mistake-proofing), change over time reduction (Singh et al., 2010,
Monden and Engineers, 1998, Hines et al., 2004, Monden and Engineers, 1983, Schonberger, 1986,
Harrison, 1992, Vinodh et al., 2010, Holden, 2010).
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