RESUMO
Despite the increasing utilization of lean practices and digital technologies (DTs) related to Industry 4.0, the impact of such dual interventions on healthcare services remains unclear. This study aims to assess the effects of those interventions and provide a comprehensive understanding of their dynamics in healthcare settings. The methodology comprised a systematic review following the PRISMA guidelines, searching for lean interventions supported by DTs. Previous studies reporting outcomes related to patient health, patient flow, quality of care, and efficiency were included. Results show that most of the improvement interventions relied on lean methodology followed by lean combined with Six Sigma. The main supporting technologies were simulation and automation, while emergency departments and laboratories were the main settings. Most interventions focus on patient flow outcomes, reporting positive effects on outcomes related to access to service and utilization of services, including reductions in turnaround time, length of stay, waiting time, and turnover time. Notably, we found scarce outcomes regarding patient health, staff wellbeing, resource use, and savings. This paper, the first to investigate the dual intervention of DTs with lean or lean-Six Sigma in healthcare, summarizes the technical and organizational challenges associated with similar interventions, encourages further research, and promotes practical applications.
Assuntos
Tecnologia Digital , Eficiência Organizacional , Atenção à Saúde , Serviço Hospitalar de Emergência , Humanos , Melhoria de Qualidade , Gestão da Qualidade TotalRESUMO
BACKGROUND: The implementation of Healthcare 4.0 technologies faces a number of barriers that have been increasingly discussed in the literature. One of the barriers presented is the lack of professionals trained in the required competencies. Such competencies can be technical, methodological, social, and personal, contributing to healthcare professionals managing and adapting to technological changes. This study aims to analyse the previous research related to the competence requirements when adopting Healthcare 4.0 technologies. METHODS: To achieve our goal, we followed the standard procedure for scoping reviews. We performed a search in the most important databases and retrieved 4976 (2011-present) publications from all the databases. After removing duplicates and performing further screening processes, we ended up with 121 articles, from which 51 were selected following an in-depth analysis to compose the final publication portfolio. RESULTS: Our results show that the competence requirements for adopting Healthcare 4.0 are widely discussed in non-clinical implementations of Industry 4.0 (I4.0) applications. Based on the citation frequency and overall relevance score, the competence requirement for adopting applications of the Internet of Things (IoT) along with technical competence is a prominent contributor to the literature. CONCLUSIONS: Healthcare organisations are in a technological transition stage and widely incorporate various technologies. Organisations seem to prioritise technologies for 'sensing' and 'communication' applications. The requirements for competence to handle the technologies used for 'processing' and 'actuation' are not prevalent in the literature portfolio.