Value flow structure and analysis to support Lean initiatives in surgical centers

Lean in hospitals can provide expressive results and benefits for several stakeholders. In these settings, Lean introduction in surgical centers could support improvements, such as staff and patient’s satisfaction increase and reduction of non-value adding time, such as late starts and waiting times for surgeries. To achieve this, Value Stream Mapping (VSM) can be seen as a robust Lean tool, which could support process mapping and identification of wastes and their sources and enable means to prioritize improvements in healthcare process flows. In this paper, a VSM structure for surgical centers is presented in three phases, aiming to identify existing processes and wastes, and suggest improvements based on Lean practices. To support the proposed tool, a literature review of similar approaches was conducted and a case study in a Brazilian hospital was developed, in order to map the surgical center’s processes and exemplify the proposed VSM. This case study also provided practical examples about the VSM introduction and analyzed aspects such as a value aggregation index for the process and the comparison of the proposed tool and other papers in the literature. Based on the proposed approach, it is expected that practical and theoretical studies could use a VSM approach to plan and execute improvement projects in surgical centers and hospitals