ResearchArticle
Healthcare Engineering: A Lean Management Approach
Abdallah A. Abdallah
School of Applied Technical Sciences, e German Jordanian University, Amman, Jordan
Correspondence should be addressed to Abdallah A. Abdallah; abdallah.abdallah@gju.edu.jo
Received 28 March 2020; Revised 5 June 2020; Accepted 21 September 2020; Published 5 October 2020
Academic Editor: Giovanni Improta
Copyright © 2020 Abdallah A. Abdallah. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
is work tries to answer the following question: can healthcare be engineered using lean management tools? Lean is known
to achieve successful results when implemented in the manufacturing sector. Typical results are operational cost reduction,
cycle time reduction, and higher customer satisfaction. e service sector, however, has seen mixed results. For the last two
decades, educators and healthcare professionals are trying to implement lean tools in healthcare. Some reported success and
many did not, for variety of reasons. In this paper, we search the literature and reveal the special nature of healthcare
services, success factors, and barriers facing implementation of lean in healthcare. We then conduct a survey of 18 elite
Jordanian hospitals to study the case holistically. Statistical analysis of the survey results confirmed some of what the
literature revealed; organizational leadership seems to be the most dominant factor, followed by knowledge of employees
about lean, training, and patient satisfaction (customer focus). Another important finding, not captured by the literature, is
that lean implementation success depends on educating physicians about continuous improvement and lean and ensuring
they are part of the improvement team. Based on the revealed enablers and obstacles, we created a full lean implementation
framework. is framework was then used along with selected engineering tools to implement lean in a major hospital
successfully. Implementation results showed 60% of reduction in cycle time, 80% reduction in operational cost, and many
other benefits.
1. Introduction
In a highly competitive world, all industrial and service
sectors work relentlessly to save cost and enhance market
standing. Healthcare organizations face even more chal-
lenges in keeping up with the competition and the cost of
providing medical services. Delivering a high-quality
medical service at an acceptable cost is the objective of
owners and managers [1]. Many organizations used quality
initiatives to achieve this challenging objective, but the
journey is not always successful [2–4].
Healthcare professionals used various lean tools for
the last two decades [5–7]. Many organizations were able
to achieve some success in reducing cost, minimizing
errors and improving profitability [8], but success is not
always the result of lean implementation. Actually, lean
implementation in healthcare has seen mixed success
results; Barnab` e et al. [9] declared that actual impact of
lean is still a puzzle, since some see success with it and
some do not. Similar notion is seen in the literature
[10–12].
Kovacevic et al. [13] declared that many healthcare
organizations used lean successfully and many others failed.
ose who succeeded were able to see improvements in
forms of saving time, saving walking distance, saving op-
erational cost.
Mannon [14] showed how systematic use of lean in an
integrated healthcare delivery system in Wisconsin (five
hospitals and 27 physician clinics) changed the role of
quality management from a system that was reactive to crises
and quality issues to one that proactively pursues methods,
processes, and strategies to improve quality for patients.
Similarly, Aij [15] showed the importance of the role of
leadership in providing successful implementation of lean in
healthcare organization.
Typical lean studies try to run current operations with
less human efforts, less space, less amounts of raw ma-
terials, and less cycle time [16]. Salam and Khan [17]
Hindawi
Journal of Healthcare Engineering
Volume 2020, Article ID 8875902, 17 pages
https://doi.org/10.1155/2020/8875902