Optimization of the diagnostic examination process: identification of a methodology based on Lean Healthcare
DOI:
https://doi.org/10.17267/2317-3378rec.2025.e6190Keywords:
Health Management, Diagnostic Tests, Patient SafetyAbstract
OBJECTIVES: To identify gaps in the process of performing diagnostic tests in a healthcare unit (primary) and propose an appropriate methodology to improve this process (secondary). METHOD: A descriptive and qualitative study was carried out in a university hospital in Salvador, Bahia. After applying an anonymous online instrument to healthcare managers involved in performing diagnostic tests, the data were correlated with current information on the Lean Healthcare methodology to define and propose the tool. RESULTS: Six healthcare managers participated. Two thematic substages were defined: “Managers’ view of the process for performing diagnostic tests” and “Association between information collected from managers and current data in the literature”. After evaluating the Lean Healthcare tools and the association with the categories listed from the managers’ responses, the one that best correlated with the challenge of organizing the process for performing diagnostic tests was “Kamishibai”. FINAL CONSIDERATIONS: The identification of Kamishibai as a methodology to improve the execution of diagnostic exams was based on the literature review and the gaps in the current process (communication failures; inadequate application of the exam request flow; quantity and actual indication of exams; inadequate physical structure and reduced support staff).
Downloads
References
1. Mendes EV. Desafios do SUS [Internet]. Brasília: Conselho Nacional de Secretários de Saúde – CONASS; 2019 [cited 2025 Jun.15th]. Available from: https://www.conass.org.br/biblioteca/desafios-do-sus
2. Costa JMH. Method for diagnosis and identification of new Product Development Process improvement opportunities using a pattern of recurrent undesirable effects [tese] [Internet]. São Carlos: Escola de Engenharia de São Carlos; 2011. https://doi.org/10.11606/T.18.2011.tde-25042011-112003
3. Freitas CC, Pires EEM, Emerick JA, Fraga BO. Process management in the hospital area: a comparative literature review [Internet]. Minas Gerais: Faculdade do Futuro; 2023 [cited 2024 Jun. 6th]. Available from: https://faculdadedofuturo.com.br/wp-content/uploads/2023/05/TCC-GestOo-de-Processos-na-rea-Hospitalar-RevisOo-Comparativa-de-Literatura-2.pdf
4. Mrazek C, Lippi G, Keppel MH, Felder TK, Oberkofler H, Haschke-Becher E, et al. Errors within the total laboratory examing process, from exam selection to medical decision-making - A review of causes, consequences, surveillance and solutions. Biochem Med (Zagreb). 2020;30:020502. https://doi.org/10.11613/BM.2020.020502
5. Barra DCC, Alvarez AG, Knihs NS. Comunicação efetiva [Internet]. Florianópolis: UFSC; 2022 [cited 2024 Jun. 6th]. Available from: https://repositorio.ufsc.br/handle/123456789/240250
6. Oliveira RGAM, Silva GAF. The main errors of the pre-analytical phase of laboratory exams. RBAC. 2022;54(1):16-25. https://doi.org/10.21877/2448-3877.202202089
7. Castello RV. Lean healthcare: um caminho para melhorias de gestão e serviços de saúde [dissertação] [Internet]. Uberlândia: Universidade Federal de Uberlândia; 2022. Available from: https://repositorio.ufu.br/handle/123456789/35436
8. Limonta GF. Conceitos Lean em sistemas de saúde: eficácia da utilização de ferramentas para gestão de estoques de medicamentos e correlatos [dissertação] [Internet]. Campinas: Universidade São Francisco; 2014. Available from: https://lyceumonline.usf.edu.br/salavirtual/documentos/2609.pdf
9. Sousa JR, Santos SCM. Content analysis in qualitative research. PDE. 2020;10(2):1396-1416. https://doi.org/10.34019/2237-9444.2020.v10.31559
10. Resolução nº 466, de 12 de dezembro de 2012 (Brazil). Aprova as seguintes diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. [Internet]. Diário Oficial da União. Available from: https://www.gov.br/conselho-nacional-de-saude/pt-br/acesso-a-informacao/atos-normativos/resolucoes/2012/resolucao-no-466.pdf
11. Srougé MPP, Cardoso LF, Nakano LCU. O impacto da otimização dos processos de alta hospitalar na economia em saúde. Int J Health Manag Rev. 2024;10(1):e355. https://doi.org/10.47172/ijhmreview.v10i1.355
12. Silva ÉA, Ribeiro LCF, Souza LT, Vitorino MGC, Valadares ACF. Assertiveness in laboratory exams - the importance of pre and post- analytical phases focusing on the final diagnosis. Revista ReCiFaQui. 2022;2(12):163-178. Available from: https://recifaqui.faqui.edu.br/index.php/recifaqui/article/view/204
13. Labone Consultoria [Internet]. Kamishibai: uma ferramenta para a gestão de processos. [cited 2020 Jun. 6th]. Available from: https://www.laboneconsultoria.com.br/kamishibai/
14. Shea G, Smith W, Koffarnus K, Knobloch MJ, Safdar N. Kamishibai cards to sustain evidence-based practices to reduce healthcare-associated infections. am J Infect Control. 2019;47(4):358-365. https://doi.org/10.1016/j.ajic.2018.10.004
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Glicia Gleide Gonçalves Gama, Maria Eduarda Aleixo Lima, Mayra Gracielle Bezerra Cardial, Gleide Glícia Gama Lordello, Andreia Santos Mendes
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
