Evaluation of the application of continuous improvement based on the Kaizen concept in Emergency Healthcare Units Ana Carolina Zeferino, Gabriel Nascimento Santos, Thais Lessa Queiroz, José Ricardo Souza Ramos Meta Avaliacao, 2023 The Brazilian Ministry of Health and the Fluminense Federal University promoted Kaizen in lean thinking implementation projects in 24-hour Emergency Care Units. This research aimed to evaluate the application of Kaizen in both projects looking for patterns, providing valuable information for the design and improvement of future projects. Both projects focused their Kaizen efforts on improving the environment and standardization, with a focus on the use of 5S. The literature shows a more comprehensive approach, making use of Kaizen also to solve recurring problems using methods of analysis and problem solving. For future projects, there should be considered to use 5S within the initial steps for the entire units and to start promoting problem solving Kaizen .
HFMEA-FUZZY application: Similarity of the eight lean wastes in 20 emergency care units Harvey Ribeiro Cosenza, Nilra do Amaral Mendes Silva, Robisom Damasceno Calado, Ana Paula Barbosa Sobral, Thaís Lessa Queiroz Cases on Lean Thinking Applications in Unconventional Systems, 2022 This study aims to demonstrate the importance of waste analysis and similarity of results. For that, the HFMEA-FUZZY was used as a tool. The study used waste results from 20 emergency care units (ECUs) from different regions of Brazilthrough the HFMEA criteria and complemented with the concepts of logic Fuzzy with the COPPE COSENZA methodology. The use of HFMEA-FUZZY aims to contribute to research in the health area where Lean healthcare will be or is already implemented. For that, it served as a basis for reports prepared after visits carried out in the emergency care units (ECUs).
Monitoring patient flow in the emergency care units (UPA) in the City of Guarulhos, Sao Paulo, Brazil Newton Narciso Pereira, Patrick Fernandes Ribeiro da Fonseca, Andrei Bonamigo, Luis Enrique Valdiviezo Viera, Thaís Lessa Queiroz Cases on Lean Thinking Applications in Unconventional Systems, 2022 Performance indicators are an important tool for managers to identify how their organization is performing over time. Thus, a concept of the patient's timeline within the health unit was defined, which consists of monitoring from entry to exit, considering all the steps that patients went through during their stay in the emergency care units (UPA). This concept was applied to allow the monitoring of the performance of two UPA's being classified as (1) and (2) in the city of Guarulhos, SP. Data treatment was realized by Excel and were collected from 383 patients (UPA 1 only odd days) and 1123 patients (UPA 2 all days) between 02/01/2021 and 02/28/2021 then proceeded to the organization of data to analyze the processes flow involved. Patients were grouped according to risk classification—red, orange, yellow, green, and blue—and especially medical clinic, orthopedics, pediatrics, dental attendance. Both UPA evaluated the major attendance were classified with green and blue, and in terms of treatment, the medical clinic was priority when compared with others offered in these UPA.
Monitoring Patient Flow in the One Emergency Care Unit (UPA) in São Paulo Brazil Newton Narciso Pereira, Patrick Fernandes Ribeiro da Fonseca, Luis Enrique Viera, Thaís Lessa Queiroz, Robisom Damasceno Calado IFAC Papersonline, 2022 This article aims to evaluate the flow of patients within an Emergency Care Unit (UPA) located in State of São Paulo, Brazil. Patients are classified according to the degree of risk and the medical specialties of care. An analysis entitled the patients timeline was performed, which considers from the arrival to the departure of patients (length of stay), involving all the processes that occur during their stay at the UPA. Data were collected during the entire month of February 2021. A modeling was developed using the Knime software. The results showed that 383 patients were attended, 222 classified as green (less urgent), 110 yellow (urgent), 28 orange (very urgent), 12 blue (non-urgent) and 11 red (emergency). In total, 263 attended were at the medical clinic, 83 by orthopedics, 36 by pediatrics and 1 other service. The average medical attendance time in the office was 5 minutes and the average patient length of stay was 274 minutes. Considering that cases classified as red/urgent are a priority, we found that the average waiting time for triage was 9.70 minutes, above the recommendation of the Ministry of Health, which recommends immediate care. Our conclusion is that, for triage, all patients are in the same queue, and risk classification occurs after this process. Thus, it is important to note the possibility of reducing the waiting time for triage, especially for the most severe cases, since these times were longer than the patient care at the medical attendance office.
Potential of continuing education in Health of improvement practices in urgency and emergencies in Emergency Care Units - UPA-24h Adalberto da Cruz Lima, Christiane Lima Barbosa, Sandra Maria do Amaral Chaves, Jackson Gonçalves Oliveira, Thaís Lessa Queiroz, Robisom Damasceno Calado IFAC Papersonline, 2022 The practice of Lean in the 24-hour Emergency Care Units is a reality in the 50 units that were part of the Lean Project in the 24-hour UPA of the Ministry of Health in partnership with the Fluminense Federal University. However, the continuity of the good practices developed by the improvement teams is threatened of being lost at the end of the Project with the departure of the consultants who helped in the implementation of the Lean Healthcare in this unity. In this sense, the objective of this work is to present a pedagogical methodology with potential for the implementation of the Permanent Education Center (Permanent Education in Health - EPS) as an instrument not only of education but also of internalization of this practice in the culture of Emergency Care Units. In the research method, a bibliographic research was used about the types of education followed by a qualitative and cross-analysis of data and information from the Virtual Platform of the Lean Project in the UPAs in the first version. The results presented: a strategic planning of the technical visits; the establishment of a tutor as a training facilitator; the practical action of the work teams according to the reality in each UPA; record of improvements via reports; dissemination of information using media platforms. As a conclusion, it can be stated that there was training via didactic resources and that permanent education contributed greatly to the success of the implementation of Lean Healthcare in the studied units.
