Original Articles
Vol. 42 No. 3 (2025)
https://doi.org/10.4081/scenario.2025.613

Improving healthcare processes through lean methodology: the case of the Orbetello emergency department

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Received: 7 November 2024
Accepted: 28 June 2025
Published: 6 August 2025
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Emergency room nursing, emergency care, triage

Authors

Simone Nykieforuk
sim.nyk@hotmail.it
https://orcid.org/0009-0005-7856-5209
Nurse, Nursing Manager for the Hospital Emergency and Urgent Care Area, USL Tuscany South-East, Emergency Department, Orbetello Hospital, Italy.
Sonia Peri
Nurse, Nursing Manager for the Hospital Emergency and Urgent Care Area, USL Tuscany South-East, Emergency Department, Grosseto Hospital, Italy.
Gabriele Taddei
Director, Professional Operational Unit "Organizational and Managerial Integration of Nursing and Support Resources and Activities in the Emergency and Urgent Care Area", USL Tuscany South-East, Italy.
Simona Portrandolfo
Nurse, USL Tuscany South-East, Emergency Department, Grosseto Hospital, Italy.

Introduction: there is an increasing need to ensure a patient-centered approach that defines the most suitable pathway for each patient from the first contact. In the Orbetello Emergency Room (ER), a passive waiting period often occurred between the triage phase and the blood test procedure, negatively impacting patients' length of stay in the ER. This problem led to the development of a Lean improvement project.

Materials and Methods: a structured project was carried out following the Lean methodology, aiming to eliminate the waiting time between triage and blood sampling and, consequently, reduce the length of stay in the ER.

Results: the project allowed for a reorganization of the blood testing process in the ER, reducing passive waiting times and patients’ overall length of stay.

Discussion: to improve the quality of care provided in the ER, it is essential to rethink the organization of processes to reduce waiting times and waste, placing the patient at the center of the organizational structure.

Conclusions: the implemented Lean project fostered greater awareness among the entire ER medical and nursing team about the importance of continuously working on and revising processes for ongoing improvement.

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Improving healthcare processes through lean methodology: the case of the Orbetello emergency department. (2025). Scenario® - Il Nursing Nella Sopravvivenza, 42(3). https://doi.org/10.4081/scenario.2025.613
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