Principles and tools of Lean Thinking for patient flow management in Emergency Rooms. A narrative review of literature

Introduction: Lean Thinking can also be applied in Emergency Department, where overcrowding and workloads that exceed the availability of resources result in long waiting times, delays in treatments and increased length of hospital stays.

Materials and methods: a literature review was conducted by consulting Medline databases via PubMed, GoogleScholar, Scopus and Cinhal. The research was conducted between October/December 2022. Only works that concerned the clinical area of interest, in Italian and English, published in the last 5 years were included.

Results: 6 of the 14 articles identified during the search phase were included.

Discussion: by rigorously following the theoretical path, choosing the appropriate tools, involving front-line staff, who have a more in-depth vision of the processes and applying the principles and methodologies of Lean Thinking to healthcare processes, it is possible to increase the efficiency of services, reduce waste in terms of waiting and improve the quality of the working environment for operators.

Conclusions: the key elements of the Lean methodology in the Emergency Department are the ability to change, the involvement of leadership, a clear mapping of processes and the introduction of small improvements that are realistic and sustainable in the medium to long term.