Lean Healthcare for Home Healthcare Operations: Multi-Case Study in Colombia

This research aims to apply Lean Healthcare principles to home healthcare. The objective is to identify the wastes (muda in Japanese) in the delivery of home healthcare services. A multi-case study with a series of focus groups with healthcare staff and administrative personnel from three different healthcare institutions in Bogotá and Cali was performed. Nurses, physicians, therapists and administrative staff participated in the study. The eight types of muda are characterized in the operation: waiting times, transportation, inventory, movements, overprocessing activities, defects, non-value-added activities, and underutilization of staff. The most frequent muda are associated to the planning of routes for the operation and scheduling the visits, the body postures required to examine patients in a home setting, and the difficulties to transport medium and large equipment. Participant struggled the most with identifying muda associated with underutilization of staff. These results allow to provide insights for better home healthcare services.