Lean Healthcare: proposta de melhoria contínua para os processos logísticos da gestão de medicamentos em um hospital universitário

Abstract

Objective: This study aims to propose an intervention model for the continuous improvement of logistics processes regarding medication management in a university hospital, grounded in Lean principles and operationalized through Lean tools. The research addresses the growing interest in the literature regarding the adaptation of the Lean philosophy—originally developed for industrial production—to the hospital context, aiming to reduce waste, costs, and inefficiencies while focusing on creating value for the patient. Theoretical Framework: Situated within the Public Administration and Organizations research line, the study is grounded in three pillars: hospital medication logistics and supply chain management; public procurement; and Lean Thinking applied to healthcare (Lean Healthcare). Methodology: This is an applied, qualitative, and exploratory study conducted under an interpretivist paradigm and an inductive approach. It employs a case study method, with data collection carried out through document analysis. Main Results: Six bottlenecks or forms of waste were identified: complex logistics flow, process variability, high inventory levels, operational errors, underutilization of indicators, and limited organizational learning. Based on these findings, an intervention model supported by Lean tools was structured and subsequently materialized into a Continuous Improvement Guide for hospital medication management. Originality and Relevance: The originality lies in proposing an intervention model structured for the context of public university hospitals, integrating Lean principles and tools into a systematized approach for the continuous improvement of medication logistics. Its relevance is demonstrated by the pursuit of sustainable solutions for chronic challenges in hospital management. Practical Contributions: The proposed model is expected to assist managers in identifying waste, standardizing processes, rationalizing inventory, enhancing logistics management, strengthening evidence-based decision-making, and increasing efficiency in public hospital administration.