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Do Lean Practices Lead to More Time at the Bedside?

Brackett, Tiffany; Comer, Linda; Whichello, Ramona

The Journal for Healthcare Quality (JHQ): March 2013 - Volume 35 - Issue 2 - p 7–14
doi: 10.1111/j.1945-1474.2011.00169.x
Feature Articles

The aim of this review is to evaluate the application of value-added processes in healthcare, with an emphasis on their effects on bedside nursing. Literature relevant to Lean methodology and inpatient care was reviewed, excluding all research related to other service lines (i.e., surgical services, emergency services, laboratory, radiology, etc.). Increased value is also an important tenet of transforming care at the bedside (TCAB), an initiative launched by the Institute for Healthcare Improvement (IHI) and the Robert Wood Johnson Foundation (RWJF). Therefore, articles concerning TCAB were also included in this review. A systematic study of the literature revealed varied applications of Lean principles in practice, ranging from the implementation of a single tool, to full organizational restructuring. All articles reviewed reported positive results, although the majority lacked strong supporting evidence for claims of improvement. Even though there is some indication that the application of Lean principles to nursing processes is successful in improving specific outcomes, the authors cannot conclude that the implementation of Lean methodology or TCAB greatly influences direct patient care, or increases time spent at the bedside.

For more information on this article, contact Tiffany Brackett at

Tiffany Brackett, MSN, RN, is currently employed as Core Measures Coordinator at MedWest-Haywood, part of MedWest Health System in Western North Carolina.

Linda Comer, PhD, RN, LPC, CNE, is currently on faculty at Western Carolina University in Cullowhee, North Carolina. She serves as the associate director of Graduate Nursing Programs, coordinator of the Nurse Educator Program, and coordinator of RN to MSN program.

Ramona Whichello, MN, RN, NEA-BC, is currently on faculty at Western Carolina University in Cullowhee, North Carolina. She serves as the coordinator for the RN to BSN program, as well as the coordinator for the MSN Nursing Administration track.

© 2013 National Association for Healthcare Quality
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