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Lean-Oriented Layout Design of a Health Care Facility

Fogliatto, Flavio S., PhD; Tortorella, Guilherme L., PhD; Anzanello, Michel J., PhD; Tonetto, Leandro M., PhD

doi: 10.1097/QMH.0000000000000193
Lean Methodology

Background: In this article, we propose a method that integrates systematic layout planning techniques to lean health care practices aided by multicriteria decision analysis that could be applied to reformulate the layout of health care facilities.

Methods: We analyze a high-variety sterilization unit of a large public hospital located in Brazil. The unit is currently implementing lean practices, and layout changes are required to provide more efficient materials and information flows.

Results: Traditional design of health care facilities is not aligned with lean implementation and its underlying practices and principles. We propose the integration of such approaches to enhance their benefits. To rank and select the best layout alternative, a multicriteria decision analysis method (analytic hierarchy process) is adopted.

Conclusions: There are 3 contributions here: the integration of lean principles into traditional health care facility design practices, the use of multicriteria decision analysis to refine the determination of the best layout solution, and the application of our propositions in a real case study.

Industrial Engineering Department, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (Drs Fogliatto and Anzanello); Industrial Engineering Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil (Dr Tortorella); and Graduate Program in Design, Universidade do Vale do Rio dos Sinos, São Leopoldo, Rio Grande do Sul, Brazil (Dr Tonetto).

Correspondence: Flavio S. Fogliatto, PhD, Industrial Engineering Department, Federal University of Rio Grande do Sul, Av Osvaldo Aranha, 99, 5° andar, Porto Alegre/RS, CEP 90035-190, Brazil (

The authors declare no conflicts of interest.

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