Lean healthcare processes: Effective technology integration and comprehensive decision support using requirements engineering methods

Healthcare faces many challenges in delivering better service quality and fulfilling, rapidly, changing needs. Lean management approaches, widely adopted in healthcare, provide methods and tools for process improvement. However, the main pitfall of the Lean approach in healthcare is a narrow focus on patient values and needs that often excludes those of caregivers, among others. Caregivers in hospitals are a special type of employees, different from those of most other organizations. They are intensively immersed in a dynamic context in which they treat end-users (patients) with many variables to consider, and multiple critical procedures to follow. It is essential to consider their needs and goals, in addition to organizational goals and values, in any change management process, especially if changes involve new technology. In this paper, we propose a Lean-AbPI model that combines the main concepts of Lean management with the Activity-based Process Integration approach (AbPI). AbPI provides several integration alternatives of new processes into existing ones while analyzing the impact of the changes on stakeholder/user needs, organizational goals, and performance objectives. The use of the Lean-AbPI model is demonstrated through a real hospital case study. The results show that using the model, a comprehensive analysis is provided that leads to improved decision support and implementation-related rationales traceability.