Pull processes in health care: a systematic literature review
(PT-BR) - Processos puxados em saúde: uma revisão sistemática da literatura
Rafael Consentino de la Vega; Gustavo Oliveira Pinto; Fatima Faria Ribeiro; Thaís Spiegel
Abstract
Keywords
Resumo
Resumo:: O paradigma da produção enxuta (lean production) surge na indústria automobilística, mas é progressivamente adaptado e adotado por outros setores. Serviços de saúde são, em geral, cocriados pelo usuário, o que impõe uma dificuldade lógica na aplicação de um dos princípios desse paradigma: o estabelecimento de processos puxados. Este artigo investiga como processos puxados têm sido aplicados nas adaptações da produção enxuta para o setor de saúde (lean healthcare). Foi realizada uma análise bibliométrica de 267 documentos publicados entre 2004 e 2021 e também uma revisão qualitativa dos 233 documentos cujos textos completos foram localizados. A quantidade de documentos cresce a partir de 2012, com concentração de publicações e citações nos EUA, Brasil e Reino Unido. São 39 os textos que apresentam uma aplicação do conceito, mas a maior parte trata de puxar o fluxo de produtos intermediários, não sujeitos ao desafio lógico em questão. Apenas oito textos tratam efetivamente de puxar o fluxo de usuários. A principal conclusão é que puxar processos aparenta ter um objetivo distinto quando aplicado no fluxo de usuários em saúde: o objetivo seria menos a eliminação de filas (equivalentes a estoques intermediários), mas sobretudo a eliminação de ociosidade em recursos de capacidade limitada a jusante.
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Referências
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