Leader: Chiara Verbano (UNIPD); Other collaborator(s): Anna Tiso (UNIPD)
This task aims at developing a framework to continuously improve long-term care pathways in terms of efficiency, effectiveness, safety and patient satisfaction adopting a lean and safety perspective. Lean and Safety Management (L&SM) combines two managerial approaches which have been successfully applied separately to hospital clinical pathways but hold the potential for a useful integrated application: lean healthcare (LH) and clinical risk management (CRM). L&SM can lead benefits also on long-term care pathways, that require the integration of hospital and territorial care, according to the care continuity model (Decree 71/2022). The final purpose is to develop guidelines to improve the quality of care provided in long-term pathways and promote sustainability, which is also defined as one of main limit of L&SM. To this end, the key elements affecting results sustainability in the long term have been identified and analysed, focusing in particular on two aspects: performance measurement and lean training. The formulated guidelines will provide support both for academics and healthcare providers.
- A Structured Literature Review has been performed adopting PRISMA protocol (Liberati et al., 2009), focused on the adoption of L&SM in the territorial ambulatory healthcare setting (TAH). The analysis focused on the adoption of performance measurement systems in L&SM projects, through the identification of the pursued project objectives, the employed performance measurement indicators and the monitored results, confirming a gap of knowledge about these themes.
- Analysis of a chronic care pathway (Chronic Obstructive Pulmonary Disease) in a Spanish hospital adopting a L&SM perspective. The improvement project aimed to improve the integration and coordination between the hospitalization care activities and the post-hospitalization care provided in the territory. The implementation of a performance measurement system allowed to test some of the performance indicators identified in the literature review and included in the dataset.
- Analysis in a lean and safety perspective of a primary care centre in Veneto region, focusing on chronic care pathway, in particular on Type 2 Diabetes Mellitus.
- Extended abstract presented at the 16th Annual Euromed Academy Of Business Conference 2023:
Pozzan, C., Tiso, A., Ronchi, F., & Verbano, C. (2023). Health Lean Management to improve primary care centres and ambulatory care: a systematic literature review. In Business Transformation in Uncertain Global Environments, pp. 1047-1050. ISBN: 978-9963-711-98-7.
- Short paper e Poster presented at the 19th European Conference on Management Leadership and Governance 2023:
Tiso, A., Cháfer-Vilaplana, J., Torrego-Ellacurìa, M., Morales Contreras, M. F., Verbano, C., (2023). Lean and safety management: a project to improve the continuity of care for chronic patients. In Proceedings of the 19th European Conference on Management Leadership and Governance 2023, pp.553-556. ISBN:978-1914587-92-4. ISSN:2048-9021
- Short paper e Poster presented at the 19th European Conference on Management Leadership and Governance 2023:
Pozzan, C., Tiso A., Ronchi, F., Verbano, C., (2023). Lean and safety management in primary care centres: an italian case study. In Proceedings of the 17th European Conference on Management Leadership and Governance 2023. pp.550-552. ISBN:978-1-914587-92-4. ISSN:2048-9021
- Performance measurement indicators supporting lean and safety management in community-based ambulatory healthcare have been grasped from the structure literature review and categorized based on the improvement objectives they are associated with, in order to address their choice in future performance improvement projects.
- Creation of a dataset of indicators to measure, improve and sustain the quality of care provided in long-term pathways in L&SM project developed in TAH.
- Development of guidelines for healthcare and policy providers to improve and guarantee the sustainability of L&SM projects and results.
- Short paper presented at the 16th International Conference on Education and New Learning Technologies Conference:
Tiso A., Pozzan, C., Verbano, C., (2024). Lean and safety management: a systematic literature review of performance measurement indicators for quality improvement in territorial ambulatory health care. 16th International Conference on Education and New Learning Technologies Conference Proceedings, pp. 5966-5973. ISBN: 978-84-09-62938-1. ISSN: 2340-1117. doi: 10.21125/edulearn.2024.1426.
- Presentation of “L&SM application in territorial ambulatory care pathways” for the Stakeholder Meeting of Spoke 5 held in Rome on 16-17 April 2024;
- Extended abstract and Poster presentation at the Age-It General Meeting held in Venice on 20-22 May 2024:
Tiso, A., Pozzan, C., Verbano, C. (2024). Performance measurement indicators supporting Lean and Safety Management in territorial ambulatory health care: a systematic literature review.
- Submission of the contribution “Performance measurement indicators supporting lean and safety management in community-based ambulatory healthcare” for the first WP6 deliverable "Dataset of indicators"
- Submission of the contribution “Sustainable Improvement in Territorial Ambulatory Health Care: The Role of Performance Measurement in Lean and Safety Management Projects” for the second WP6 deliverable “Policy brief”
- Presentation of “Performance measurement indicators to sustain Lean and Safety Management projects: an application in chronic care pathways” at PE8 meeting – University of Padova on 22-23 October 2024