Lean-Oriented Layout Design of a Health Care Facility

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.

[1]  Michele Lanzetta,et al.  Heuristics for scheduling a two-stage hybrid flow shop with parallel batching machines: application at a hospital sterilisation plant , 2013 .

[2]  Ibrahim H. Osman,et al.  A mixed integer programming formulation for solving operating theatre layout problem: A multi-goal approach , 2013, Proceedings of 2013 International Conference on Industrial Engineering and Systems Management (IESM).

[3]  Reuven R. Levary,et al.  Planning facilities layout in clinical laboratories using a group decision making process , 1986 .

[4]  Russell D. Meller,et al.  A multiple-drawer medication layout problem in automated dispensing cabinets , 2012, Health care management science.

[5]  G. Tortorella,et al.  Making the value flow: application of value stream mapping in a Brazilian public healthcare organisation , 2017 .

[6]  Hu-Chen Liu,et al.  Integrating systematic layout planning with fuzzy constraint theory to design and optimize the facility layout for operating theatre in hospitals , 2015, J. Intell. Manuf..

[7]  Jose Arturo Garza-Reyes,et al.  The role of the physical layout in the implementation of lean management initiatives , 2011 .

[8]  A. N. Elshafei,et al.  Hospital Layout as a Quadratic Assignment Problem , 1977 .

[9]  Chirakiat Saithong,et al.  Design and Selection of Plant Layout by Mean of Analytic Hierarchy Process: A Case Study of Medical Device Producer , 2013 .

[10]  Monika Motaghi,et al.  OPTIMIZATION OF HOSPITAL LAYOUT THROUGH THE APPLICATION OF HEURISTIC TECHNIQUES (DIAMOND ALGORITHM) IN SHAFA HOSPITAL (2009) , 2011 .

[11]  D. Mavalankar,et al.  Planning and implementing a program of renovations of emergency obstetric care facilities: experiences in Rajasthan, India , 2002, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[12]  Taho Yang,et al.  Lean principles and simulation optimization for emergency department layout design , 2015, Ind. Manag. Data Syst..

[13]  Kirk R. Karwan,et al.  Multi-Level Strategic Evaluation of Hospital Plans and Decisions , 1992 .

[14]  Ian W. Gibson.  An approach to hospital planning and design using discrete event simulation , 2007, 2007 Winter Simulation Conference.

[15]  AlissA l. McDowell,et al.  Selecting a pharmacy layout design using a weighted scoring system. , 2012, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[16]  John Nicholas,et al.  An Integrated Lean-Methods Approach to Hospital Facilities Redesign , 2012, Hospital topics.

[17]  Thomas Hanne,et al.  Bringing Robustness to Patient Flow Management Through Optimized Patient Transports in Hospitals , 2009, Interfaces.

[18]  B. Murtagh,et al.  A heuristic procedure for solving the quadratic assignment problem , 1982 .

[19]  Kevin J. Duggan,et al.  Creating Mixed Model Value Streams: Practical Lean Techniques for Building to Demand, Second Edition , 2012 .

[20]  Brian Abraham,et al.  Digital room-layout planning for complex manual handling hospital discharges , 2014 .

[21]  Robin S Liggett,et al.  Automated facilities layout: past, present and future , 2000 .

[22]  R. Lozano,et al.  Human resources for health and universal health coverage: fostering equity and effective coverage. , 2013, Bulletin of the World Health Organization.

[23]  Moacir Godinho Filho,et al.  Lean healthcare in developing countries: evidence from Brazilian hospitals , 2017, The International journal of health planning and management.

[24]  Leti Vos,et al.  Evaluating hospital design from an operations management perspective , 2007, Health care management science.

[25]  Johann Hurink,et al.  Clustering clinical departments for wards to achieve a prespecified blocking probability , 2015, OR Spectr..

[26]  Qiang Su,et al.  An applied case of quadratic assignment problem in hospital department layout , 2015, 2015 12th International Conference on Service Systems and Service Management (ICSSSM).

[27]  G L Delon.  Quantitative methods for evaluating hospital design. A methodology for total hospital design. , 1970, Health services research.

[28]  Stefan Nickel,et al.  Planning and Organisation in the Hospital , 2000 .

[29]  Ibrahim H. Osman,et al.  Multi-Agent System for solving Dynamic Operating Theater Facility Layout Problem , 2015 .

[30]  Jakob Krarup,et al.  A hospital facility layout problem finally solved , 2001, J. Intell. Manuf..

[31]  Stefan Helber,et al.  A hierarchical facility layout planning approach for large and complex hospitals , 2014 .

[33]  I-Cheng Yeh,et al.  Architectural layout optimization using annealed neural network , 2006 .

[34]  Martin Bicher,et al.  Adjacency in hospital planning , 2015 .

[35]  Lou Y. Liang,et al.  The strategies of tabu search technique for facility layout optimization , 2008 .

[36]  B. K. Ouda,et al.  Improving operating theatre design using facilities layout planning , 2012, 2012 Cairo International Biomedical Engineering Conference (CIBEC).

[37]  Thomas L. Saaty,et al.  The legitimacy of rank reversal , 1984 .

[38]  V. Lopes,et al.  The Analytic Hierarchy Process as a Means for Integrated Watershed Management , 2003 .

[39]  Panos M. Pardalos,et al.  GRASP with Path-Relinking for Facility Layout , 2013 .

[40]  Katherine Leach-Kemon,et al.  Financing of global health: tracking development assistance for health from 1990 to 2007 , 2009, The Lancet.

[41]  Richard J. Boucherie,et al.  Health care logistics and space: Accounting for the physical build environment , 2012, Proceedings Title: Proceedings of the 2012 Winter Simulation Conference (WSC).

[42]  Eric R. Zieyel.  Operations research : applications and algorithms , 1988 .

[43]  David Morgareidge,et al.  Performance-driven design with the support of digital tools: Applying discrete event simulation and space syntax on the design of the emergency department , 2014 .

[44]  M. Bohanec,et al.  The Analytic Hierarchy Process , 2004 .

[45]  B. Whitehead,et al.  The planning of single-storey layouts , 1965 .

[46]  Christian Stummer,et al.  Determining Location and Size of Medical Departments in a Hospital Network: A Multiobjective Decision Support Approach , 2004, Health care management science.

[47]  Stefan Nickel,et al.  Multi-period layout planning for hospital wards , 2013 .

[48]  Flavio S Fogliatto,et al.  A Six Sigma Approach to Analyze Time-to-Assembly Variance of Surgical Trays in a Sterile Services Department , 2017, Journal for healthcare quality : official publication of the National Association for Healthcare Quality.

[49]  John B. Kidd,et al.  Toyota Production System , 1993 .

[50]  Bruno Agard,et al.  Integrating occupational health and safety in facility layout planning, part I: methodology , 2015 .

[51]  M. Khadem,et al.  Evaluating the layout of the emergency department of a public hospital using computer simulation modeling: A case study , 2008, 2008 IEEE International Conference on Industrial Engineering and Engineering Management.

[52]  Chris Hicks,et al.  Applying lean principles to the design of healthcare facilities , 2015 .