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Implementation of Lean healthcare methodology in designing an Intravitreal Injection Center: first Italian experience

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Abstract

Purpose

The principles of the Lean methodology, introduced by Toyota to improve productivity, are relevant to other settings, including healthcare. We aimed to use Lean methodology to design a new setting in our ophthalmology clinic to improve the management of patients receiving an intravitreal injection for ocular diseases.

Methods

The location of services, days of operation, scheduling and processing of patients, utilization of staff, data recording methods, and examination and surgical procedures were analyzed, and a new Intravitreal Injection Center was developed according to Lean principles.

Results

The new setting, which is confined to a single floor, in contrast to the previous system, which necessitated that patients visit various locations spread over three floors of the hospital, demonstrated benefits for patients and improved the flow and management of patients through the system with a need for fewer team members. The intravitreal injection service improved with regard to both the quality and speed of the overall procedure and the efficient use of staff.

Conclusion

Our aim to achieve a fast and one-way route to move patients through intravitreal injection administration was achieved, limiting any waste of time and space and improving the capacity management of the center. The system is of relevance to other ophthalmology clinic settings and facilitates the collection of valuable epidemiological and clinical information on the response of patients to different drugs and treatment regimens.

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Data are available from the first author.

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Acknowledgements

We thank Ray Hill, independent medical writers acting on behalf of Springer Healthcare Communications, who provided English-language editing and journal styling prior to submission. This assistance was funded by Novartis Farma (Grant No. 328 NOV121-20).

Funding

We received funding by Novartis Farma for English-language editing and journal styling.

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Authors and Affiliations

  1. Eye Clinic, Azienda Ospedaliero-Universitaria Policlinico, University of Bari, Piazza Giulio Cesare, 11, 70124, Bari, BA, Italy

    Maria Oliva Grassi, Claudio Furino, Nicola Recchimurzo, Fabio De Vitis, Giancarlo Sborgia, Luigi Sborgia, Arianna Meleleo, Teresa Molfetta, Marina Piepoli, Francesco Boscia & Giovanni Alessio

  2. School of Management, Politecnico di Milano, Milan, Italy

    Paolo Locatelli

Authors
  1. Maria Oliva Grassi
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  2. Claudio Furino
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  3. Nicola Recchimurzo
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  4. Fabio De Vitis
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  5. Giancarlo Sborgia
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  11. Francesco Boscia
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  12. Giovanni Alessio
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MOG, CF, NR, FDV, GS, LS, AM, TM, MP and PL. The first draft of the manuscript was written by MOG, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Maria Oliva Grassi.

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The authors declare they have no conflicts of interest. The authors have no proprietary or commercial interest in the medical devices that are involved in this manuscript.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Grassi, M.O., Furino, C., Recchimurzo, N. et al. Implementation of Lean healthcare methodology in designing an Intravitreal Injection Center: first Italian experience. Int Ophthalmol 40, 2607–2615 (2020). https://doi.org/10.1007/s10792-020-01441-1

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  • DOI: https://doi.org/10.1007/s10792-020-01441-1

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