Samuel Martins Drei and Paulo Sérgio de Arruda Ignácio
The objective of this paper is to propose a systematic application of Lean Healthcare in the hospitalization activity in the medical clinic entry process.
Abstract
Purpose
The objective of this paper is to propose a systematic application of Lean Healthcare in the hospitalization activity in the medical clinic entry process.
Design/methodology/approach
The methodology used is established in three stages: the first aims to map the process in which the focus activity is inserted, using lean tools, as well as integrating the employees involved in the application. The second is the proposal to apply the systematic, together with the employees, using the A3 tool step by step. Finally, the third stage confirms the applied systematic, collecting the results and analyzing the initial situation with those reached.
Findings
As a result, improvements were made in the medical clinic entry process, such as reduced waiting time for patients, at approximately 53.8%, with a decrease in the standard deviation of the times – of approximately 79.14%, and displacement of those involved, of 72%, in addition to eliminating unnecessary activities for the process. Furthermore, the empirical results on the efficiency of this systemic application in medical clinic enable the replication of this proposal, generating a systematic.
Research limitations/implications
Despite establishing a systematic proposal with real results, it is focused on only one application, due to time limitations, may generate a subjective evaluation of the systematic. Thus, for future research, it is recommended to expand this systemic application in other activities of different processes.
Practical implications
The practical implications of this paper are precisely related to the data obtained with the application made, developing a Lean Healthcare systematic not previously seen, which is strategic, systemic and has a roadmap to assist in its application and, in addition, brings with it practical results that prove their efficiency.
Social implications
The social implications of this paper are presented in its empirical results, considering that the study hospital serves, in addition to its host city, 28 other smaller municipalities around it, improving the flow of processes, ensuring better management of the clinic doctor. In addition, the results can assist the processes flow of other medical clinics in hospitals around the world, especially at critical moments, such as pandemics or epidemics.
Originality/value
Due to the positive results obtained in the systematic application, this paper fills a gap identified in the literature, proposing a systematic application of Lean Healthcare that is systemic and strategic, in addition to including a roadmap and analysis of data applied in a medium-sized Brazilian hospital, presenting positive practical results exposed in the paper.
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I am indebted to Anthony Waterman for identifying the largely illegible phrase cuius regio, eius religio, found near the end of Ostrander’s notes. Waterman writes, in explanation…
Abstract
I am indebted to Anthony Waterman for identifying the largely illegible phrase cuius regio, eius religio, found near the end of Ostrander’s notes. Waterman writes, in explanation, apropos of Martin Luther: Lit. ‘whatever of the king, so of the religion’: it means that L. thought (being the Erastian he was), that the religion of a country should be that of its sovereign prince. Note: (a), the assumption, almost universal at that time, that there can be only ONE church in any Christian nation; and (b) the assumption, standard until the Scottish Enlightenment I should think (though people like Locke begin to chip away at it) that – as Louis XIV put it with admirable economy, ‘l’etat c’est moi’ (Waterman to Samuels, December 12, 2002).
Nobody concerned with political economy can neglect the history of economic doctrines. Structural changes in the economy and society influence economic thinking and, conversely…
Abstract
Nobody concerned with political economy can neglect the history of economic doctrines. Structural changes in the economy and society influence economic thinking and, conversely, innovative thought structures and attitudes have almost always forced economic institutions and modes of behaviour to adjust. We learn from the history of economic doctrines how a particular theory emerged and whether, and in which environment, it could take root. We can see how a school evolves out of a common methodological perception and similar techniques of analysis, and how it has to establish itself. The interaction between unresolved problems on the one hand, and the search for better solutions or explanations on the other, leads to a change in paradigma and to the formation of new lines of reasoning. As long as the real world is subject to progress and change scientific search for explanation must out of necessity continue.
To determine where, when, how, and wherefore European social theory hit upon the formula of “the True, the Good, and the Beautiful,” and how its structural position as a skeleton…
Abstract
Purpose
To determine where, when, how, and wherefore European social theory hit upon the formula of “the True, the Good, and the Beautiful,” and how its structural position as a skeleton for the theory of action has changed.
Methodology/approach
Genealogy, library research, and unusually good fortune were used to trace back the origin of what was to become a ubiquitous phrase, and to reconstruct the debates that made deploying the term seem important to writers.
Findings
The triad, although sometimes used accidentally in the renaissance, assumed a key structural place with a rise of Neo-Platonism in the eighteenth century associated with a new interest in providing a serious analysis of taste. It was a focus on taste that allowed the Beautiful to assume a position that was structurally homologous to those of the True and the Good, long understood as potential parallels. Although the first efforts were ones that attempted to emphasize the unification of the human spirit, the triad, once formulated, was attractive to faculties theorists more interested in decomposing the soul. They seized upon the triad as corresponding to an emerging sense of a tripartition of the soul. Finally, the members of the triad became re-understood as values, now as orthogonal dimensions.
Originality/value
This seems to be the first time the story of the development of the triad – one of the most ubiquitous architectonics in social thought – has been told.
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Rebecca Jean Emigh and Dylan Riley
In this chapter, we review the historical development of elite theory, and then we propose a way forward beyond it. Elite theory emerged as a critique of democracy in the late…
Abstract
In this chapter, we review the historical development of elite theory, and then we propose a way forward beyond it. Elite theory emerged as a critique of democracy in the late 19th century. Although it used historical materials illustratively, it tended to be ahistorical theoretically because its primary aim was to demonstrate the perdurance of elites even in conditions of mass suffrage. Lachmann was the first scholar to develop elite theory as a truly historical and explanatory framework by combining it with elements of Marxism. Even Lachmann's theory, however, remained inadequate because it did not rest on a fully articulated theory of power. In this introduction, we suggest a “relational power theory” as a remedy to this situation, and we use it to formulate a general heuristic for the study of elites, nonelites, and their interrelationships. To illustrate its utility, we show how it can illuminate the chapters in this volume (though they were not necessarily written for these purposes).
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How can we understand the colonial state? Specifically, what explains variation in “native policy,” the cornerstone of colonial rule? This article examines the development of…
Abstract
How can we understand the colonial state? Specifically, what explains variation in “native policy,” the cornerstone of colonial rule? This article examines the development of German colonialism in Southwest Africa (with respect to the Hereros, Witboois, and Rehoboth Basters), Samoa, and Qingdao, China. I emphasize five main determinants of policy: (1) precolonial ethnographic representations; (2) colonial officials' competitive jockeying with one another for cultural distinction; (3) colonial officials' psychic processes of imaginary identification with the colonized; (4) practices of collaboration and resistance by the colonized; and (5) the structure of the colonial state as a determinant of its own policies.