Improving Healthcare Operations: The Application of Lean, Agile and Leagility in Care Pathway Design

Healthcare Systems in the Twenty-first CenturyThe Context: Global HealthcareThe Context—UK HealthcareHealthcare Operations ManagementQuality Improvement and the NHSOutline of the StudyDefinitionsConclusionsStructure of the PublicationReferencesImproving Healthcare SystemsSupply Chain ManagementSystems Thinking and Seamless Healthcare SystemsQuality Improvement in HealthcareConclusionsReferencesLean in HealthcareFundamentals of Lean ThinkingLean from a Supply Chain PerspectiveCritics of LeanKey Themes in the Lean Healthcare LiteratureContemporary Writings on Lean in HealthcareImproved Patient SatisfactionReadiness for Lean ImplementationEffectiveness of Lean Interventions in HealthcareConclusionsReferencesDelivering Agile and Person-centred CareAgility—A Manufacturing PerspectiveAgility from a Supply Chain PerspectivePerson-Centred CareCo-designing and Co-producing HealthImprovement CyclesConclusionsReferencesLeanness Plus Agility = LeagilityLeanness and Agility—LeagilityLeagile Supply ChainsDecoupling PointsFront-Office and Back-Office ActivitiesLeagility in HealthcareConclusionsReferencesMethodologyPreparation and Understanding the Research EnvironmentStudy Design and MethodsSelection of Care PathwaysChronic Obstructive Pulmonary Disease PathwayHuntington’s Disease PathwayData Collection and Data AnalysisNon-participant ObservationSemi-structured Interviews with Patients, Relatives/Carers and Staff ParticipantsFocus GroupsValidation of ResultsData AnalysisCredibility and RigourConclusionsReferencesAnalysis of the COPD Pathway: Lean, Agile and LeagilityChronic Obstructive Pulmonary DiseaseThematic Analysis of DataArchitecture of the COPD PathwayDefinitions of PathwayProcess Map: Visualising the PathwayCritical Points in the PathwayCare Management in the CommunityDecoupling Back-Office and Front-Office ActivitiesPatient FlowsInformation FlowsAvailability of InformationCommunicationMedication InformationInformation Feedback LoopsResource FlowsEmotional FlowsDiscussionConclusionsReferencesAnalysis of the Huntington’s Disease Pathway: Lean, Agility and LeagilityHuntington’s Disease PathwayThematic Analysis of DataArchitecture of the HD Patient PathwayLean and the HD PathwayAgility and the HD PathwayDecoupling Back-Office and Front-Office ActivitiesFrom Person-Centred Care to Family-Centred CareInformation FlowsRole of the BrokerEmotional FlowsResource FlowCo-production of CareDiscussionConclusionsReferencesDiscussion and Theoretical ReflectionsPathway ArchitectureLean, Agile and Leagile in Pathway DesignRole of the Brokering AgentEmotional FlowsConclusionsReferencesLinking Theory and PracticeQuality improvement in healthcareSystems thinking and seamless healthcare systemsSupply chain management and pathway designImplications of the ResearchHealthcare Organisations and PractitionersAcademicsPolicy makersLimitations of the StudyResearch AgendaConclusionsReferences
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