Lean thinking in sanità: il caso della logistica degli approvvigionamenti e della distribuzione ospedaliera dei farmaci

Journal title MECOSAN
Author/s Roberto Vona, Nadia Di Paola
Publishing Year 2015 Issue 2014/91
Language Italian Pages 18 P. 105-122 File size 387 KB
DOI 10.3280/MESA2014-091006
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Lean thinking in healthcare: hospital procurement logistics and drug distribution - Taking into account the most recent literature on management of health care systems, this paper focuses on lean production, in order to assess the collective mindfulness in the healthcare. To reach the goal, we analyze procurement and distribution processes of drugs and medical and diagnostics devices in a public hospital located in Southern Italy. The paper proposes a tool for assessing the collective mindfulness of a lean management intervention, and tests it thanks to the case study. The results show a lack of awareness of the external significance of the lean practices.

Keywords: Procurement, distribution, drug, logistics, lean production, healthcare.

  1. Anessi Pessina E., Cantu E. (a cura di) (2000). L’aziendalizzazione della sanità in Italia. Milano: Egea.
  2. Askarian M., Vakili M., Gholamhosein K. (2004). Results of a hospital waste survey in private hospitals in Fars province, Iran. Waste Management, 24: 347-352. DOI: 10.1016/j.wasman.2003.09.008
  3. Barney J.B. (1991). Firm resources and sustained competitive advantage. Journal of Management Studies, 17(1): 99-120. DOI: 10.1177/014920639101700108
  4. Borgonovi E. (2000). La spesa sanitaria: investimento per lo sviluppo o consumo. L’industria, 21 (3): 427-448.
  5. Borgonovi E., Rondo Brovetto P. (1994). Management challenges and markets. The International journal of health planning and management, 9 (1): 25-38. DOI: 10.1002/hpm.4740090104
  6. Brandao de Souza L. (2009). Trends and approaches in lean healthcare. Leadership in Health Services, 22 (2): 121-139. DOI: 10.1108/17511870910953788
  7. Caldarelli A., Maffei M., Spano R. (2012). I sistemi di valutazione della performance dei Direttori Generali come processo trasformazionale. Un’analisi empirica dei Servizi Sanitari Regionali Italiani. Management Control, 3. DOI: 10.3280/MACO2012-003003
  8. Cavaliere B. (2000). La specializzazione orizzontale delle mansioni: sistemi di valutazione applicabili alla professione infermieristica. Rivista di Management Infermieristico, 1.
  9. Charabarty T., Giri B.C., Chaudhuri K.S. (1998). An EOQ model for items with Weibull distribution deterioration, shortages and trend demand: an extension of Philip’s model. Computers and Operations Research, 25 (7): 649-658. DOI: 10.1016/s0305-0548(97)00081-6
  10. Chassin M.R., Loeb J.M. (2013). High-Reliability Health Care: Getting There from Here. Milbank
  11. Quarterly, 91 (3): 459-490. DOI: 10.1111/1468-0009.12023
  12. Danas K., Roudsari A., Ketikidis P.H. (2006). The Applicability of a Multi-attribute Classification
  13. Framework in the Healthcare Industry. Journal of Manufacturing Technology Management, 17 (6):
  14. 772-785. DOI: 10.1108/17410380610678792
  15. Deshpande R., Farley J.U., Webster F.E.Jr. (1993). Corporate culture, customer orientation, and innovativeness in Japanese firms: A quadrad analysis. Journal of Marketing, 57: 23-37. DOI: 10.4135/9781452231426.n4
  16. De Treville S.D., Antonakis J. (2006). Could lean production job design be intrinsically motivating? Contextual, configurational, and levels-of-analysis issues. Journal of Operations Management, 24 (2):
  17. 99-123. DOI: 10.1016/j.jom.2005.04.001
  18. Fattore G., Torbica A. (2006). Inpatient reimbursement system in Italy: How do tariffs relate to costs? Health care management science, 9 (3): 251-258. DOI: 10.1007/s10729-006-9092-2
  19. Galgano A., Galgano C. (2006). Il sistema Toyota per la sanità: più qualità e meno sprechi. Milano:
  20. Guerini e associati.
  21. Gallmann F., Belvedere V. (2011). Linking service level, inventory management and warehousing practices: A case-based managerial analysis. Operations management research, 4: 28-38. DOI: 10.1007/s12063-010-0043-1
  22. Guimaraes, C.M., de Carvalho, J.C. (2012). Lean Healthcare across Cultures: State-Of-The-Art. American International Journal of Contemporary Research, 2: 187-206.
  23. Herzlinger R.E. (2006). Why Innovation in Health Care Is So Hard. Harvard Business Review, May: 58-66.
  24. Holden R.J. (2011). Lean Thinking in emergency departments: a critical review. Annals of emergency medicine, 57 (3): 265-278. DOI: 10.1016/j.annemergmed.2010.08.001
  25. Hollingsworth B. (2008). The Measurement of Efficiency and Productivity of Health Care Delivery. Health Economics, 17 (10): 1107-1128. DOI: 10.1002/hec.1391
  26. Holweg, M. (2007). The genealogy of lean production. Journal of Operations Management, 25 (2): 420-437. DOI: 10.1016/j.jom.2006.04.001
  27. Hopp W.J., Spearman M.L. (2004). To pull or not to pull: what is the question? Manufacturing & Service Operations Management, 6 (2): 133-148. DOI: 10.1287/msom.1030.0028
  28. Jenkinson C., Coulter A., Bruster, S. (2002). The Picker Patient Experience Questionnaire: development and validation using data from in-patient surveys in five countries. International Journal for Quality in Health Care, 14 (5): 353-358. DOI: 10.1093/intqhc/14.5.353
  29. Joosten T., Bongers I., Janssen R. (2009). Application of lean thinking to health care: issues and observations. International Journal for Quality in Health Care, 21(5): 341-347. DOI: 10.1093/intqhc/mzp036
  30. Landry S., Philippe R. (2004). How Logistics can Service Healthcare. Supply Chain Forum, 5 (2): 24-30.
  31. Li L.X., Benton W.C. (1996). Performance measurement criteria in health care organizations,
  32. Review and future research directions. European Journal of Operations Research, 93: 449-468. DOI: 10.1016/0377-2217(95)00375-4
  33. Lutz S., Loedding H., Wiendahl H.P. (2003). Logistics oriented inventory analysis. International Journal of Production Economics, 85: 217-231. DOI: 10.1016/s0925-5273(03)00111-7
  34. Mapelli V. (2007). I sistemi di governance dei Servizi sanitari regionali. Quaderni Formez, 57: 1-314.
  35. Min W., Pheng L.S. (2007). Modeling just-in-time purchasing in the ready mixed concrete industry. International Journal of Production Economics, 107: 190-201. DOI: 10.1016/j.ijpe.2006.08.010
  36. Ndubisi N.O. (2012). Mindfulness, reliability, preemptive conflict handling, customer orientation and outcomes in Malaysia’s healthcare sector. Journal of Business Research, 65 (4): 537-546. DOI: 10.1016/j.jbusres.2011.02.019
  37. NHSIII – National Health Service Institute for Innovation and Improvement (2007). Going lean in the NHS, Warwick, NHS Institute for Innovation and Improvement.
  38. OECD (2013). Health Data. Paris, OECD.
  39. Olko P., Winch R. (2002). Introducing waste segregation. Health Estate Journal: 29-31.
  40. Palumbo F., Dominici G., La Commare U., Levanti, G. (2013). Il processo di incubazione per la creazione di imprese vitali. Il caso del Consorzio ARCA. Atti del XXV Convegno annuale di Sinergie.
  41. Peterson P.B. (2002). The misplaced origin of Justin-time production methods. Management Decision , 40 (1): 82-88. DOI: 10.1108/00251740210413398
  42. Pettersen J. (2009). Defining lean production: some conceptual and practical issues. The TQM Journal, 21 (2): 127-142. DOI: 10.1108/17542730910938137
  43. Piconi I., Mascia D. (2010). L’analisi delle migrazioni manageriali nel Ssn: Il caso dei direttori generali. Mecosan, 73: 41-54.
  44. Prada G., Grimes K., McCleery A., Nguyen D., Pomey M.P., Reed V. (2004). Challenging Health Care System Sustainability – Understanding Health System Performance of Leading Countries, The Conference Board of Canada.
  45. Radnor Z. (2010). Process Improvement and Lean Thinking: using knowledge and information to improve performance. Connecting Knowledge and Performance in Public Services: 173-198. DOI: 10.1017/cbo9780511762000.010
  46. Radnor Z.J., Holweg, M., & Waring, J. (2012). Lean in healthcare: The unfilled promise? Social Science & Medicine, 74 (3): 364-371. DOI: 10.1016/j.socscimed.2011.02.011
  47. Schonberger R.J. (1982). A revolutionary way to streamline the factory. The Wall Street Journal, 24.
  48. Shah R., Ward P.T. (2007). Defining and developing measures of lean production. Journal of operations management, 25 (4), pp.785-805. DOI: 10.1016/j.jom.2007.01.019
  49. Timmermans S. and Berg M. (2003). The practice of medical technology. Sociology of Health & Illness, 25: 97-114. DOI: 10.1111/1467-9566.00342
  50. Tudor T.L., Marsh C.L., Butler S., Van Horn J.A., Jenkin L.E.T. (2008). Realising resource efficiency in the management of healthcare waste from the Cornwall National Health Service (NHS) in the UK. Waste Management, 28: 1209-1218. DOI: 10.1016/j.wasman.2007.04.004
  51. Waring J.J., Bishop S. (2010). “Water cooler” learning: Knowledge sharing at the clinical “backstage” and its contribution to patient safety. Journal of Health organization and Management, 24 (4): 325-342.
  52. Weick K.E., Sutcliffe K.M. (2001). Managing the unexpected. San Francisco, Jossey-Bass.
  53. Womack J.P., Jones D.T. (1996). Beyond Toyota: how to root out waste and pursue perfection. Harvard business review, 74 (5): 4-16.
  54. Womack J.P., Jones D.T., Roos D. (1990). The Machine That Changed the World: The Story of Lean Production: How Japan’s Secret Weapon in the Global Auto Wars Will Revolutionize Western Industry. New York (US): Rawson Associates.
  55. Yin R.K. (2009). Case study research: Design and methods. Vol. 5. Thousand Oaks (US): SAGE Publications.
  56. Young T., McClean S. (2008). A critical look at Lean Thinking in healthcare. Quality and Safety in Health Care, 17: 382-386. DOI: 10.1136/qshc.2006.020131
  57. Zheng J., Bakker E., Knight L., Gilhespy H., Harland C., Walker H. (2006). A strategic case for e-adoption in healthcare supply chains. International Journal of Information Management, 226: 190-231. DOI: 10.1016/j.ijinfomgt.2006.03.010

  • La realizzazione di una metodologia per la misurazione delle performance dei coordinatori infermieristici in un ospedale per intensità di cura di alta specializzazione attraverso l'approccio del PDCA Carlotta Patrone, Lucia Cassettari, Francesca Giovannini, Isabella Cevasco, in MECOSAN 106/2019 pp.111
    DOI: 10.3280/MESA2018-106006
  • La digitalizzazione dei servizi di supporto in sanità. L'esperienza di ESTAR Luca Dal Bene, Paolo Franchi, Antonella Garna, Giacomo Pieraccioli, Monica Piovi, Paolo Torrico, in MECOSAN 123/2023 pp.195
    DOI: 10.3280/mesa2022-123oa15603
  • Applicazione della metodologia SMED per il miglioramento delle operations nelle sale operatorie. Il caso Azienda Ospedaliera Universitaria Senese Jacopo Guercini, Vincenzo Mezzatesta, Andrea Chiarini, Caterina Bianciardi, Lucia Bellandi, Sara Moi, Pasquale Biandolino, in MECOSAN 98/2016 pp.83
    DOI: 10.3280/MESA2016-098005

Roberto Vona, Nadia Di Paola, Lean thinking in sanità: il caso della logistica degli approvvigionamenti e della distribuzione ospedaliera dei farmaci in "MECOSAN" 91/2014, pp 105-122, DOI: 10.3280/MESA2014-091006