LEAN AND THE ECRS PRINCIPLE: DEVELOPING A FRAMEWORK TO MINIMISE WASTE IN HEALTHCARE SECTORS
Abstract
Background: The healthcare system is characterised by complexities and fragmentation, which sometimes leads to lower quality of care and increased inefficiencies. Therefore, organisations are expected to invest in the improvement of both the quality and efficiency of their healthcare systems. Lean philosophy offers an improvement method encompassing a wide range of stakeholders, including frontline workers, that aims to redesign healthcare systems by eliminating waste. As Lean begins to be adopted within healthcare systems, various elements of Lean philosophy and principles have been specified and adapted. However, despite the wide interest in Lean methodology within healthcare systems, there has been a distinct lack of emphasis on one of its key principles, ECRS (Eliminate, Combine, Rearrange, and Simplify).
Materials and Methods: This study aims to develop a framework using Lean and the ECRS principle to minimise waste within healthcare sectors. It researched literature from the following databases: Medline, CINAHL, Google Scholar, Embase, and the Cochrane Library, adhering to set guidelines to ensure the search remained within the realms of the study. In addition to the electronic database searches, the review will discuss national publications where relevant, the grey literature, and the official websites of various organisations.
Result: Although the literature highlights the importance of the ECRS principle especially in the industrial and service sectors, there is a dearth in applying and adopting the ECRS approach in healthcare sectors. Consequently, this review developed a framework for facilitating a systematic way of thinking to generate different ideas for minimising waste in the healthcare sector. Further, a worksheet for processes improvement using the ECRS principles was developed and incorporated into the framework.
Conclusion: It can be concluded that the ECRS method could be an essential part of the improvement toolkit and necessary for successful Lean implementation within the healthcare sector. This is the first attempt to properly highlight ECRS as a method recommended to be used in healthcare sector.
Keywords: Lean, ECRS, value stream mapping, hospital, healthcare