Yalın Hastane Uygulanan Hastanelerin Verimliliğinin İncelenmesi
Özet
Yalın, başlangıçta otomotiv ve imalat endüstrilerinde geliştirilmiş bir kalite iyileştirme metodolojisi olup, son yıllarda sağlık sektöründe de yaygın şekilde uygulanmaya başlamıştır. Yalın yönetim, sağlık hizmetlerinde süreçlerin iyileştirilmesi, israfın azaltılması ve hasta odaklı hizmet anlayışının güçlendirilmesi amacıyla kullanılan etkili bir yaklaşımdır. Sınırlı kaynaklara, yüksek hasta beklentilerine ve karmaşık işleyişe sahip olan hastaneler, zamanla yalın dönüşüm çalışmalarının odağı hâline gelmiştir. Yalın uygulamaların sağlık hizmetlerinde en belirgin katkılarından biri, hastane verimliliğini artırmasıdır. Bu sistematik derlemenin amacı, yalın hastane uygulamalarının sağlık kurumlarının verimliliği üzerindeki etkilerini incelemek ve literatürde bildirilen kazanımları bütüncül bir bakış açısıyla değerlendirmektir. Literatür incelemeleri, yalın uygulamaların hasta bekleme sürelerinin azalması, acil servis ve poliklinik akışlarının hızlanması, yatış ve taburculuk süreçlerinin kısalması, hatalı işlem oranlarının düşmesi, çalışan iş yükünün dengelenmesi ve maliyetlerin azalması gibi birçok olumlu çıktıyla ilişkili olduğunu göstermektedir. Bulgular, yalın hastane uygulamalarının sağlık kurumlarında sürdürülebilir verimlilik artışı sağlayabildiğini ortaya koymakta ve yalın yaklaşımın modern sağlık sistemlerinde stratejik bir dönüşüm aracı olarak değerlendirilebileceğini göstermektedir.
Lean is a quality improvement methodology that was initially developed in the automotive and manufacturing industries, and in recent years, it has been widely applied in the healthcare sector. Lean management is an effective approach used in healthcare services to improve processes, reduce waste, and strengthen a patient-centered service approach. Hospitals, which have limited resources, high patient expectations and complex operations, have become the focus of lean transformation efforts over time. One of the most obvious contributions of lean practices in healthcare is that they increase hospital efficiency. The aim of this review is to examine the effects of lean hospital practices on the efficiency of health institutions and to evaluate the achievements reported in the literature from a holistic perspective. Literature reviews show that lean practices are associated with many positive outcomes such as reduced patient waiting times, acceleration of emergency department and outpatient clinic flows, shortening of hospitalization and discharge processes, decrease in erroneous procedure rates, balancing employee workload and reducing costs. The findings reveal that lean hospital practices can provide sustainable productivity increase in healthcare institutions and show that the lean approach can be considered as a strategic transformation tool in modern healthcare systems.
Referanslar
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. National Academies Press. https://pubmed.ncbi.nlm.nih.gov/25057539/
Joosten, T., Bongers, I., & Janssen, R. (2009). Application of lean thinking to health care: İssues and observations. International Journal for Quality in Health Care, 21(5), 341.
Graban, M. (2018). Lean hospitals: Improving quality, patient safety, and employee engagement (3rd bs).
Radnor, Z. J., Holweg, M., & Waring, J. (2012). Lean in healthcare: The unfilled promise? Social Science & Medicine, 74(3), 364-371.
Zepeda-Lugo, C., Tlapa, D., & Baez-Lopez, Y. (2020). Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review. International Journal of Environmental Research and Public Health, 17(15), 5609.
Quality in business: Concept and definition. (t.y.). Geliş tarihi 07 Eylül 2025, gönderen https://collectionperformance.com/quality-in-business-concept-and-definition/
Nanda, V. (t.y.). Quality Management System Handbook for Product Development Companies. Geliş tarihi 31 Ağustos 2025, gönderen https://books.google.com.tr/books?id=guizsuAAyR4C&pg=PA1&redir_esc=y#v=onepage&q&f=false
Ciampa, D. (1991). Total quality: A users’ guide for implementation.
Understanding Quality Measurement. (t.y.). Agency for Healthcare Research and Quality. Geliş tarihi 31 Ağustos 2025, gönderen https://www.ahrq.gov/patient-safety/quality-resources/tools/chtoolbx/understand/index.html
Chassin, M. R., Galvin, R. W., & Donaldson, M. S. (1998). The Urgent Need to Improve Health Care Quality. JAMA, 280(11), 1000-1005.
Ohno, T. (t.y.). Toyota Production System: Beyond Large-Scale Production. Geliş tarihi 10 Eylül 2025, gönderen https://books.google.com.tr/books?id=7_-67SshOy8C&printsec=frontcover&redir_esc=y#v=onepage&q&f=false
The Fundamentals and Advantages of the Lean Methodology. (t.y.). KaiNexus Blog. Geliş tarihi 11 Eylül 2025, gönderen https://blog.kainexus.com/the-fundamentals-of-the-lean-methodology
Abu Bakar, K., Mohd. Sam, M. F., & Qureshi, M. I. (2022). Lean manufacturing design of a two-sided assembly line balancing problem work cell. Lecture Notes in Mechanical Engineering, 25, 249-259.
Womack, J. P., & Jones, D. T. (1997). Lean thinking—Banish waste and create wealth in your corporation. Journal of the Operational Research Society, 48(11), 1148.
Imai, M. (2007). Gemba Kaizen: A Commonsense, Low-Cost Approach to Management.
Liker, J. K. (t.y.). The 14 principles of the Toyota way: An executive summary of the culture behind TPS. Geliş tarihi https://www.researchgate.net/publication/290007864
The Impact of Lean Manufacturing Concepts on Industrial Processes’ Efficiency and Waste Reduction. (t.y.). ResearchGate. Geliş tarihi 14 Eylül 2025, gönderen https://www.researchgate.net/publication/381250819_THE_IMPACT_OF_LEAN_MANUFACTURING_CONCEPTS_ON_INDUSTRIAL_PROCESSES%E2%80%99_EFFICIENCY_AND_WASTE_REDUCTION
Rother, M., & Shook, J. (2018). Learning to see: Value-stream mapping to create value and eliminate muda. https://www.researchgate.net/publication/244433983_Learning_to_See_Value_Stream_Mapping_to_Create_Value_and_Eliminate_Muda
Sobek, D. K., & Smalley, A. (2008). Understanding A3 thinking: A critical component of Toyota’s PDCA management system.
Kaplan, G. S., Patterson, S. H., Ching, J. M., & Blackmore, C. (2014). Why Lean doesn’t work for everyone. BMJ Quality & Safety, 23(12), 970-973.
van Rossum, L., Aij, K. H., Simons, F. E., van der Eng, N., & ten Have, W. D. (2016). Lean healthcare from a change management perspective. Journal of Health Organization and Management, 30(3), 475-493.
Kinsman, L., Rotter, T., Stevenson, K., Bath, B., Goodridge, D., & Harrison, L. (2014). The largest Lean transformation in the world: The implementation and evaluation of lean in Saskatchewan healthcare. Healthcare Quarterly, 17(2), 29-32.
Dellifraine, J. L., Langabeer, J. R., & Nembhard, I. M. (2010). Assessing the evidence of Six Sigma and Lean in the health care industry. Quality Management in Health Care, 19(3), 211-225.
Üyess, Ö., Kiliçarslan, M., & Hastane, Y. (2018). Sağlıkta İsraf. https://iksadyayinevi.com/wp-content/uploads/2020/02/SA%C4%9ELIKTA-%C4%B0SRAF-YALIN-HASTANE-.pdf
Toussaint, J. S., & Berry, L. L. (2013). The promise of lean in health care. Mayo Clinic Proceedings, 88(1), 74-82.
D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A comprehensive review. Health Policy, 119(9), 1197-1209.
Timurtas, M. (2020). Hastanelerde Yalın Altı Sigma Uygulamalarının Verimlilik Ve Performansa Etkisi; Bir Sistematik Derleme. Sağlıkta Kalite ve Akreditasyon Dergisi, 3(2), 1-9.
Doğan, N. Ö., & Yağlı, B. Ş. (2019). Sağlık sektöründe yalın düşünce: Bir literatür derlemesi. Hacettepe Sağlık İdaresi Dergisi, 22(2), 467-490.
de Barros, L. B., Bassi, L. de C., Caldas, L. P., Sarantopoulos, A., Zeferino, E. B. B., & Minatogawa, V. (2021). Lean Healthcare Tools for Processes Evaluation: An Integrative Review. International Journal of Environmental Research and Public Health, 18(14).
Acar, S. (2023). Yalın Yönetimin Sağlık Sektörü Uygulamalarına İlişkin Örnekler ve Literatür İncelemesi. Bingöl Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, (26), 241-263.
Talero-Sarmiento, L. H., Escobar-Rodríguez, L. Y., Gomez-Avila, F. L., & Parra-Sanchez, D. T. (2024). A literature review on Lean healthcare: İmplementation strategies, challenges, and future research directions. Cogent Engineering, 11(1).
Wang, J., Lv, H., Chen, M., Liu, C., Ren, W., Jiang, H., & Zhang, L. (2025). A Systematic Review of Lean Implementation in Hospitals: Impact on Efficiency, Quality, Cost, and Satisfaction. International Journal of Health Policy and Management, 14, 8974.
Referanslar
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. National Academies Press. https://pubmed.ncbi.nlm.nih.gov/25057539/
Joosten, T., Bongers, I., & Janssen, R. (2009). Application of lean thinking to health care: İssues and observations. International Journal for Quality in Health Care, 21(5), 341.
Graban, M. (2018). Lean hospitals: Improving quality, patient safety, and employee engagement (3rd bs).
Radnor, Z. J., Holweg, M., & Waring, J. (2012). Lean in healthcare: The unfilled promise? Social Science & Medicine, 74(3), 364-371.
Zepeda-Lugo, C., Tlapa, D., & Baez-Lopez, Y. (2020). Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review. International Journal of Environmental Research and Public Health, 17(15), 5609.
Quality in business: Concept and definition. (t.y.). Geliş tarihi 07 Eylül 2025, gönderen https://collectionperformance.com/quality-in-business-concept-and-definition/
Nanda, V. (t.y.). Quality Management System Handbook for Product Development Companies. Geliş tarihi 31 Ağustos 2025, gönderen https://books.google.com.tr/books?id=guizsuAAyR4C&pg=PA1&redir_esc=y#v=onepage&q&f=false
Ciampa, D. (1991). Total quality: A users’ guide for implementation.
Understanding Quality Measurement. (t.y.). Agency for Healthcare Research and Quality. Geliş tarihi 31 Ağustos 2025, gönderen https://www.ahrq.gov/patient-safety/quality-resources/tools/chtoolbx/understand/index.html
Chassin, M. R., Galvin, R. W., & Donaldson, M. S. (1998). The Urgent Need to Improve Health Care Quality. JAMA, 280(11), 1000-1005.
Ohno, T. (t.y.). Toyota Production System: Beyond Large-Scale Production. Geliş tarihi 10 Eylül 2025, gönderen https://books.google.com.tr/books?id=7_-67SshOy8C&printsec=frontcover&redir_esc=y#v=onepage&q&f=false
The Fundamentals and Advantages of the Lean Methodology. (t.y.). KaiNexus Blog. Geliş tarihi 11 Eylül 2025, gönderen https://blog.kainexus.com/the-fundamentals-of-the-lean-methodology
Abu Bakar, K., Mohd. Sam, M. F., & Qureshi, M. I. (2022). Lean manufacturing design of a two-sided assembly line balancing problem work cell. Lecture Notes in Mechanical Engineering, 25, 249-259.
Womack, J. P., & Jones, D. T. (1997). Lean thinking—Banish waste and create wealth in your corporation. Journal of the Operational Research Society, 48(11), 1148.
Imai, M. (2007). Gemba Kaizen: A Commonsense, Low-Cost Approach to Management.
Liker, J. K. (t.y.). The 14 principles of the Toyota way: An executive summary of the culture behind TPS. Geliş tarihi https://www.researchgate.net/publication/290007864
The Impact of Lean Manufacturing Concepts on Industrial Processes’ Efficiency and Waste Reduction. (t.y.). ResearchGate. Geliş tarihi 14 Eylül 2025, gönderen https://www.researchgate.net/publication/381250819_THE_IMPACT_OF_LEAN_MANUFACTURING_CONCEPTS_ON_INDUSTRIAL_PROCESSES%E2%80%99_EFFICIENCY_AND_WASTE_REDUCTION
Rother, M., & Shook, J. (2018). Learning to see: Value-stream mapping to create value and eliminate muda. https://www.researchgate.net/publication/244433983_Learning_to_See_Value_Stream_Mapping_to_Create_Value_and_Eliminate_Muda
Sobek, D. K., & Smalley, A. (2008). Understanding A3 thinking: A critical component of Toyota’s PDCA management system.
Kaplan, G. S., Patterson, S. H., Ching, J. M., & Blackmore, C. (2014). Why Lean doesn’t work for everyone. BMJ Quality & Safety, 23(12), 970-973.
van Rossum, L., Aij, K. H., Simons, F. E., van der Eng, N., & ten Have, W. D. (2016). Lean healthcare from a change management perspective. Journal of Health Organization and Management, 30(3), 475-493.
Kinsman, L., Rotter, T., Stevenson, K., Bath, B., Goodridge, D., & Harrison, L. (2014). The largest Lean transformation in the world: The implementation and evaluation of lean in Saskatchewan healthcare. Healthcare Quarterly, 17(2), 29-32.
Dellifraine, J. L., Langabeer, J. R., & Nembhard, I. M. (2010). Assessing the evidence of Six Sigma and Lean in the health care industry. Quality Management in Health Care, 19(3), 211-225.
Üyess, Ö., Kiliçarslan, M., & Hastane, Y. (2018). Sağlıkta İsraf. https://iksadyayinevi.com/wp-content/uploads/2020/02/SA%C4%9ELIKTA-%C4%B0SRAF-YALIN-HASTANE-.pdf
Toussaint, J. S., & Berry, L. L. (2013). The promise of lean in health care. Mayo Clinic Proceedings, 88(1), 74-82.
D’Andreamatteo, A., Ianni, L., Lega, F., & Sargiacomo, M. (2015). Lean in healthcare: A comprehensive review. Health Policy, 119(9), 1197-1209.
Timurtas, M. (2020). Hastanelerde Yalın Altı Sigma Uygulamalarının Verimlilik Ve Performansa Etkisi; Bir Sistematik Derleme. Sağlıkta Kalite ve Akreditasyon Dergisi, 3(2), 1-9.
Doğan, N. Ö., & Yağlı, B. Ş. (2019). Sağlık sektöründe yalın düşünce: Bir literatür derlemesi. Hacettepe Sağlık İdaresi Dergisi, 22(2), 467-490.
de Barros, L. B., Bassi, L. de C., Caldas, L. P., Sarantopoulos, A., Zeferino, E. B. B., & Minatogawa, V. (2021). Lean Healthcare Tools for Processes Evaluation: An Integrative Review. International Journal of Environmental Research and Public Health, 18(14).
Acar, S. (2023). Yalın Yönetimin Sağlık Sektörü Uygulamalarına İlişkin Örnekler ve Literatür İncelemesi. Bingöl Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, (26), 241-263.
Talero-Sarmiento, L. H., Escobar-Rodríguez, L. Y., Gomez-Avila, F. L., & Parra-Sanchez, D. T. (2024). A literature review on Lean healthcare: İmplementation strategies, challenges, and future research directions. Cogent Engineering, 11(1).
Wang, J., Lv, H., Chen, M., Liu, C., Ren, W., Jiang, H., & Zhang, L. (2025). A Systematic Review of Lean Implementation in Hospitals: Impact on Efficiency, Quality, Cost, and Satisfaction. International Journal of Health Policy and Management, 14, 8974.
