Simulation modelling and lean management in healthcare: first evidences and research agenda

There is a growth in the literature on simulation in healthcare that has been flourishing in the last few years, since it allows predicting the consequences of different alternative scenarios without the risks and the costs of real experiments. However, no literature reviews can be found on how and in which cases simulation modelling can support the adoption of Health Lean Management (HLM), in order to maximise the value for patients, reducing wastes. Therefore, this research aims to supply a comprehensive view of the state of the art about the combined application of HLM and simulation, gaining benefits in health service delivery. Through a systematic literature review, a database of papers has been analysed, considering the context of the application, lean tools and practices, simulation models and software, and results obtained, in addition to descriptive characteristics. The projects analysed in the papers regard mostly emergency settings, outpatient care, surgery and medical laboratory, with the aim of improving the patient flow and achieving mainly efficiency and patient safety. The paper discusses which simulation models and software have been adopted to support the implementation of HLM tools and practices, in relation to the specific performance improvements achieved, triggering managerial implications and future research directions.