Guidelines for overcoming hospital managerial challenges: a systematic literature review

Purpose: The need to respond to accreditation institutes’ and patients’ requirements and to align healthcare results with increased medical knowledge is focusing greater attention on quality in healthcare. Different tools and techniques have been adopted to measure and manage quality, but clinical errors are still too numerous, suggesting that traditional quality improvement systems are unable to deal appropriately with hospital challenges. The purpose of the paper is to grasp the current tools, practices, and guidelines adopted in healthcare to improve quality and patient safety and create a base for future research on this young subject. Methods: A systematic literature review has been carried out. A search of academic databases, including papers that focus not only on lean management, but also on clinical errors and risk reduction, yielded 47 papers. The general characteristics of the selected papers were analyzed, and a content analysis was conducted. Results: A variety of managerial techniques, tools, and practices are being adopted in healthcare, and traditional methodologies have to be integrated with the latest ones in order to reduce errors and ensure high quality and patient safety. As it has been demonstrated, they are useful not only for achieving efficiency objectives, but also for reaching higher quality and patient safety. Critical indications and guidelines for successful implementation of new health managerial methodologies are provided and synthesized in an operative scheme useful for extending and deepening knowledge of these issues with further studies. Conclusion: This research contributes to introducing a new theme in healthcare literature regarding the development of successful projects with both clinical risk management and health lean management objectives, and should address solutions for improving healthcare even in the current context of decreasing resources.