Visual Management System to improve care planning and controlling: the case of intensive care unit

Health Lean Management (HLM) is usually implemented to enhance the operational performance in health care; nevertheless, scant attention is devoted to visual control and daily accountability processes. This paper aims at investigating how to adopt a visual management system to: plan and control patient journey in health care operations and perform a continuous improvement process. Conducting in-depth interviews and observations, participating in meetings and collecting documentation, the patient journey board and daily briefngs of an Intensive Care Unit were studied and improved. In the patient journey board, the Plan, Do and Check phases were reported, distinguishing between actual and planned actions for the patient care. The daily meetings were organised and a continuous improvement board was also developed to solve specifc issues (Act phase), by creating ad-hoc teams, involving the staff and reporting transparently on the board. Operational and sociotechnical performance, before and after the adoption of HLM, were assessed demonstrating the effectiveness and efciency of visual management tools.