Extreme Makeover in a health center: LEAN methodology applied to clinical practice

Part of Special Series: WONCA World Rural Health Conference Abstracts 2022go to url


name here
Maria João Nuno Lopes
1 GP

name here
Sofia Monteiro
2 Masters, Resident *


*Mrs Sofia Monteiro


1, 2 Unidade Local de Saúde da Guarda, Guarda, Portugal


10 January 2023 Volume 23 Issue 1


RECEIVED: 20 September 2022

ACCEPTED: 20 September 2022


Nuno Lopes M, Monteiro S.  Extreme Makeover in a health center: LEAN methodology applied to clinical practice. Rural and Remote Health 2023; 23: 8176. https://doi.org/10.22605/RRH8176


This work is licensed under a Creative Commons Attribution 4.0 International Licence

go to urlCited by

no pdf available, use your browser's print function to create one


Introduction: The LEAN methodology is an integration of methods and tools developed in the 90s in the industrial sector. It aims to reduce waste (things that don’t add value to the final product), add worth and work towards continuous quality improvement.

Methods: LEAN tools to improve the clinical practice of a health center include:

  • 5S methodology: helps organize, clean, develop and maintain a productive work environment;
  • 'Spaghetti' diagram: displays the movement and distance that a given element has to travel throughout the entire process; and
  • Time and motion studies: measure the various times associated with the process and the associated motion.
  • Results: The LEAN methodology made it possible to manage space and time efficiently and optimally. There was a substantial reduction in both the time and number of trips for not only the health professionals but also for the patients.

    Discussion: Clinical practice should focus on the permission of continuous quality improvement. The LEAN methodology, through its different tools, generates an increase in productivity and profitability. It promotes teamwork through multidisciplinary teams and the empowerment and training of employees. The implementation of the LEAN methodology improved the practices and strengthened the team spirit based on everyone's participation, because the whole is greater than the sum of the parts.

    You might also be interested in:

    2022 - ‘Most nurses in the rural or remote health clinics run away from their job due to no remote allowances and poor working equipment and environment'. Health professional leaders’ perception of shortages in the nursing workforce in underserved areas in Vanuatu

    2021 - 'I’m still here, that’s probably the best part'. Lives of those living rurally with an implantable cardioverter defibrillator: a qualitative study

    2013 - District specific correlates for hypertension in Kaoma and Kasama rural districts of Zambia

    This PDF has been produced for your convenience. Always refer to the live site https://www.rrh.org.au/journal/article/8176 for the Version of Record.