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Crespo de Carvalho, J., Ramos, M. & Paixão, C. (2013). A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service. Risk Management and Healthcare Policy. 2014 (7), 1-10

J. L. Carvalho et al.,  "A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service", in Risk Management and Healthcare Policy, vol. 2014, no. 7, pp. 1-10, 2013

@article{carvalho2013_1734532053622,
	author = "Crespo de Carvalho, J. and Ramos, M. and Paixão, C.",
	title = "A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service",
	journal = "Risk Management and Healthcare Policy",
	year = "2013",
	volume = "2014",
	number = "7",
	doi = "10.2147/RMHP.S49535",
	pages = "1-10",
	url = "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864937/"
}

TY  - JOUR
TI  - A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service
T2  - Risk Management and Healthcare Policy
VL  - 2014
IS  - 7
AU  - Crespo de Carvalho, J.
AU  - Ramos, M.
AU  - Paixão, C.
PY  - 2013
SP  - 1-10
SN  - 1179-1594
DO  - 10.2147/RMHP.S49535
UR  - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864937/
AB  - Lean practices and thinking have increased substantially in the last few years.
Applications of lean practices to health care are found worldwide. Despite that, new contribu-
tions are required because the application of lean thinking to hospitals has a long way to go.
Lean practices and thinking do not include, in the literature or practice programs, any references
to triage systems in health care units. The common triage systems require physical presence,
but there are alternative methods to avoid the need to move patients: these alternative triage
systems, given their characteristics, may be included in the spectrum of lean practices. Currently,
patients that are already known to suffer from cancer are encouraged to go to hospital (public
or private, with an oncological focus) when facing side effects from chemotherapy or radiation
treatments; they are then submitted to a triage system (present themselves to the hospital for
examination). The authors of this paper propose the introduction of telephone or email triage
for impaired patients as a valid substitute for moving them physically, thereby often avoiding
several unnecessary moves. This approach has, in fact, characteristics similar to a lean practice
in that it reduces costs and maintains, if done properly, the overall service offered. The pro-
posed ‘remote’ triage emerged from the results of a large survey sent to patients and also as the
outcome of a set of semistructured interviews conducted with hospital nurses. With the results
they obtained, the authors felt comfortable proposing this approach both to public and private
hospitals, because the study was conducted in the most important, largest, and best-known
oncological unit in Spain. As a final result, the health care unit studied is now taking the first
steps to implement a remote triage system by telephone, and has begun to reduce the previously
necessary movement of impaired patients.
ER  -