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2 . 2021

Experience of application of the concept of sustainable development in the lean ambulatory healthcare


Currently, health care is actively discussing issues of improving the efficiency of medical organizations for the implementation of the national project "Healthcare", while the key performance indicators are not only indicators of the quality and availability of medical care, but also the optimal resource provision, increasing the efficiency of main and auxiliary processes, timely implementation of organizational changes and achievement of strategic objectives set for a medical organization.

A significant part of outpatient clinics in our country are included in the program "Creation of a new model of a medical organization providing primary health care to the population." Using the concept of lean manufacturing, medical organizations have achieved significant results in optimizing the work of the registry, conducting preventive medical examinations and medical examinations, etc.

Analyzing the effectiveness of the implemented changes in the long term, we came to the conclusion that the effectiveness of the processes is significantly reduced for a number of reasons. To address this issue, the concept of sustainable development of a medical organization was introduced, which changed the approaches to project management, and made it possible to consolidate the results achieved.

The aim is to analyze the effectiveness of the implementation of the concept of sustainable development of a lean ambulatory healthcare.

Material and methods. The study of the effectiveness of the city ambulatory healthcare was carried out from 2018 to 2021. Research methods such as comparative analysis, organizational and functional modeling were used.

Results. In the process of introducing the concept of sustainable development in a lean polyclinic, we have combined the processes of strategic planning, process management carried out taking into account the optimization of resource provision, the introduction of changes and replication of experience. As a result, the efficiency of the organization's activities in a number of processes increased by 6.09 times; the number of patients who received the preventive medical examination service increased 3 times; in a related process, the availability of medical care by doctors by specialists for children with specialized diseases has been increased by 5 times; the number of completed cases was increased by 3 times; the satisfaction of the patients' relatives increased 10 times.

The implementation of the changes did not require additional resource support, and the new work procedure demonstrates sustainable performance indicators.

Keywords:sustainable development, ambulatory healthcare, Lean Six Sigma, improvement

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

Contribution. Research design, development and management of a research project, work with conclusions, description of research results - Latuha O.A.; general management of a research project, collection and analysis of materials, discussion of research results - Kalinichenko A.V.; analysis of materials - Bravve Yu.I.; work in a project group for the implementation of changes, collection and analysis of material, paper design - Tolstova K.S.

For citation: Latuha O.A., Kalinichenko A.V., Bravve Yu.I., Tolstova K.S. Experience of application of the concept of sustainable development in the lean ambulatory healthcare. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [HEALTHCARE MANAGEMENT: News, Views, Education. Bulletin of VSHOUZ]. 2021; 7 (2): 66-76. DOI: (in Russian)


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Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ), Associate Professor of the Department of Public Health and Health Care, Health Economics, Faculty of Pediatric of the Pirogov Russian National Research Medical University
Medicine today

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