<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0028-3746</journal-id>
<journal-title><![CDATA[Neumología y cirugía de tórax]]></journal-title>
<abbrev-journal-title><![CDATA[Neumol. cir. torax]]></abbrev-journal-title>
<issn>0028-3746</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Neumología y Cirugía de Tórax; Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Sociedad Cubana de Neumología; Sociedad Paraguaya de Neumología; Sociedad Boliviana de Neumología.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0028-37462020000400230</article-id>
<article-id pub-id-type="doi">10.35366/97965</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[The Lean model on the pulmonary lobectomy process: results and pitfalls of a continuous journey]]></article-title>
<article-title xml:lang="es"><![CDATA[El modelo «Lean» en el proceso de la lobectomía pulmonar: resultados y dificultades de un viaje continuo]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almanzo]]></surname>
<given-names><![CDATA[Santiago]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Defranchi]]></surname>
<given-names><![CDATA[Sebastián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bertolotti]]></surname>
<given-names><![CDATA[Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Parrilla]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Viviana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Favaloro]]></surname>
<given-names><![CDATA[Roberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Fundación Favaloro General Thoracic Surgery Service ]]></institution>
<addr-line><![CDATA[Ciudad de Buenos Aires ]]></addr-line>
<country>Argentina</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>79</volume>
<numero>4</numero>
<fpage>230</fpage>
<lpage>235</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0028-37462020000400230&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0028-37462020000400230&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0028-37462020000400230&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Objective:  Our objective was to describe the course and results of implementing a lean methodology program for lobectomy.  Material and methods:  A hospital initiative to improve efficiency started in 2012, applying the lean model in the general thoracic surgery service. Processes were mapped, eliminating non-value adding steps and identifying improvement opportunities. The impact of the lean implementation was assessed for patients that underwent lobectomy. Three periods were defined and compared: Baseline period 2008 to 2012 (period 1); Lean implementation period 2013 to 2014 (period 2); Full implementation period 2015 to 2018 (period 3).  Results: 178 lobectomies were performed: 70, 29 and 79 patients during each period. Mean age was 60.29 ± 12.25 years; 99-178 (55.6%) were males. Hospital length of stay (LOS) decreased significantly during period 3 (6 versus 8 versus 4 days; p &lt; 0.001). Major complications increased significantly during period 2 (8.6 versus 24.1 versus 7.6%; p = 0.036) and stabilized thereafter. There were no differences in 30-day mortality and readmission rates between periods. Direct economic contribution margin improved significantly (-0.35 to 9.51%; p = 0.002).  Conclusions: Lean implementation for lobectomy can result in decreased LOS and improved direct contribution margin. Efforts should be directed to minimize the negative impact that changing prevailing standards could have.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Objetivo:  Describir los resultados de la implementación de la metodología «Lean» para lobectomía.  Material y métodos:  En 2012 comenzó una iniciativa hospitalaria para mejorar la eficiencia, aplicando el modelo «Lean» en el servicio de cirugía torácica. Se mapearon procesos, eliminando pasos sin valor e identificando oportunidades de mejora. Se evaluó y comparó el impacto en pacientes sometidos a lobectomía en tres períodos: referencia, 2008 a 2012 (período 1); implementación, 2013 a 2014 (período 2); e implementación completa, 2015 a 2018 (período 3).  Resultados:  178 lobectomías: 70, 29 y 79 durante cada período. La edad media fue de 60.29 ± 12.25 años; 99-178 (55.6%) eran hombres. La estancia hospitalaria disminuyó durante el período 3 (6 versus 8 versus 4 días; p &lt; 0.001). Las complicaciones mayores aumentaron durante el período 2 (8.6 versus 24.1 versus 7.6%; p = 0.036) y se estabilizaron posteriormente. No hubo diferencias en la mortalidad a los 30 días ni en las tasas de reingreso. El margen de contribución económica directa mejoró (-0.35 a 9.51%; p = 0.002).  Conclusiones:  El modelo «Lean» puede disminuir la estadía hospitalaria y mejorar el margen de contribución directa. Se debe minimizar el impacto negativo que podrían tener los cambios en los estándares prevalecientes.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Lobectomy]]></kwd>
<kwd lng="en"><![CDATA[process improvement]]></kwd>
<kwd lng="en"><![CDATA[Lean]]></kwd>
<kwd lng="es"><![CDATA[Lobectomía]]></kwd>
<kwd lng="es"><![CDATA[mejora de procesos]]></kwd>
<kwd lng="es"><![CDATA[metodología Lean]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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