]> 2026-05-21T18:32:31-03:00 Lean and Resilience in the healthcare supply chain 0 pt-br engenharia de producao Tortorella, Guilherme Luz Rodriguez, Carlos Manuel Taboada Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Engenharia de Produção Alemsan, Najla 2024 2460310.5 117 p. 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001000800000003000900008005001700017008004100034040003800075090002700113100001900140245018300159260001000342300001800352500004400370502016600414504002500580520349500605520329004100650002907390700004307419700005207462710010207514856006907616 00000ntm a2200000 a 4500 07951 000 0 241017s2024    scba   gsm    000 0 eng d 008 0 ##$a BR-FlWIK $b por $c BR-FlWIK $d BR-FlUSC 040 0 ##$a CETD $b UFSC $c PEPS $d 5880 090 0 1#$a Alemsan, Najla 100 0 10$a Lean and Resilience in the healthcare supply chain $h [recurso eletrônico] / $c Najla Alemsan ; orientador, Guilherme Luz Tortorella ; coorientador, Carlos Manuel Taboada Rodriguez, 245 0 ##$c 2024. 260 0 ##$a 117 p. : $b il. 300 0 ##$a Disponível somente em versão on-line. 500 0 ##$a Tese (doutorado) – Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-Graduação em Engenharia de Produção, Florianópolis, 2024. 502 0 ##$a Inclui referências. 504 0 ##$a Embora as práticas lean tenham sido amplamente adotadas para melhorar a eficiência e a qualidade nas operações de saúde, há preocupações de que essa abordagem possa aumentar a vulnerabilidade a eventos disruptivos e afetar a resiliência. A literatura atual frequentemente trata lean e resiliência como conceitos separados, com poucos estudos explorando sua integração na cadeia de suprimentos de saúde, e este trabalho visa preencher essa lacuna. Portanto, o objetivo geral deste trabalho é investigar a integração do lean management e da resiliência na cadeia de suprimentos de saúde. Para alcançar esse objetivo, três objetivos específicos foram definidos: (i) Identificar a relação entre práticas lean e capacidades de resiliência na cadeia de suprimentos de saúde; (ii) Examinar o papel mediador do desenvolvimento da resiliência na associação entre a adoção de princípios lean e o desempenho operacional na cadeia de suprimentos de saúde; e (iii) Analisar a implementação de práticas lean e capacidades de resiliência na cadeia de suprimentos de saúde em diferentes cenários disruptivos. A metodologia deste estudo consiste em três fases. Na Fase 1, foi realizada uma revisão de escopo para mapear a relação entre práticas lean e capacidades de resiliência na cadeia de suprimentos de saúde. Na Fase 2, uma pesquisa quantitativa foi aplicada a profissionais da cadeia de suprimentos de saúde no Brasil para coletar dados sobre a adoção de princípios lean, desenvolvimento da resiliência e o desempenho operacional. Na Fase 3, um estudo de caso foi realizado na cadeia de suprimentos de saúde italiana, visando analisar a aplicação de práticas lean e capacidades de resiliência em diferentes cenários disruptivos. Na revisão de escopo, um framework foi proposto e destacou as principais práticas lean, as principais capacidades de resiliência e os principais fluxos de valor para cada nível da cadeia de suprimentos de saúde. Posteriormente, na Fase 2, as duas hipóteses testadas foram validadas: a adoção de princípios lean influencia o desenvolvimento da resiliência, e o desenvolvimento da resiliência medeia a relação entre a adoção de princípios lean e o desempenho operacional. Na Fase 3, o estudo de caso mostrou que a aplicação de práticas lean e capacidades de resiliência varia conforme o cenário disruptivo. No entanto, a prática de JIT e capacidade de antecipação foram consideradas críticas em quase todas as organizações e cenários estudados. A tese contribui tanto para a teoria quanto para a prática, fornecendo a ligação entre práticas lean e capacidades de resiliência, destacando seu potencial sinérgico. Para gestores de saúde, os achados oferecem diretrizes práticas para priorizar e implementar práticas lean que aumentem a resiliência. Algumas limitações incluem o tamanho da amostra da pesquisa, restrito a profissionais da cadeia de suprimentos de saúde no Brasil, e o estudo de caso, confinado a organizações italianas, o que pode não captar totalmente os desafios em diferentes contextos. Sugestões para pesquisas futuras incluem realizar estudos comparativos em diferentes países, examinar o papel de paradigmas como Indústria 4.0 e práticas verdes na melhoria da integração de práticas lean e capacidades de resiliência na cadeia de suprimentos de saúde, e realizar entrevistas e grupos focais com profissionais da cadeia de suprimentos de saúde. 8#$a Abstract: While lean practices have been widely adopted to enhance efficiency and quality in healthcare operations, there are concerns that this approach might increase vulnerability to disruptive events and affect resilience. The current literature often treats lean and resilience as separate concepts, with few studies exploring their integration within the healthcare supply chain and this work aims to fill this gap. Therefore, the general objective of this work is to investigate the integration of lean management and resilience within the healthcare supply chain. To achieve this objective, three specific objectives were defined: (i) To identify the relationship between lean practices and resilience capabilities in the healthcare supply chain; (ii) To examine the mediating role of resilience development on the association between lean principles adoption and operational performance in the healthcare supply chain; and (iii) To analyze the deployment of lean practices and resilience capabilities within the healthcare supply chain across different disruptive scenarios. The methodology of this study consists of three phases. In phase 1, a scoping review was conducted to map the relationship between lean practices and resilience capabilities in the healthcare supply chain. In phase 2, a quantitative survey was applied to healthcare supply chain professionals in Brazil to collect data on lean practices adoption, resilience development, and operational performance. In phase 3, a case study was conducted in the Italian healthcare supply chain, aiming to analyze the application of lean practices and resilience capabilities across different disruptive scenarios. The proposed framework from phase 1 highlighted the main lean practices, key resilience capabilities, and main value streams for each level of the healthcare supply chain. Subsequently, in phase 2, the two tested hypotheses were validated: Lean principles adoption influences resilience development, and resilience development mediates the relationship between lean principles adoption and operational performance. In Phase 3, the case study showed that the application of lean practices and resilience capabilities varies depending on the disruptive scenario. However, JIT practice and anticipation capability were considered critical across almost all studied organizations and scenarios. The research contributes to both theory and practice by providing the linking between lean practices with resilience capabilities, highlighting their synergistic potential. For healthcare managers, the findings offer practical guidelines for prioritizing and implementing lean practices that enhance resilience. Some limitations include the survey sample size being restricted to healthcare supply chain professionals in Brazil, and the case study being confined to Italian organizations, which might not capture the challenges across different contexts. Future research suggestions include conducting comparative studies in different countries, examining the role of paradigms such as Industry 4.0 and green practices in enhancing the integration of lean practices and resilience capabilities in the healthcare supply chain, and conducting interviews and focus groups with healthcare supply chain professionals. 520 0 04$a Engenharia de produção 650 0 1#$a Tortorella, Guilherme Luz, $e orientador 1#$a Rodriguez, Carlos Manuel Taboada, $e coorientador 700 0 2#$a Universidade Federal de Santa Catarina. $b Programa de Pós-Graduação em Engenharia de Produção 710 0 40$z Versão integral em pdf $u https://bu.ufsc.br/teses/PEPS5880-T.pdf 856 0 B000163 001 0 BR-FlWIK 003 0 20241017133750.0 005