<?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>1684-1824</journal-id>
<journal-title><![CDATA[Revista Médica Electrónica]]></journal-title>
<abbrev-journal-title><![CDATA[Rev.Med.Electrón.]]></abbrev-journal-title>
<issn>1684-1824</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Matanzas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1684-18242023000400629</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Modelación de los flujos de pacientes de alto riesgo con COVID-19 en Matanzas con enfoque Lean]]></article-title>
<article-title xml:lang="en"><![CDATA[Modeling the flows of high risk patients with COVID-19 in Matanzas with a Lean approach]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Suárez]]></surname>
<given-names><![CDATA[Yasniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marqués-León]]></surname>
<given-names><![CDATA[Maylín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Nariño]]></surname>
<given-names><![CDATA[Arialys]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos-Pérez]]></surname>
<given-names><![CDATA[Orlando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Matanzas  ]]></institution>
<addr-line><![CDATA[ Matanzas]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Ciencias Médicas de Matanzas  ]]></institution>
<addr-line><![CDATA[ Matanzas]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Empresa de Proyectos de Arquitectura e Ingeniería de Matanzas  ]]></institution>
<addr-line><![CDATA[ Matanzas]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2023</year>
</pub-date>
<volume>45</volume>
<numero>4</numero>
<fpage>629</fpage>
<lpage>643</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1684-18242023000400629&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1684-18242023000400629&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1684-18242023000400629&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  En el contexto de la pandemia, la gestión eficiente de los flujos de pacientes con enfoque en su trayectoria es crucial. En este sentido, el enfoque Lean permite aumentar el rendimiento del sistema sanitario, al eliminar actividades que no generan valor al paciente.  Objetivo:  Realizar un análisis integral de los flujos de pacientes de alto riesgo con COVID-19 en Matanzas, utilizando el enfoque Lean.  Materiales y métodos:  Se implementó una metodología de tipo cuantitativa, estructurada en cuatro etapas, para la gestión integrada de los flujos de pacientes de alto riesgo con COVID-19, mediante el enfoque Lean. Esta metodología integra herramientas para la selección de expertos, representación de procesos, análisis estructural y mapas de flujos de valor. Se aplicó durante del período de mayor incidencia de la pandemia en Matanzas (1 de mayo al 1 de agosto de 2021).  Resultados:  Se identificaron deficiencias relacionadas con los flujos de pacientes de alto riesgo con COVID-19 en Matanzas. Se realizó un análisis integral de los flujos, con el fin de realizar una propuesta de mejoras con enfoque Lean. La propuesta garantizó una optimización de 1510 minutos por ciclos de atención, con una eficiencia del 85,86 % del tiempo total de cada ciclo (etapa del tratamiento), y del 59,38 % de los tiempos de espera entre ellos.  Conclusiones:  Las herramientas Lean permiten realizar un análisis integral de los flujos de pacientes, además de mostrar una vía para su gestión, centrada en la trayectoria y no en la ocupación del recurso.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  In the context of the pandemic, the efficient management of the patients flow with a focus on their trajectory is crucial. In this sense, the Lean approach allows to increase the performance of the health care system, eliminating activities that do not generate value for the patient.  Objective:  To carry out an integral analysis of the high risk patients flow with COVID-19 in Matanzas, using the Lean approach.  Materials and methods:  A quantitative methodology, structured in four stages was implemented for the integrated management of the flow of high risk patients with COVID-19, using the Lean approach. This methodology integrates tools for the selection of experts, process representation, structural analysis and value flow maps. It was applied during the period of highest incidence of the pandemic in Matanzas (May 1st to August 1st 2021).  Results:  Deficiencies related to the flows of high risks patients with COVID-19 in Matanzas were identified. A comprehensive analysis of the flows was carried out in order to make a proposal for improvements with a Lean approach. The proposal guaranteed an optimization of 1 500 minutes per service cycle, with an efficiency of 85.86% of the total time of each cycle (treatment stage), and 59.38% of the waiting times between them.  Conclusions:  Lean tools allow a comprehensive analysis of the patients&#8217; flow, in addition to showing a route for their management, focused on the trajectory and not on the occupation of the resource.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[gestión integrada]]></kwd>
<kwd lng="es"><![CDATA[flujo de pacientes]]></kwd>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[enfoque Lean.]]></kwd>
<kwd lng="en"><![CDATA[integrated management]]></kwd>
<kwd lng="en"><![CDATA[patients flow]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[Lean approach]]></kwd>
</kwd-group>
</article-meta>
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