Abstract Paper aims This article aims to study the logistics problems in Brazilian hospitals through Lean methods, approaching different aspects of logistics and the procedures adopted in health institutions such as receiving, storage and transporting. Originality The rising of hospitals’ costs is importantly impacted by hospital logistics. They are caused by aspects such as unstandardized processes and inadequate layout and equipment in critical stages of logistic operations. However, these problems are rarely addressed in literature. Research method We developed, through Design Science Research and lean tools, a model based on route, rhythm and routine (3 R’s) that enables the identification of logistics problems. Main findings Hospitals present complex logistic operations. The application of the model developed identified improvement opportunities due to unnecessary activities, lack of space and infrastructure, and lack of standardized procedures. These findings enable improvements in operations and a better comprehension of the factors that impact the processes of internal logistics. Implications for theory and practice The model provides a comprehensive view of the logistical process, its stages and aspects of improvement. Therefore, hospital managers can better identify and address logistical problems directly at non-value adding activities. Adaptations may be required due to the healthcare environment specificities.

As interpretações acerca do Sistema Toyota de Produção (STP), apontando o Just-In-Time e o Kanban como sua essência, demostram um entendimento limitado de sua verdadeira abrangência e potencialidade. O STP está estruturado sobre a base da completa eliminação das perdas, tendo o JIT e a autonomação como seus dois pilares de sustentação. O Controle da Qualidade Zero Defeitos (CQZD) aparece, também, como elemento essencial para a operacionalização da autonomação e funcionalidade de todo o sistema. Neste artigo, pretende-se apresentar um modelo que represente esta interpretação. Com este propósito, o modelo apresentado por Monden é adotado como ponto de partida, introduzindo-lhe, no entanto, significativas mudanças. Neste artigo, discute-se cada uma das relações mantidas pela autonomação e pelo CQZD com os diversos componentes do sistema.

The interpretations of the Toyota Production System (TPS) which point out to Just-In-Time (JIT) and Kanban as its essence are evidence of restrictive understanding of its real reach and strength. The TPS has the "complete elimination of wastes " as its grounds and JIT and autonomation as its two pillars. Zero Defect Quality Control (ZDQC) appears as essential support to the operation of autonomation and Systems working. In this paper it is proposed a model which may portray the above interpretation of TPS. On this purpose, the model proposed by Monden was taken up as a starting point. Nevertheless, it was necessary to introduce significant changes. It is also discussed the nature o@f links among autonomation, ZDCQ and all Systems components.