<?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>0012-7353</journal-id>
<journal-title><![CDATA[DYNA]]></journal-title>
<abbrev-journal-title><![CDATA[Dyna rev.fac.nac.minas]]></abbrev-journal-title>
<issn>0012-7353</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional de Colombia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0012-73532025000500101</article-id>
<article-id pub-id-type="doi">10.15446/dyna.v92n239.120207</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Improvement of the efficiency of hospital care: a simulation-based approach]]></article-title>
<article-title xml:lang="es"><![CDATA[Mejora de la eficiencia de la atención hospitalaria: un enfoque basado en la simulación]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Osorio-Canchig]]></surname>
<given-names><![CDATA[Katherine Tatiana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reyes-Vásquez]]></surname>
<given-names><![CDATA[John Paúl]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aldás-Salazar]]></surname>
<given-names><![CDATA[Darwin Santiago]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Técnica de Ambato Facultad de Ingeniería en Sistemas, Electrónica e Industrial ]]></institution>
<addr-line><![CDATA[Ambato ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>92</volume>
<numero>239</numero>
<fpage>101</fpage>
<lpage>110</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0012-73532025000500101&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0012-73532025000500101&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0012-73532025000500101&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract This article analyses the implementation of lean manufacturing tools integrated with industry 4.0 technologies, specifically with the discrete event simulation, to improve the operational performance of hospital processes. This study applied a quantitative and experimental methodological approach to the implementation of lean healthcare (LH) to reduce waste. Thus, statistical and scenario modelling tools called ExpertFit and Experimenter are employed using FlexSim software in the healthcare environment. Here, a detailed diagnosis of critical processes is performed, with emphasis on identifying bottlenecks in patient weighing, triage and surgery. The results reveal significant limitations in the responsiveness of the system to sudden increases in demand. The simulation model then proposes a structural intervention involving the addition of four nurses and three doctors. This reveals a potential increase in operational efficiency of up to 36.8% over the projected demand. Finally, this study highlights the relevance of the methodological integration of LH as a strategy for the systematic elimination of waste and the promotion of a culture of continuous improvement in decision-making. This multidimensional approach provides a transferable analytical framework for both academic researchers and healthcare professionals, contributing to the development of more efficient and adaptable hospital management models.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Este artículo analiza la implementación herramientas lean manufacturing integradas con tecnologías de la industria 4.0, específicamente con la simulación de eventos discretos para la mejora del rendimiento operacional de procesos hospitalarios. Para el estudio se aplica un enfoque metodológico cuantitativo y experimental con la implementación lean healthcare (LH) que permite reducir los desperdicios. Así, se emplean herramientas estadísticas y de modelamiento de escenarios denominadas ExpertFit y Experimenter utilizando el software FlexSim en el entorno sanitario. Aquí, se realiza un diagnóstico detallado de los procesos críticos, con énfasis en identificar cuellos de botella en el pesaje de pacientes, triaje y cirugías. Los resultados revelan limitaciones significativas en la capacidad de respuesta del sistema ante incrementos súbitos de demanda. Luego, el modelo de simulación propone una intervención estructural que contempla la incorporación de cuatro profesionales de enfermería y tres facultativos doctores. Esto revela un incremento potencial de la eficiencia operativa de hasta 36.8% con respecto a la demanda proyectada. Finalmente, el estudio destaca la relevancia de la integración metodológica de LH como estrategia para la eliminación sistemática de desperdicios y la promoción de una cultura de mejora continua en la toma de decisiones. Este enfoque multidimensional proporciona un marco analítico transferible tanto para investigadores académicos como para profesionales del sector salud, contribuyendo al desarrollo de modelos de gestión hospitalaria más eficientes y adaptables.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[industry 4.0]]></kwd>
<kwd lng="en"><![CDATA[simulation]]></kwd>
<kwd lng="en"><![CDATA[lean healthcare]]></kwd>
<kwd lng="es"><![CDATA[industria 4.0]]></kwd>
<kwd lng="es"><![CDATA[simulación]]></kwd>
<kwd lng="es"><![CDATA[atención sanitaria ajustada]]></kwd>
</kwd-group>
</article-meta>
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