نوع مقاله: مقاله پژوهشی

نویسندگان

مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه : ﻣﻔﻬﻮم مدیریت ﻧﺎب، رﻳﺸﻪ کن کردن اﺗﻼف و ﺁﻓﺮﻳﻨﺶ ارزش در ﺳﺎزﻣﺎن اﺳــﺖ. این مطالعه با هدف تعیین تاثیر اجرای مدیریت ناب بر بهبود فرآیندهای  بیمارستانی در شهر تهران انجام شده است.مواد و روش: در این مطالعه موردی، میزان رضایت بیماران و ترخیص با رضایت شخصی قبل و بعد از انجام مداخله بررسی شده است. برای اجرای مدیریت ناب از اسپاگتی چارت استفاده شد. کلیه بخش های درمانی، اداری و پاراکلینیک یک بیمارستان خصوصی جنرال شهر تهران در دیماه 1394 تا تیرماه 1395 بررسی شدند. داده ها با استفاده از پرسشنامه رضایت سنجی بیماران و فرم های محقق ساخته گردآوری شده و به کمک آمار توصیفی در نرم افزارExcel  تحلیل شد.یافته‌ها: استفاده از اسپاگتی چارت، باعث کاهش مسیر در فعالیت فرآیند ترخیص بیماران مرد 55% یعنی 224 متر (از 408 به 184 متر) و بیماران زن 41% یعنی 224 متر (از 546 به 321 متر) شد. مداخلات اجرا شده شامل انتقال واحد بیمه از طبقه سه به همکف و انتقال واحد ترخیص از طبقه یک به همکف بود. اجرای این مداخلات باعث 8/0 درصد (از 8/6 به 6 درصد) کاهش میزان ترخیص با رضایت شخصی و افزایش 8% میزان رضایت کلی بیماران شد.بحث و نتیجه‌گیری: اجرای مدیریت ناب در بیمارستان منجر به حذف اتلافات از فرآیندهای ارایه خدمات به بیماران و کاهش جریان فعالیت بیماران می شود. ضروری است که با بررسی وضعیت موجود بیمارستان‌ها و ترسیم تصویری از دورنما و آینده مدیریت بیمارستان ناب، اقدام به تدوین نقشه راه نمود و حرکت بسوی مدیریت بیمارستان ناب را آغاز نمود. 

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Lean Management on Improving Hospital Processes: from 2014 to 2016

نویسندگان [English]

  • Hossein Ebrahimipour
  • Elahe Houshmand
  • Ali Vafaei Najar
  • Amin Adel
  • Seyed Saeed Tabatabaei

Social determinates of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

چکیده [English]

Background: The concept of lean management refers to the elimination of waste and creation of value in an organization. The aim of this study was to determine the effect of lean management on improving surgery ward processes in a private hospital in Tehran.
Methods: In this case study, the level of patients’ consent and their voluntary discharge both before and after the intervention were investigated. Spaghetti chart methods were used to implement lean management. All clinical, administrative, and paraclinical wards of a private general hospital in Tehran from January 2014 to July 2016 were studied. The data were collected using patients’ consent analysis questionnaires and researcher developed forms, and they were analyzed through descriptive statistics in Excel software.
Results: The use of Spaghetti chart reduced the path in the process of discharging male patients was by 55%, 224 meter (from 408 to 184 m), and female patients by 41%, 224 m (from 546 to 321 m). The implemented interventions included the transfer of the Insurance Unit from the third floor to the ground floor and the transfer of the Discharge Unit from the first floor to the ground floor. The implementation of interventions reduced the frequency of voluntary discharge by 0.8% (from 6.8% to 6%), and it increased patients’ overall satisfaction by 8%.
Conclusion: Lean management in the hospital leads to the elimination of waste from the process of service delivery and the flow of activities performed. It is necessary to study the hospitals status quo, draw a picture of the forthcoming goals, determine the future status of the lean hospital management, and consequently, draw a map to move towards the lean hospital.

کلیدواژه‌ها [English]

  • Quality Improvement
  • Management Quality Circles
  • Hospital Administration
  • Operating Room

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