Condel Jennifer L, Sharbaugh David T, Raab Stephen S
Department of Pathology, University of Pittsburgh Medical Center, Shadyside Hospital, Cancer Pavilion, 3rd Floor, 5150 Centre Avenue, Pittsburgh, PA 15232, USA.
Clin Lab Med. 2004 Dec;24(4):865-99. doi: 10.1016/j.cll.2004.07.001.
The current state of our health care system calls for dramatic changes. In their pathology department, the authors believe these changes may be accomplished by accepting the long-term commitment of applying a lean production system. The ideal state of zero pathology errors is one that should be pursued by consistently asking, "Why can't we?" The philosophy of lean production systems began in the manufacturing industry: "All we are doing is looking at the time from the moment the customer gives us an order to the point when we collect the cash. And we are reducing that time line by removing non-value added wastes". The ultimate goals in pathology and overall health care are not so different. The authors' intention is to provide the patient (customer) with the most accurate diagnostic information in a timely and efficient manner. Their lead histotechnologist recently summarized this philosophy: she indicated that she felt she could sleep better at night knowing she truly did the best job she could. Her chances of making an error (in cutting or labeling) were dramatically decreased in the one-by-one continuous flow work process compared with previous practices. By designing a system that enables employees to be successful in meeting customer demand, and by empowering the frontline staff in the development and problem solving processes, one can meet the challenges of eliminating waste and build an improved, efficient system.
我们医疗保健系统的现状需要进行重大变革。作者认为,在他们的病理科,这些变革可以通过接受应用精益生产系统的长期承诺来实现。零病理错误的理想状态是应该通过不断追问“为什么我们做不到?”来追求的。精益生产系统的理念始于制造业:“我们所做的一切就是关注从客户给我们下订单的那一刻到我们收到款项的那一刻的时间。我们通过消除非增值浪费来缩短这个时间线”。病理和整体医疗保健的最终目标并没有太大不同。作者的意图是以及时、高效的方式为患者(客户)提供最准确的诊断信息。他们的首席组织病理技师最近总结了这一理念:她表示,知道自己真的尽了最大努力,她晚上能睡得更好。与以前的做法相比,在逐个连续流程工作过程中,她出错(切片或标记方面)的几率大幅降低。通过设计一个能让员工成功满足客户需求的系统,并通过赋予一线员工在开发和解决问题过程中的权力,就能应对消除浪费的挑战,建立一个更好、更高效的系统。