Johnson Joyce E, Smith Amy L, Mastro Kari A
Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
Nurs Adm Q. 2012 Jul-Sep;36(3):234-42. doi: 10.1097/NAQ.0b013e318258c3d5.
The advent of health care reform means new pressures on American hospitals, which will be forced to do more with less. In the next decade, increased use of "Lean" principles and practices in hospitals can create real value by reducing waste and improving productivity, costs, quality, and the timely delivery of patient care services. In 2010, the Institute of Medicine recommended that nurses lead collaborative quality improvement efforts and assume a major role in redesigning health care in the United States. In this article, we provide an overview of the use of Lean techniques in health care and 2 case studies of successful, nurse-directed Lean initiatives at the Robert Wood Johnson University Hospital. The article concludes with some lessons we have learned and implications for nursing education in the future that must include the concepts, tools, and skills required for adapting Lean to the patient care environment.
医疗保健改革的出现给美国医院带来了新的压力，医院将被迫用更少的资源做更多的事情。在未来十年，医院更多地运用“精益”原则和实践能够通过减少浪费、提高生产率、降低成本、提升质量以及及时提供患者护理服务来创造真正的价值。2010年，医学研究所建议护士引领协作性质量改进工作，并在美国医疗保健重新设计中发挥主要作用。在本文中，我们概述了精益技术在医疗保健中的应用，并介绍了罗伯特·伍德·约翰逊大学医院两项由护士主导的成功精益举措的案例研究。文章最后总结了我们学到的一些经验教训以及对未来护理教育的启示，未来护理教育必须涵盖将精益理念应用于患者护理环境所需的概念、工具和技能。
