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利用精益工具提升印度一家医院的价值并缩短门诊等待时间。

Utilizing lean tools to improve value and reduce outpatient wait times in an Indian hospital.

作者信息

Miller Richard, Chalapati Nirisha

机构信息

Operations Management, University of Dallas, Irving, Texas, USA.

出版信息

Leadersh Health Serv (Bradf Engl). 2015;28(1):57-69. doi: 10.1108/LHS-01-2014-0001.

Abstract

PURPOSE

This paper aims to demonstrate how lean tools were applied to some unique issues of providing healthcare in a developing country where many patients face challenges not found in developed countries. The challenges provide insight into how lean tools can be utilized to provide similar results across the world.

DESIGN/METHODOLOGY/APPROACH: This paper is based on a qualitative case study carried out by a master's student implementing lean at a hospital in India.

FINDINGS

This paper finds that lean tools such as value-stream mapping and root cause analysis can lead to dramatic reductions in waste and improvements in productivity. The problems of the majority of patients paying for their own healthcare and lacking transportation created scheduling problems that required patients to receive their diagnosis and pay for treatment within a single day. Many additional wastes were identified that were significantly impacting the hospital's ability to provide care. As a result of this project, average outpatient wait times were reduced from 1 hour to 15 minutes along with a significant increase in labor productivity.

PRACTICAL IMPLICATIONS

The results demonstrate how lean tools can increase value to the patients. It also provides are framework that can be utilized for healthcare providers in developed and developing countries to analyze their value streams to reduce waste.

ORIGINALITY/VALUE: This paper is one of the first to address the unique issues of implementing lean to a healthcare setting in a developing country.

摘要

目的

本文旨在展示精益工具如何应用于发展中国家提供医疗保健服务时遇到的一些独特问题,在这些国家,许多患者面临着发达国家所没有的挑战。这些挑战为了解如何在全球范围内利用精益工具取得类似成果提供了见解。

设计/方法/途径:本文基于一名硕士研究生在印度一家医院实施精益管理时所进行的定性案例研究。

研究结果

本文发现,诸如价值流映射和根本原因分析等精益工具可大幅减少浪费并提高生产率。大多数患者自费医疗且缺乏交通工具的问题导致了排班问题,要求患者在一天内完成诊断并支付治疗费用。还发现了许多其他显著影响医院提供护理能力的浪费现象。由于该项目,门诊平均等待时间从1小时缩短至15分钟,劳动生产率也显著提高。

实际意义

研究结果展示了精益工具如何为患者增加价值。它还提供了一个框架,可供发达国家和发展中国家的医疗服务提供者用于分析其价值流以减少浪费。

原创性/价值:本文是首批探讨在发展中国家医疗环境中实施精益管理所面临独特问题的文章之一。

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