Dyas Sheila R, Greenfield Eric, Messimer Sherri, Thotakura Swati, Gholston Sampson, Doughty Tracy, Hays Mary, Ivey Richard, Spalding Joseph, Phillips Robin
J Healthc Manag. 2015 Nov-Dec;60(6):442-57.
The objective of this report is to present a simplified, activity-based costing approach for hospital emergency departments (EDs) to use with Lean Six Sigma cost-benefit analyses. The cost model complexity is reduced by removing diagnostic and condition-specific costs, thereby revealing the underlying process activities' cost inefficiencies. Examples are provided for evaluating the cost savings from reducing discharge delays and the cost impact of keeping patients in the ED (boarding) after the decision to admit has been made. The process-improvement cost model provides a needed tool in selecting, prioritizing, and validating Lean process-improvement projects in the ED and other areas of patient care that involve multiple dissimilar diagnoses.
本报告的目的是提出一种简化的、基于作业成本法的方法，供医院急诊科用于精益六西格玛成本效益分析。通过去除诊断和特定病情成本，降低成本模型的复杂性，从而揭示基础流程活动中的成本低效问题。提供了一些示例，用于评估减少出院延迟所节省的成本，以及在做出收治决定后将患者留在急诊科（滞留）的成本影响。该流程改进成本模型为在急诊科以及涉及多种不同诊断的其他患者护理领域选择、确定精益流程改进项目的优先级并进行验证提供了一种必要工具。
