Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, USA; Lawrence Center for Quality and Safety, Massachusetts General Hospital and Massachusetts General Physicians' Organization, USA.
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, USA; Lawrence Center for Quality and Safety, Massachusetts General Hospital and Massachusetts General Physicians' Organization, USA.
Healthc (Amst). 2017 Dec;5(4):214-220. doi: 10.1016/j.hjdsi.2016.12.001. Epub 2017 Jan 3.
Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects. We share our experience mapping emergency care processes at a teaching hospital in Ghana as a case study of Lean's application in a relatively resource limited setting. From this work, we conclude that process mapping, a critical first step in further process re-design, is a cost effective, low tech activity which can be feasibly used in low resource environments to initiate quality improvement.
急诊科（ED）人满为患已成为全球关注的问题，因为拥有规范化急诊医疗体系的国家数量不断增加，而中低收入国家的创伤和非传染性疾病负担也在增加。有鉴于此，国际急诊医学文献已经概述了在中低收入国家开展注重护理流程的运营项目的必要性。尽管如此，描述这类项目的已发表文献却十分有限。我们分享了在加纳一家教学医院进行急诊护理流程绘图的经验，以此作为将精益应用于资源相对有限环境的案例研究。通过这项工作，我们得出结论，流程绘图是进一步流程再设计的关键第一步，它是一种具有成本效益且低技术含量的活动，可以在资源匮乏的环境中切实用于启动质量改进。
