Edelman Eric R, Hamaekers Ankie E W, Buhre Wolfgang F, van Merode Godefridus G
Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands.
Department of Anesthesiology, Maastricht University Medical Center+, Maastricht, Netherlands.
Front Med (Lausanne). 2017 Jul 13;4:107. doi: 10.3389/fmed.2017.00107. eCollection 2017.
The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+) has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+'s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the people on the work floor in observing opportunities for improvement and realizing these has shown itself to be essential.
马斯特里赫特大学医学中心（MUMC+）引入卓越运营模式，在大学医院中尚属首次，规模也是空前的。MUMC+的政策制定者将来自其他各种商业、管理及医疗理念和框架的不同元素融合成一种独特的组合。本文总结了该系统的发展历程及其最重要的方面。由于手术室在医院运作中发挥着核心作用，因此特别关注了手术室的作用以及在那里所取得的改进。MUMC+是荷兰东南部及周边地区领先的三级医疗中心。区域、国家和国际的发展趋势促使MUMC+从2009年起开始对其护理流程进行重大重组。最初对精益六西格玛和业务建模的试验与从世界各地其他中心汲取的经验教训相结合，形成了MUMC+自己的卓越运营模式。在撰写本文时，许多不同类型的改进项目已成功完成。现在，医院的每个部门都普遍将卓越运营和设计思维作为开发新护理模式的方法。2014年的一项评估揭示了一些改进机会。大量项目正在进行中，但尽管首批项目早在2012年就已启动，但所有项目中有75%尚未完成。这导致了一些政策变化，主要集中在对项目进行更密集的监控，并尝试让更多改进项目直接由一线经理负责。事实证明，关注患者价值、持续改进和减少浪费是适用于一般医疗保健，特别是适用于大学医院的非常合适的原则。在系统层面进行改进，同时直接让一线员工参与观察改进机会并实现这些机会，已证明是至关重要的。
