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利用价值流图改善资源匮乏医疗机构的医疗服务质量。

Using Value Stream Mapping to improve quality of care in low-resource facility settings.

作者信息

Ramaswamy Rohit, Rothschild Claire, Alabi Funmi, Wachira Eric, Muigai Faith, Pearson Nick

机构信息

University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Jacaranda Health, Nairobi, Kenya.

出版信息

Int J Qual Health Care. 2017 Nov 1;29(7):961-965. doi: 10.1093/intqhc/mzx142.

Abstract

QUALITY PROBLEM OR ISSUE

Jacaranda Health (JH) is a Kenya-based organization that attempts to provide affordable, high-quality maternal and newborn healthcare through a chain of private health facilities in Nairobi.

INITIAL ASSESSMENT

JH needed to adopted quality improvement as an organization-wide strategy to optimize effectiveness and efficiency.

CHOICE OF SOLUTION

Value Stream Mapping, a Lean Management tool, was used to engage staff in prioritizing opportunities to improve clinical outcomes and patient-centered quality of care.

IMPLEMENTATION

Implementation was accomplished through a five-step process: (i) leadership engagement and commitment; (ii) staff training; (iii) team formation; (iv) process walkthrough; and (v) construction and validation.

EVALUATION

The Value Stream Map allowed the organization to come together and develop an end-to-end view of the process of care at JH and to select improvement opportunities for the entire system.

LESSONS LEARNED

The Value Stream Map is a simple visual tool that allows organizations to engage staff at all levels to gain commitment around quality improvement efforts.

摘要

质量问题或议题

蓝花楹健康组织(JH)是一家总部位于肯尼亚的机构,试图通过内罗毕的一系列私立医疗机构提供经济实惠、高质量的孕产妇和新生儿医疗保健服务。

初步评估

JH需要将质量改进作为一项全组织范围的战略加以采用,以优化有效性和效率。

解决方案选择

价值流图,一种精益管理工具,被用于让员工参与确定改善临床结果和以患者为中心的护理质量的机会的优先级。

实施

通过一个五步流程来实现实施:(i)领导层参与和承诺;(ii)员工培训;(iii)团队组建;(iv)流程演练;以及(v)构建与验证。

评估

价值流图使该组织能够凝聚起来,形成对JH护理流程的端到端视图,并为整个系统选择改进机会。

经验教训

价值流图是一种简单的可视化工具,它能让组织促使各级员工参与,围绕质量改进工作获得承诺。

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