精益方法改善大型城市医保医疗机构手术室择期第一台手术准时开始。
Lean methods to improve operating room elective first case on-time starts in a large, urban, safety net medical center.
机构信息
Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, USA; Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
出版信息
Am J Surg. 2018 Aug;216(2):194-201. doi: 10.1016/j.amjsurg.2018.05.002. Epub 2018 May 24.
BACKGROUND
Delays in first cases contribute to multiple operating room (OR) inefficiencies and decreases in OR productivity.
METHODS
Lean process improvement methods were used to redesign the existing workflow for elective first cases of the day in a large, urban, public hospital. First case start times were prospectively recorded from May 2, 2016 through December 29, 2017.
RESULTS
Data from 415 operating days were examined, 86 days prior to, 35 days during, and 294 days after implementation of interventions in the pre-operative holding area. During this time, of 23,891 operations performed, 14,981 were elective procedures, 5963 (39.8%) of which were first cases of the day. The mean rate of elective first case on-time starts per week went from 23.5% before and during to 73.0% after implementation of lean interventions (p < 0.0000001).
CONCLUSIONS
Implementation of lean interventions in the pre-operative holding area was associated with significantly improved rates of elective first case on-time starts.
背景
首台手术延迟会导致多个手术室（OR）效率低下，降低手术室生产力。
方法
在一家大型城市公立医院，采用精益流程改进方法重新设计当天择期首台手术的现有工作流程。从 2016 年 5 月 2 日至 2017 年 12 月 29 日，前瞻性地记录首台手术的开始时间。
结果
对 415 个手术日的数据进行了检查，在术前等候区实施干预措施之前的 86 天、期间的 35 天和之后的 294 天。在此期间，共进行了 23891 次手术，其中 14981 次为择期手术，5963 次（39.8%）为首台手术。在实施精益干预措施之前和期间，择期首台手术按时开始的平均比例为 23.5%，而实施后提高到 73.0%（p < 0.0000001）。
结论
在术前等候区实施精益干预措施与择期首台手术按时开始的比例显著提高有关。
Zotero 插件