Division of Pulmonary and Critical Medicine, Amarillo Veterans Affairs Health Care System, Texas Tech University Health Sciences Center at Amarillo, Amarillo, TX.
Chest. 2018 Dec;154(6):1448-1454. doi: 10.1016/j.chest.2018.06.005. Epub 2018 Jul 10.
To improve the delivery of patient care, governments and health-care institutions adopted quality improvement methods that had been developed decades earlier in manufacturing industries. Many health-care practitioners are either unaware or are inexperienced about what these practices entail and whether they are successful in health care. This article reviews Lean, an improvement philosophy made famous by the Toyota Motor Company. Lean uses a set of instruments and incorporates a long-term vision aiming for continuous improvement. It focuses on eliminating waste as perceived by the patient, thereby maximizing quality and safety for the patient. However, the effort required for the attainment of Lean's goals is often not appreciated. Indeed, successful and sustainable implementation requires immense institutional culture change combined with innovative leadership and motivated frontline health-care professionals.
为了改善患者护理的提供，政府和医疗机构采用了早在几十年前就在制造业中开发的质量改进方法。许多医疗保健从业者要么不知道，要么没有经验，不知道这些做法需要什么，也不知道它们在医疗保健中是否成功。本文回顾了精益（Lean），这是一种由丰田汽车公司（Toyota Motor Company）创造的著名改进理念。精益使用了一组工具，并融入了旨在持续改进的长期愿景。它专注于消除患者眼中的浪费，从而最大程度地提高患者的质量和安全。然而，实现精益目标所需的努力往往不被欣赏。事实上，成功和可持续的实施需要巨大的机构文化变革，以及创新的领导力和有动力的一线医疗保健专业人员。
