Nicosia Francesca M, Park Linda G, Gray Caroline P, Yakir Maayan J, Hung Dorothy Y
University of California, San Francisco, California, USA.
San Francisco Veterans Medical Center, San Francisco, California, USA.
Glob Qual Nurs Res. 2018 Nov 20;5:2333393618810658. doi: 10.1177/2333393618810658. eCollection 2018 Jan-Dec.
As hospitals around the world increasingly face pressure to improve efficiency, "Lean" process improvement has become a popular approach to improving patient flow. In this article, we examine nurses' perspectives on the implementation of Lean redesigns to the inpatient discharge process. We found that nurses experienced competing demands and tensions related to their time and professional roles and responsibilities as a result of Lean. Four main themes included (a) addressing the needs of individual patients, while still maintaining overall patient flow; (b) meeting discharge efficiency targets while also achieving high patient satisfaction scores; (c) "wasting time" to save time; and (d) the "real" work of providing clinical care versus the "Lean" work of process improvement. Our findings highlight the importance of soliciting hospital nurses' perspectives when implementing Lean process improvements to improve efficiency and patient flow.
随着世界各地的医院面临着越来越大的提高效率的压力，“精益”流程改进已成为改善患者流程的一种流行方法。在本文中，我们研究了护士对将精益重新设计应用于住院患者出院流程的看法。我们发现，由于精益理念，护士在时间以及专业角色和职责方面面临相互冲突的需求和压力。四个主要主题包括：(a) 满足个体患者的需求，同时仍保持整体患者流程；(b) 达到出院效率目标，同时获得高患者满意度评分；(c) “浪费时间”以节省时间；以及 (d) 提供临床护理的“实际”工作与流程改进的“精益”工作。我们的研究结果凸显了在实施精益流程改进以提高效率和患者流程时征求医院护士意见的重要性。
