Offord Natalie, Harriman Paul, Downes Tom
Sheffield Teaching Hospitals, Sheffield, UK.
Service Improvement Team, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Future Hosp J. 2017 Feb;4(1):30-32. doi: 10.7861/futurehosp.4-1-30.
The 2012 Royal College of Physicians report is clear that 'decisions about service redesign must be clinically led and clinicians must be prepared to challenge the way services - including their own service - are organised'. This paper describes a service redesign in which we have gained learning and experience in two areas. Firstly, a description of measured improvement by the innovation of redesigning the traditional hospital-based assessment of frail older patients' home support needs (assess to discharge) into their own home and meeting those needs in real time (discharge to assess). In combination with the formation of a collaborative health and social care community team to deliver this new process, there has been a reduction in the length of stay from completion of acute hospital care to getting home (from 5.5 days to 1.2 days for those patients that require support at home). Secondly, the methodology through which this has been achieved. We describe our translation of a Toyota methodology used for the design of complex cars to use for engaging staff and patients in the design of a healthcare process.
2012年皇家内科医师学院的报告明确指出，“服务重新设计的决策必须以临床为主导，临床医生必须准备好挑战服务的组织方式，包括他们自己所在的服务部门”。本文描述了一项服务重新设计，我们在两个方面获得了经验教训。首先，介绍通过创新取得的可衡量的改进，即将传统的基于医院的对体弱老年患者家庭支持需求的评估（入院评估）改为在患者家中进行实时评估（出院评估）。结合组建一个协作式健康和社会护理社区团队来实施这一新流程，从急性医院护理结束到回家的住院时间有所缩短（对于那些在家中需要支持的患者，从5.5天缩短至1.2天）。其次，阐述实现这一目标所采用的方法。我们描述了如何将用于设计复杂汽车的丰田方法应用于医疗保健流程设计中，以促使员工和患者参与其中。
