J Neurosci Nurs. 2020 Jun;52(3):132-135. doi: 10.1097/JNN.0000000000000505.
Our organization was experiencing a delay in treatment of large vessel occlusions. With a goal of door-to-groin puncture in less than 90 minutes, our organization was averaging a door-to-groin puncture time of greater than 100 minutes and identified the need for a process change.
A multidisciplinary group was formed to process map current state and define future state. Lean methodology was used to implement rapid cycle change and create standard work. Because this was an improvement on a current process, institutional review board approval was not needed.
The result was achieving door-to-groin puncture times less than 90 minutes and a subsequent decrease in door-to-groin puncture goal to less than 80 minutes. In addition, improved communication was seen between multiple departments responsible for the care of large vessel occlusion patients.
Using Lean methodology with a multidisciplinary team is effective for implementing and sustaining process change.
我们的机构在治疗大血管闭塞方面出现了延误。为了实现门到腹股沟穿刺时间少于 90 分钟的目标，我们的机构平均门到腹股沟穿刺时间超过 100 分钟，因此确定需要进行流程变革。
成立了一个多学科小组来绘制当前状态图并定义未来状态。采用精益方法实施快速循环变革并创建标准工作。由于这是对现有流程的改进，因此不需要机构审查委员会的批准。
结果是实现了门到腹股沟穿刺时间少于 90 分钟，随后将门到腹股沟穿刺目标降低到 80 分钟以内。此外，还改善了负责大血管闭塞患者护理的多个部门之间的沟通。
使用多学科团队的精益方法对于实施和维持流程变革是有效的。
