Alkaabi Maitha, Simsekler Mecit Can Emre, Jayaraman Raja, Al Kaf Abdulqader, Ghalib Hussam, Quraini Dima, Ellahham Samer, Tuzcu E Murat, Demirli Kudret
Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates.
Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Risk Manag Healthc Policy. 2021 Jan 5;13:3235-3243. doi: 10.2147/RMHP.S283189. eCollection 2020.
Waste identification plays a vital role in lean healthcare applications. While the value stream map (VSM) is among the most commonly used tools for waste identification, it may be limited to visualize the behaviour of dynamic and complex healthcare systems. To address this limitation, system modelling techniques (SMTs) can be used to provide a comprehensive picture of various system-wide wastes. However, there is a lack of evidence in the current literature about the potential contribution of SMTs for waste identification in healthcare processes.
This study evaluates the usability and utility of six types of SMTs along with the VSM. For the evaluation, interview-based questionnaires were conducted with twelve stakeholders from the outpatient clinic at the Heart and Vascular Institute at Cleveland Clinic Abu Dhabi.
VSM was found to be the most useful diagram in waste identification in general. However, some SMTs that represent the system behaviour outperformed the VSM in identifying particular waste types, e.g., communication diagram in identifying over-processing waste and flow diagram in identifying transportation waste.
As behavioural SMTs and VSM have unique strengths in identifying particular waste types, the use of multiple diagrams is recommended for a comprehensive waste identification in lean. However, limited resources and time, as well as limited experience of stakeholders with SMTs, may still present obstacles for their potential contribution in lean healthcare applications.
废物识别在精益医疗应用中起着至关重要的作用。虽然价值流图（VSM）是废物识别中最常用的工具之一，但它可能在可视化动态和复杂医疗系统的行为方面存在局限性。为解决这一局限性，系统建模技术（SMTs）可用于全面呈现各种全系统废物的情况。然而，当前文献中缺乏关于SMTs在医疗过程中对废物识别潜在贡献的证据。
本研究评估了六种类型的SMTs以及VSM的可用性和实用性。为进行评估，对阿布扎比克利夫兰诊所心脏与血管研究所门诊的12名利益相关者进行了基于访谈的问卷调查。
总体而言，VSM被认为是废物识别中最有用的图表。然而，一些表示系统行为的SMTs在识别特定类型的废物方面优于VSM，例如，通信图在识别过度加工废物方面，流程图在识别运输废物方面。
由于行为SMTs和VSM在识别特定类型的废物方面具有独特优势，建议使用多种图表进行精益中的全面废物识别。然而，资源和时间有限，以及利益相关者对SMTs的经验有限，可能仍然会阻碍它们在精益医疗应用中的潜在贡献。
