Raveglia Federico, Orlandi Riccardo, Rimessi Arianna, Minervini Fabrizio, Cioffi Ugo, De Simone Matilde, Guttadauro Angelo, Scarci Marco
Thoracic Surgery, San Gerardo Hospital, Azienda Socio Sanitaria Territoriale (ASST)-Monza, Monza, Italy.
Thoracic Surgery, Lucerne Cantonal Hospital, University of Lucerne, Lucerne, Switzerland.
Front Surg. 2021 Jun 24;8:695341. doi: 10.3389/fsurg.2021.695341. eCollection 2021.
The coronavirus disease 2019 (COVID-19) pandemic has changed many aspects of our private and professional routine. In particular, the lockdowns have severely affected the entire healthcare system and hospital activities, forcing it to rethink the protocols in force. We suggest that this scenario, in spite of the new challenges involving so far complex healthcare providers, may lead to the unique opportunity to rethink pathways and management of patients. Indeed, having to resume institutional activity after a long interruption that has completely canceled the previously existing schemes, healthcare providers have the unique opportunity to overcome obsolete and "we have always done in this way" model on the wave of the general desire to resume a normal life. Furthermore, the pandemic has highlighted some flaws in our health system, highlighting those critical issues that most need to be addressed. This article is a review of pre-pandemic literature addressing the use of Lean Six Sigma (LSS) and standardization processes in thoracic surgery to improve efficiency. Our goal is to identify the main issues that could be successfully improved along the entire pathway of a patient from the first referral to diagnosis, hospitalization, and surgical operation up to convalescence. Furthermore, we aim to identify the standardization processes that have been implemented to achieve significant improvements in patient outcomes while reducing costs. The methods and goals that could be used in the near future to modernize our healthcare systems are drawn up from a careful reading and interpretation in light of the pandemic of the most significant review articles in the literature.
2019年冠状病毒病（COVID-19）大流行改变了我们个人生活和工作的许多方面。特别是，封锁措施严重影响了整个医疗系统和医院活动，迫使人们重新思考现行的医疗方案。我们认为，尽管目前的情况给复杂的医疗服务提供者带来了新的挑战，但这可能带来重新思考患者就医途径和管理方式的独特机遇。事实上，在经历了长期中断，完全打乱了先前的既定模式之后，医疗服务提供者需要恢复机构活动，在人们普遍渴望恢复正常生活的浪潮下，他们有独特的机会摒弃过时的、“我们一直都是这样做”的模式。此外，大流行凸显了我们医疗系统中的一些缺陷，突出了那些最需要解决的关键问题。本文是一篇综述，回顾了疫情前关于在胸外科手术中使用精益六西格玛（LSS）和标准化流程以提高效率的文献。我们的目标是确定在患者从首次转诊到诊断、住院、手术直至康复的整个过程中可以成功改进的主要问题。此外，我们旨在确定为在降低成本的同时显著改善患者预后而实施的标准化流程。根据对文献中最重要的综述文章在疫情背景下的仔细研读和解读，制定了在不久的将来可用于使我们的医疗系统现代化的方法和目标。
