Ojo Bukola, Feldman Rachel, Rampersad Sally
Seattle Children's Hospital and University of Washington School of Medicine, Seattle, Washington, USA.
Paediatr Anaesth. 2022 Nov;32(11):1209-1215. doi: 10.1111/pan.14439. Epub 2022 Apr 5.
Measurement of quality and improvement in medicine has existed since Florence Nightingale's time. In modern times, medicine has sought to learn from other high-reliability industries such as aviation and nuclear power, where errors can result in catastrophic outcomes. Lean is a unique quality improvement strategy that seeks to improve both quality and safety by driving out waste and, where possible, standardizing work practices. It is a visual system with work aids and signals built into the workspace. An important tenet is that ideas come from the workers and that there is an iterative improvement. The improvement efforts are always viewed from the perspective of the customer, our patients, families, and coworkers. This paper describes the evolution of Lean in healthcare and highlights core principles of Lean. Examples are used to describe how various Lean tools can be applied by pediatric anesthesiologists to solve clinical problems.
自弗洛伦斯·南丁格尔时代起，医学领域就开始进行质量衡量与改进。在现代，医学一直在寻求向其他高可靠性行业学习，如航空和核电行业，在这些行业中，错误可能导致灾难性后果。精益是一种独特的质量改进策略，旨在通过消除浪费并在可能的情况下使工作流程标准化来提高质量和安全性。它是一个在工作空间中内置了工作辅助工具和信号的可视化系统。一个重要原则是，想法来自工人，并且存在迭代改进。改进工作始终从客户、我们的患者、家属和同事的角度来审视。本文描述了精益在医疗保健领域的发展历程，并突出了精益的核心原则。文中通过实例阐述了儿科麻醉医生如何应用各种精益工具来解决临床问题。
