The Effect of Lean Hospital Practices on Nurses' Direct Care Activities: Time and Motion Study

Area of Science:

• Healthcare Management
• Nursing Practice
• Process Improvement

Background:

• Lean management is recognized for improving efficiency and patient care outcomes.
• Frequent interruptions and high patient loads impede nurses' direct patient care, impacting safety.
• Optimizing nursing workflows is crucial for delivering high-quality healthcare.

Purpose of the Study:

• To evaluate the impact of lean management practices on nurses' direct patient care activities.
• To assess the effect of lean management on interruptions encountered by nurses.
• To identify inefficiencies in nursing workflows and their effect on patient care.

Main Methods:

• A single-centre, observational, pre-post time and motion study was conducted from August 2019 to July 2022.
• Included survey, direct observation of nurses' activities and interruptions, and focus groups.
• 34 nurses from surgical, internal medicine, and mixed services participated in the observation phase.

Main Results:

• Direct patient care time increased post-lean implementation (surgical: 50.67%, internal: 50.09%, mixed: 44.38%).
• Waste rates decreased by 35.81% and documentation time by 23.55%.
• Overall interruptions significantly decreased (p < 0.05).

Conclusions:

• Lean management effectively reduces waste and enhances direct patient care time.
• Implementation of lean principles improves patient safety and care quality.
• Continuous improvement initiatives are vital for sustained success in nursing practices.