开发一个具有成本效益的手术安排系统,应用精益思维和丰田的手术相关大数据方法,以改善医院的数据使用:以用户为中心的设计方法
Chien-Chung Lin1,2, Jian-Hong Shen3, Shu-Fang Chen4
1Department of Orthopedic Surgery, Taipei City Hospital, Taipei, Taiwan.
JMIR formative research
|May 24, 2024
概括
精益原则和丰田方法简化了外科手术安排,减少了任务时间,提高了效率,而没有增加成本. 对于患者安全和系统可靠性,正在进行不断的改进.
科学领域:
- 医疗保健管理的管理
- 运营研究 运营研究
- 工业工程 工业工程 工业工程
背景情况:
- 手术安排对于患者体验和医院资源管理至关重要,手术室成本强调了效率的必要性.
- 全球外科手术安排实践因难以预测不同患者病情的外科医生时间而有所不同.
- 灵感来自于丰田生产系统的精益思维原则,识别和消除过程中的浪费,这对于改善医疗保健质量和患者安全至关重要.
研究的目的:
- 利用精益思维和丰田方法开发一个更有效的外科手术安排系统.
- 为了使排程系统与用户需求保持一致,而不会引入额外的财务负担.
- 提高外科手术工作流程管理的响应能力和效率.
主要方法:
- 实施5个丰田原则:指定价值,确定价值流,实现流动,建立吸引力和追求完美.
- 在Excel中开发两个Visual Basic for Applications宏:一个用于计算平均手术时间,另一个用于估计持续时间并从手术前数据生成报告.
- 创建一个全面的价值流地图,以识别和解决手术前数据子系统中的低效率问题.
主要成果:
- 总体调度时间从301秒减少到261秒 (P=.02) 和修订的处理时间从99秒减少到62秒 (P<.001).
- 尽管有所改善,但有21%的护士由于熟悉而更喜欢旧的系统.
- 新系统确保数据隐私,通过安全的LINE组简化传播,允许实时更新,并监控了超过3年的外科手术持续时间.
结论:
- 精益原则和丰田方法与计算机编程相结合,为外科手术安排提供了一种振兴的方法.
- 这种方法为手术调度挑战提供了有效的解决方案,使得新系统能够在没有额外成本的情况下实现.
- 目前的努力集中在持续改进上,特别是在手术前的患者确认阶段,以进一步提高患者的安全性.
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