نوع مقاله : مقاله پژوهشی

نویسندگان

1 استاد، مهندسی صنایع، گروه مهندسی صنایع، دانشکده مهندسی صنایع، دانشگاه علم و صنعت ایران، تهران، ایران

2 استادیار، مهندسی صنایع، گروه مهندسی صنایع، دانشکده مهندسی صنایع، دانشگاه علم و صنعت ایران، تهران، ایران

3 کارشناس ارشد، مهندسی صنایع، گروه مهندسی صنایع، دانشکده مهندسی صنایع، دانشگاه علم و صنعت ایران، تهران، ایران

چکیده

مقدمه: طی سال‌های اخیر، با افزایش هزینه‌های بهداشت و درمان و اهمیت کارکرد مؤثر این بخش به دلیل رابطه مستقیم با جان انسان‌ها، بهبود عملکرد آن مورد توجه بیشتری قرار گرفته است. هدف از انجام مطالعه حاضر، ارزیابی عملکرد سریع اورژانس بیمارستان بر اساس اصول ناب بود.روش بررسی: به منظور تحقق پیاده‌سازی جامع مفهوم ناب که یکی از ابزارهای مهم بهبود محسوب می‌شود، مدل ارزیابی عملکرد Goodson برای بخش اورژانس توسعه یافته است. در این روش، از تیم ارزیابی عملکرد شامل خبرگان ناب و پرسش‌نامه و برگه سنجش معیارها به عنوان ابزار اندازه‌گیری استفاده گردید و در نهایت، مدل در یکی از مراکز بزرگ اورژانس شهر تهران مورد ارزیابی قرار گرفت.یافته‌ها: معیارهای ناب بر اساس ویژگی‌های منحصر به فرد بخش اورژانس تعریف شد و پرسش‌نامه مخصوص با توجه به مدل اصلی طراحی گردید.نتیجه‌گیری: سرعت عمل مدل طراحی شده به مدیران این بخش‌ها کمک می‌کند تا بدون صرف هزینه و اطلاعات زیاد و در اسرع وقت، نقاط ضعف سازمان را در راستای ناب‌سازی شناسایی کنند و نسبت به برطرف نمودن آن اقدام نمایند. این روش یک رویکرد موازی و مکمل با سایر روش‌های ارزیابی عملکرد می‌باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation of the Performance of Hospital Rapid Emergency Department based on the Lean Principles

نویسندگان [English]

  • Mohammad Saidi-Mehrabad 1
  • Rouzbeh Ghousi 2
  • Seyedeh Gelareh Emami 3

1 Professor, Industrial Engineering, Department of Industrial Engineering, School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran

2 Assistant Professor, Industrial Engineering, Department of Industrial Engineering, School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran

3 MSc, Industrial Engineering, Department of Industrial Engineering, School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran

چکیده [English]

Introduction: Over the past years, with the rising cost of health care in most countries and the importance of proper functioning of health centers due to their close relation with human life, much attention has been paid to various parts of hospital performance. The main goal of this article was improving the quality of health services by measuring the performance of hospital rapid emergency department using lean principles in order to improve the effectiveness in this sector.Methods: To achieve comprehensive lean concepts in a health system, Goodson’s method has been developed for emergency department. This method uses an expert team and a questionnaire and a rating sheet as measuring tools. The developed method was evaluated in one of the major emergency centers in Tehran City, Iran.Results: Lean principles were defined based on special features and dynamic environment of emergency department. Moreover, according to the Goodson’s method, a specific questionnaire was designed as the measuring tool.Conclusion: Fast measurement by this model helps administrators of health sector to identify lean implementation problems in the minimum amount of time without wasting resources. This method is a parallel and complementary approach to other evaluating methods.

کلیدواژه‌ها [English]

  • Performance Evaluation
  • Emergency Medical Services, Hospitals
  • Lean Principles
  1. Decker WW, Stead LG. Application of lean thinking in health care: A role in emergency departments globally. Int J Emerg Med 2008; 1(3): 161-2.
  2. Graban M. Lean as an alternative to mass layoffs in healthcare [Online]. [cited 2012 Sep 6]; Available from: URL: https://www.beckershospitalreview.com/hospital-management-administration/lean-as-an-alternative-to-mass-layoffs-in-healthcare.html
  3. Seyed Hosseini SM, Bayat Tork A. Lean production factors assessment in non. continuous production organizations (A case study on Sadid Industry Group). Human Sciences Modares 2005; 9(2): 59-86. [In Persian].
  4. Jafari M, Akhavan P. Realizing the lean concept in the organization by reengineering processes. Modiriat-e Farda 2005; 3(9-10): 49-60. [In Persian].
  5. Bowen DE, Youngdahl WE. "Lean" service: In defense of a production-line approach. International Journal of Service Industry Management 1998; 9(3): 207-225.
  6. Mazzocato P, Holden RJ, Brommels M, Aronsson H, Backman U, Elg M, et al. How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden. BMC Health Serv Res 2012; 12: 28.
  7. Portioli-Staudacher A. Lean healthcare. An experience in Italy. In: Koch, T, editor. Lean business systems and beyond. Boston, MA: Springer US; 2008. p. 485-92.
  8. Laursen ML, Gertsen F, Johansen J. Applying lean thinking in hospitals - exploring implementation difficulties. Proceedings of the 3rd International Conference on the Management of Healthcare and Medical Technology; 2003 Sep 7-9; Warwick, UK.
  9. Bushell S, Mobley J, Shelest B. Discovering lean thinking at ProgressiveHealthcare. Journal for Quality and Participation 2002; 25(2): 20-5.
  10. Young T, Brailsford S, Connell C, Davies R, Harper P, Klein JH. Using industrial processes to improve patient care. BMJ 2004; 328(7432): 162-4.
  11. Miller D. Going lean in health care (Innovation Series 2005) [Online]. [cited 2005]; Available from: URL: https://www.entnet.org/sites/default/files/GoingLeaninHealthCareWhitePaper-3.pdf
  12. Castro PJ, Dorgon SJ, Richardson B. A healthier healthcare system for the United Kingdom. The McKinsey Quarterly 2008 [Online]. [cited 2008 Feb]; Available from: URL: https://washburn.edu/faculty/rweigand/McKinsey/McKinsey-Healthier-Care-In-UK.pdf
  13. Dickson EW, Singh S, Cheung DS, Wyatt CC, Nugent AS. Application of lean manufacturing techniques in the Emergency Department. J Emerg Med 2009; 37(2): 177-82.
  14. Bhasin S. Performance of Lean in large organisations. Journal of Manufacturing Systems 2012; 31(3): 349-57.
  15. Krogstie L, Martinsen K. Beyond Lean and Six Sigma; Cross-collaborative improvement of tolerances and process variations-a case study. Procedia CIRP 2013; 7: 610-5.
  16. Pedersen ERG, Huniche M. Determinants of lean success and failure in the Danish public sector: A negotiated order perspective. International Journal of Public Sector Management 2011; 20(2): 177-91.
  17. Narayanamurthy G, Gurumurthy A, Subramanian N, Moser R. Assessing the readiness to implement lean in healthcare institutions- A case study. Int J Prod Econ 2018; 197: 123-42.
  18. Narayanamurthy G, Gurumurthy A. Leanness assessment: A literature review. Int J Oper Prod Man 2016; 36(10): 1115-60.
  19. Ben-Tovim DI, Bassham JE, Bolch D, Martin MA, Dougherty M, Szwarcbord M. Lean thinking across a hospital: Redesigning care at the Flinders Medical Centre. Aust Health Rev 2007; 31(1): 10-5.
  20. Ben-Tovim DI, Bassham JE, Bennett DM, Dougherty ML, Martin MA, O'Neill SJ, et al. Redesigning care at the Flinders Medical Centre: Clinical process redesign using "lean thinking". Med J Aust 2008; 188(6 Suppl): S27-S31.
  21. King DL, Ben-Tovim DI, Bassham J. Redesigning emergency department patient flows: application of Lean Thinking to health care. Emerg Med Australas 2006; 18(4): 391-7.
  22. Kelly AM, Bryant M, Cox L, Jolley D. Improving emergency department efficiency by patient streaming to outcomes-based teams. Aust Health Rev 2007; 31(1): 16-21.
  23. Goodson RG. Read a Plant—Fast. Harvard Business Review 2002. [Online]. [cited 2002 May]. Available from: URL: https://hbr.org/2002/05/read-a-plant-fast
  24. Makui A, Ghousi R, Jahani E, Hamidi MR, Babaei MH. Total rapid assessment (TRA) a comprehensive method for rapid plant assessment. Applied Mathematics in Engineering, Management and Technology 2014; 2(1): 301-16.
  25. Lapin LL. Probability and statistics for modern engineering. Boston, MA: Waveland Press; 1998.
  26. Walpole RE. Probabilities and applied statistics. Trans. Arianejad MBG, Zahbion M. Tehran, Iran: Iran University of Science and Technology; 1998. [In Persian].