Use of Lean Management Methodology to Reduce the Rate of Unfinished Nursing Care in the Emergency Observation Room: A Quality Improvement Project.

IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Lixia Yang, Cuixiang Zhen, Yao Yao
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Abstract

Background and objectives: The integration of lean management in optimizing nursing workflow necessitates the careful examination of several factors, including nurses' work efficiency, patient experience, and health outcomes. To evaluate the extent of unfinished nursing care and patient satisfaction, we have incorporated the lean management approach into our quality improvement efforts. This proactive measure aims to address potential adverse outcomes, such as subpar inpatient experiences, escalated occurrence of adverse events, and decreased job satisfaction among nursing staff.

Methods: We utilized the lean management methodology of value stream mapping in a specific facility between February and August 2021, aiming to pinpoint the crucial areas for enhancing nurses' workflow. By employing fishbone diagrams, we thoroughly analyzed the underlying causes, and subsequently employed the Plan-Do-Study-Act model to execute interventions devised based on these identified causes. Interventions included: (1) specifying the time of doctors' conventional rounds; (2) changing unreasonable scheduling; (3) employing 5S management to manage nursing supplies; and (4) eliminating duplicate papers and electronic reports.

Results: After implementing these interventions, the rate of unfinished nursing reduced from 73.4% to 39.6%, and that of finished nursing care during the shift increased from 38.6% to 71.4%. Overtime was reduced from 37.2 ± 22.4 minutes to 14.1 ± 3.6 minutes. The total patient satisfaction score for the Patient Satisfaction Questionnaire short-form increased (P < .05).

Conclusions: The lean management of quality improvement methodologies provides effective enhancement to the work efficiency of nurses.

使用精益管理方法降低急诊观察室未完成护理的比率:质量改进项目。
背景和目标:要将精益管理融入优化护理工作流程中,就必须对护士的工作效率、患者体验和健康结果等多个因素进行仔细检查。为了评估未完成护理工作的程度和患者满意度,我们将精益管理方法纳入了质量改进工作中。这一积极主动的措施旨在解决潜在的不良后果,如住院患者体验不佳、不良事件发生率上升、护理人员工作满意度下降等:方法:2021 年 2 月至 8 月期间,我们在一家特定机构中采用了价值流图这一精益管理方法,旨在找出加强护士工作流程的关键领域。通过使用鱼骨图,我们深入分析了根本原因,随后采用 "计划-执行-研究-行动 "模式来执行根据这些已确定原因设计的干预措施。干预措施包括(干预措施包括:(1)规定医生常规查房的时间;(2)改变不合理的排班;(3)采用 5S 管理法管理护理用品;(4)消除重复文件和电子报告:实施这些干预措施后,未完成护理率从 73.4%降至 39.6%,当班完成护理率从 38.6%增至 71.4%。加班时间从 37.2 ± 22.4 分钟减少到 14.1 ± 3.6 分钟。患者满意度问卷短式的患者满意度总分有所增加(P < .05):精益管理质量改进方法有效提高了护士的工作效率。
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来源期刊
Quality Management in Health Care
Quality Management in Health Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
1.90
自引率
8.30%
发文量
108
期刊介绍: Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it: -Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes; -Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes; -Fosters the application of quality management science to patient care processes and clinical decision-making; -Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes; -Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.
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