ABSTRACT
Objectives: Lean management [LM] principles were first developed by a Japanese manufacturing company to maximise value and minimise waste in the automotive industry. However, these principles can also be applied in the healthcare sector. This study aimed to illustrate the process of implementing LM principles in a radiation oncology department to streamline workflow and identify and reduce waste
Methods: This study took place in the Department of Radiation Oncology, Royal Hospital, Muscat, Oman, in December 2016. A value stream map [VSM] was created for the chain of processes followed in the department. A waste analysis was conducted to determine which processes did not add value for the patient or healthcare provider
Results: Based on the VSM analysis, only six out of 13 steps were found to be of value. Necessary and unnecessary non-value-adding activities were identified. Sources of waste included parking and registration. In addition, variabilities in workload were noted
Conclusion: Overall, LM principles improve workflow, reduce waste and enhance patient and staff satisfaction. In the current study, the application of LM principles helped to improve value in a radiation oncology department
ABSTRACT
Objectives: To determine and explore the potential use of uHear as a screening test for determining hearing disability by evaluating its accuracy in a clinical setting and a soundproof booth when compared to the gold standard conventional audiometry
Methods: Seventy Sultan Qaboos University students above the age of 17 years who had normal hearing were recruited for the study. They underwent a hearing test using conventional audiometry in a soundproof room, a self-administered uHear evaluation in a side room resembling a clinic setting, and a self-administered uHear test in a soundproof booth. The mean pure tone average [PTA] of thresholds at 500, 1000, 2000 and 4000 Hz for all the three test modalities was calculated, compared, and analyzed statistically
Results: There were 36 male and 34 female students in the study. The PTA with conventional audiometry ranged from 1 to 21 dB across left and right ears. The PTA using uHear in the side room for the same participants was 25 dB in the right ear and 28 dB in the left ear [3-54 dB across all ears]. The PTA for uHear in the soundproof booth was 18 dB and 17 dB [1-43 dB] in the right and left ears, respectively. Twenty-three percent of participants were reported to have a mild hearing impairment [PTA > 25 dB] using the soundproof uHear test, and this number was 64% for the same test in the side room. For the same group, only 3% of participants were reported to have a moderate hearing impairment [PTA > 40 dB] using the uHear test in a soundproof booth, and 13% in the side room
Conclusion: uHear in any setting lacks specificity in the range of normal hearing and is highly unreliable in giving the exact hearing threshold in clinical settings. However, there is a potential for the use of uHear if it is used to rule out moderate hearing loss, even in a clinical setting, as exemplified by our study. This method needs standardization through further research