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Aiming at the management efficiency problems in the traditional medical low-value consumables management mode of the nursing unit, based on the perspective of supply chain management, this study uses lean management method to construct the lean management mode of low-value consumables with a whole cycle and whole process information monitoring, and analyzes the application effect of this mode. The results show that after the application of lean management mode, the low-value consumables of the nursing unit can achieve "consumables in use=priced consumables + un-priced consumables", the settlement cost is significantly reduced and its stability is high, and the efficiency of "supply-inventor-distribution" link is significantly enhanced. This model effectively improves the management efficiency of low-value consumables in the hospital, and also provides a reference for other hospitals to improve the management level of low-value consumables.
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Hospitals , CommerceABSTRACT
A lean management practice had been in place in Taizhou Enze Medical Center during the COVID-19 epidemic period, featuring the " principle-system-tool" theory of the Shingo model, in an effort to build a new model of COVID-19 prevention and control. The center upheld such five principles of lean management as overall planning, total involvement, system collaboration, concern with process and continuous improvement, and people-oriented practice. Under such principles, the center set up five supportive systems of lean management tools, namely risk identification, rapid screening, homogeneous treatment, customized follow-up and employee care. Integrated use of multiple tools of lean management, had improved the hospital′s crisis response ability, achieving desirable outcomes in stages in combating COVID-19 epidemic.
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Objective To explore the effect of lean management on cost control of single disease in patients with acute cerebral infarction (ACI) in stroke center. Methods A retrospective study was conducted. The patients with ACI who underwent intravenous thrombolysis in the stroke center of Taizhou Central Hospital in Zhejiang Province were enrolled. Thirty patients adopted traditional management procedures from July 2016 to September 2017 were enrolled in the control group, and 32 patients received lean management from October 2017 to December 2018 were enrolled in the lean group. The patients in the control group were treated with traditional intravenous thrombolysis, and the patients were sent to the neurology ward for intravenous thrombolysis. The patients in the lean group applied lean management value stream to optimize process management, the lean management team of the stroke center was established, and the green channel for stroke treatment was established to eliminate the waiting time as far as possible. The location of thrombolysis was changed from neurology ward to the neurological intensive care unit (NICU) in emergency department. The patients in the two groups were compared in terms of intravenous thrombolytic door-to-needle time (DNT), admission time to the neurologist's visit time (T1), CT examination time to neurology ward or NICU admission time (T2), neurology ward/NICU visit time to medication time (T3), and the proportion of patients with DNT controlled within 40 minutes, recovery of neurological impairment 7 days after thrombolysis [national institutes of health stroke scale (NIHSS) score], activity of daily living assessment (Barthel index), length of hospital stay, cost of hospital stay and patient satisfaction. At the same time, the main process quality and the implementation rate of easily missed indexes of cerebral infarction single disease were recorded. Results Compared with the control group, DNT, T1 and T2 in the lean group were significantly shortened [DNT (minutes): 39.56±11.12 vs. 63.03±19.63, T1 (minutes): 16.23±6.79 vs. 33.48±12.63, T2 (minutes): 13.45±3.84 vs. 17.47±5.56, all P < 0.01], T3 was slightly shortened (minutes: 9.88±1.95 vs. 10.95±2.69, P > 0.05), and the proportion of DNT control within 40 minutes was significantly increased [75.0% (24/32) vs. 16.7% (5/30), P < 0.01], the 7-day NIHSS score was decreased significantly (8.66±4.12 vs. 13.00±5.63, P < 0.01), 7-day Barthel index was increased significantly (71.6±16.7 vs. 54.7±17.1, P < 0.01), the length of hospital stay was significantly shortened (days: 9.69±4.06 vs. 12.47±3.83, P < 0.01), the hospital costs were significantly reduced (Yuan: 16 338±5 481 vs. 19 470±5 495, P < 0.05), the satisfaction of patients was improved significantly [(91.38±2.69)% vs. (86.53±2.78)%, P < 0.01]. In terms of the implementation rate of quality indicators such as pre-application evaluation of thrombolytic drugs, evaluation of dysphagia, and evaluation of vascular function, health education of ACI, rehabilitation evaluation and implementation within 24 hours, etc., the lean group was significantly improved as compared with the control group [(87.5% (28/32) vs. 53.3% (16/30), 96.9% (31/32) vs. 73.3% (22/30), 78.1% (25/32) vs. 43.3% (13/30), 100.0% (32/32) vs. 76.7% (23/30), 75.0% (24/32) vs. 33.3% (10/30), all P < 0.05]. Conclusion Lean thinking can realize the standardization of stroke center process, effectively utilize medical resources, improve medical quality and reduce the cost of cerebral infarction single disease.
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Hospital logistics management provides critical support for clinical work, and the management of materials is key to logistics management. Based on an analysis of current logistics management of the hospital, desirable results on logistics materials management have been harvested. The measures taken include optimizing management workflow and reinforcing cost control, in combination with such efforts as regulations improvement, higher informatization level and staff teamwork building.
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Objective To optimize the science research funding management,improve the quality of scientific research management,as well as scientific research.Methods The concept of lean management and full life cycle were brought in to analyze the problems and shortcomings under the traditional extensive management.A new administration model adopted in the full life cycle management was constructed.Results The management of hospital research funds plays a central part of the hospital scientific research management,which is also the premise to ensure the smooth implementation of hospital scientific research.Conclusions Through the exploration of full life cycle model of scientific research funds management,relevant departments,such as Department of Research,Finance Department,Equipment Department,Hospital Office and so on improved their internal functional communication,data and information can be shared,which helped streamlining the administration of research funding,as well as the plan and supervision of research funding use.
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Along with changes of medical model, hospitals need to provide best outcome with lowest cost and best patient′s experience rather than merely medical treatments. It is the cultivation of lean awareness to the doctors that could acquire such outcome. The healthcare lean awareness can be summarized as responsibility awareness, digitalized awareness, detail awareness, and outstanding awareness. Through the cultivation of lean awareness, humanism can immerse into the doctors′practice, which is conducive to train for the great masters of the medicine.
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Objective To investigate the effect of lean management on emergency biochemistry test turnaround time(TAT) in clinical laboratories.Methods Based on the approaches of standardized operations,5S on-site management,the efficiency evaluation of batch processing and one piece flow,and visual management,the median time of each workflow,the qualified rate of emergency biochemistry test TAT,the unqualified rate in a relatively concentrated period of TAT timeout and the unqualified rate of collected samples were compared before and after optimization.Results The median times (interquartile ranges) of each workflow including sample receipt and storage,result audit and sample storage-result report before and after lean management were 30 (35) min,7 (13) min,17 (8) min and 16(19) min,5(9) min,16(7) min,respectively,and there were significant differences in the former two(all P ＜0.01) but not the third (P ＞ 0.05).The median times (interquartile ranges) of TAT before and after lean management were 63 (51) min and 46 (33) min,respectively(P ＜ 0.05).The qualified rate of TAT increased from 86.00％ to 95.37％ after lean management(P ＜ 0.01).The unqualified rates in a relatively concentrated period of TAT timeout and collected samples decreased from 3.42％ to 1.00％ (P ＜0.01) and from 0.24％ to 0.17％ (P ＜ 0.01),respectively.Conclusion Lean management may improve process efficiency,reduce errors,and shorten emergency biochemistry test TAT in clinical laboratories.
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Objective:Based on annual reports on state assets,public hospitals could enhance the level of lean management about assets.Methods:The comparative analysis method was used to summarize the connection and difference between the annual report and the inventory report of the state assets in administrative institutions.On this basis,it analyzed the difficulties of public hospitals in the preparation of annual reports on state assets.Results:Through the top-level design of asset management,optimizing the process of whole life cycle management and innovating asset management tools,the public hospital not only to solve the difficulties of preparing the annual report on state assets,but also to enhance the level of lean management about assets.Conclusion:Based on the annual reports on state assets,public hospitals should change the traditional management mode of assets,improve the quality and application level of information,boost the lean management of assets,and speed up the establishment of modern hospital management system.
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Objective To investigate the application and feasibility of the single bed work efficiency in the evaluation of hospital beds efficiency,to establish the hospital beds efficiency evaluation model,in order to provide the basis for scientific and effective utilization and evaluation of beds.Methods Proposing the concept of single bed work efficiency,establishing a new evaluation model of bed efficiency,and analyzing the utilization of hospital beds in 2015.Results Single bed work efficiency is supenor to other indexes in evaluating the Utilization efficiency of hospital beds,and the new bed efficiency evaluation model is more objective and accurate.Conclusion The evaluation model of hospital beds utilization efficiency based on the single bed work efficiency is more comparable and operable,which can be widely used in hos pital delicacy management.
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Objective To explore the lean management model for the application of National Natural Science Foundation of China (NSFC).Methods Under the framework of lean management,Peking University Third Hospital (PUTH) tapped potential through the earlier stage survey and policy guidance,focused on improving efficiency based on discipline and talent,curriculum service were also provided to bolster application quality.This paper reviewed the NSFC application situation of PUTH in 2014 2016 and compared with 2011-2013,summarized the management experience.Results All the indexes increased significantly during 2014-2016,also achieved a breakthrough in talent projects.Compared with 2011 2013,the application number of 2014-2016 increased by 34.8％,meanwhile,both the support number and amount of NSFC increased 44.2％ and 111.6 ％ respectively.We also achieved 71.8％ growth and added 5 experts in high end talent projects.Conclusions The lean management significantly improves the management efficiency,and we hope to make reference to other clinical hospitals in promoting basic research management.
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In recent years , lean management has been applied to hospital management from industrial management .This arti-cle cultivatesthe idea of administratorfrom innovative awareness and quality view aspect .The daily medical management was improved by consummating the rules and regulations , the implementation of structured electronic medical record system management , and the estab-lishment of a feedback mechanism .In the aspect of advanced ideas , psychological intervention , and harmonious culture to create a people-oriented atmosphere , etc.lean management was implied to improve work efficiency and quality control .
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The authors probed into the application and feasibility of DRGs in improving the efficiency and quality of hospital medical services,in order to establish a lean management mode based on DRGs.DRGs are seen as different from other means of management,with such evaluation of medical services being more comparable and operable,and the evaluation results more trustworthy.Application of such practice can obviously improve the efficiency and quality of medical services,making it widely applicable to hospital′s lean management.
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Objective:Discussion on application effect of lean management practices in a hospital operating room medical supplies management.Methods: By comparison in 2013(the traditional management model) and 2014(lean management mode) of medical supplies hospital operating room use, storage, physician satisfaction of supplies and other indicators, the effect of medical supplies management lean management mode evaluation.Results: The 2014 hospital operating room medical supplies inventory types species, size species, total stock capital yuan, inventory area m2 were significantly lower and the differences were statistically significant(t=19.701,t=10.605,t=14.214,t=12.714;P<0.05) in 2013; significantly higher than in 2013(82.98%) and the difference in 2014 for supplies of hospital surgeon satisfaction rate (96.23%) were statistically significant(x2=4.857,P<0.05); 2014 hospital surgical medical supplies leak charges fell compared with 92.86% in 2013, invoices and goods do not correspond to decrease the incidence of 100% compared with 2013.Conclusion: Lean management practices in hospital operating room medical supplies will help strengthen the management of capital flows, standardize their management and improve efficiency.
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Objective:To discuss the application of lean management of medical consumables in stomatological hospital and evaluate the operation effect.Methods: Based on the lean management of medical consumables of School of Stomatology, China Medical University, the medical consumables are composed of high valuable and common consumables. Traceable and sub-base management are carried out for all the medical consumables.Results: Lean management runs well and improves the scientificity and precision of hospital management.Conclusion: The operation costs are reduced and management benefit is increased.
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Hospital performance evaluation based on lean management is discussed in the paper, which covers all hospital staff by means of appropriate evaluation tools,accurate division of groups to evaluate,precise setting of evaluation indexes,refined relationship between evaluation and remuneration, and strict execution and feedback.This contributed to overall performance betterment of the hospital, and rational performance evaluation and remuneration patterns.
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Introduced in the paper are key measures and characteristics of the attending in charge system,following the theory of lean management and under leadership of the department head of the hospital.Authors hold the practice as enhancing administrative functionality of the department head, avoiding disadvantages incurred by traditional attending in charge system,and upholding quality of care management,making it a worthwhile attempt for China's healthcare system.
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Clinical skills training center of Dongyang People's hospital introduced lean man-agement conception into the resident clinical skills training. The recruited residents were grouped by degree, the training contents were detailed, and teaching plans were normalized, and small class teach-ing and real-time feedback were implemented, which improved the normalization and standardization of resident training. The implementation of lean management leads to great progress in resident train-ing, but still needs further efforts. Only in the long-term management of standardization, can lean man-agement conception be embedded in daily work, making clinical skills training center play its role in cultivating medical talents effectively.
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Lean management,when introduced to optimize emergency operations,may improve medical service.It has been proved in practice that ideas and methodology of lean management guarantee emergency services by ensuring safety and quality of emergency operation process.In addition,it minimizes costs and enhances the business and social efficiency of the hospital.
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Targeting such setbacks as difficulty to registerand difficulty to see doctors at outpatient clinic services,the hospital adopted the lean management since August 2010.For example,diversified reengineering of the outpatient service process in place,which has improved outpatient traffic at the registration section by means of innovated appointment mode and outpatients total reservation;workload balance by means of through-counters for registration and fee payment as well as the timeinterval outpatient visits to doctors; reduced human costs and outpatient back-forth movement by means of integrated service and resources integration.Lean management plays a positive role in hospital management,as proven by much shortened outpatient waiting time,much higher outpatient satisfaction,for a win-win of both patients and the hospital.
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Lean management theory is applied to the management of the devices and staffs of radiology department. With the current flow evaluated, the working efficiency and patient satisfaction are increased.