Satisfacción con el servicio de posortodoncia de la Universidad Santo Tomás según métricas Lean-Six-Sigma / SatisfactionService Post-Orthodontic University Santo Tomas According ToLean-Six-Sigma Metrics

Introducción: La metodología Lean-Six-Sigma es utilizada actualmente en el área de la salud con el objeto de mejorar la calidad y competitividad de los servicios; pero aún no se tienen reportes de su uso en el área de ortodoncia. Objetivo: Determinar la satisfacción posortodoncia por medio de niveles sigma de los pacientes que asisten a una clínica docente-asistencial en Bucaramanga, Colombia. Métodos: Estudio observacional, descriptivo, transversal. La población estuvo constituida por 100 pacientes de ambos sexos, que ya habían concluido el tratamiento de ortodoncia. Se seleccionó toda la población que hubiera finalizado el tratamiento entre julio de 2017 y junio 2018 de acuerdo con criterios de inclusión y exclusión. Se realizó una encuesta telefónica de 17 preguntas y siete dimensiones de satisfacción. La confiabilidad del cuestionario se evaluó con la consistencia interna del cuestionario mediante el alpha de Cronbach en el que se obtuvo 0,87, y para la validez se utilizó el método de Lawshe. Se usó la metodología Lean-Six-Sigma para evaluar la calidad de la satisfacción; se presentan los resultados en porcentaje y niveles sigma. Resultados: La calidad en satisfacción en el servicio fue de 91,27 por ciento (medido convencionalmente) y 1,36 sigmas; en el grupo de 16-19 años fue de 93,6 por ciento y 1,52 sigmas; y para el grupo de más de 27 años, 84,9 por ciento y 1,03 sigmas. El sexo femenino reportó un 88,57 por ciento y 1,2 sigmas, mientras que el masculino, 93,46 por ciento y 1,51 sigmas. Conclusiones: Los resultados de satisfacción en ortodoncia, medidos por métodos convencionales, mostraron porcentajes aceptables, pero mostraron resultados incompetentes al medirse con niveles sigma, lo cual indica que existen problemas ocultos por identificar y que corresponderían a una siguiente investigación(AU)

Introduction: The Lean-Six-Sigma methodology is currently used in the health area in order to improve the quality and competitiveness of services; but there are still no reports of its use in the orthodontic area. Objective : to determine the post-orthodontic satisfaction by means of sigma levels of the patients who attend a teaching-assistance clinic in Bucaramanga, Colombia. Methods: Observational descriptive cross-sectional study. Population: 100 patients (female and male) who finish orthodontic treatment. Sample selection method: the entire population that had completed the treatment between July 2017 and June 2018 was selected according to inclusion and exclusion criteria. A telephone survey of 17 questions and seven dimensions of satisfaction was carried out. The reliability of the questionnaire was evaluated with the internal consistency of the questionnaire by means of the Cronbach's alpha in which 0.87 was obtained, and the Lawshe method was used for validity. The Lean-Six-Sigma methodology was used to assess the quality of satisfaction; Results are presented in percentage and sigma levels. Results: The quality of service satisfaction was 91.27 percent (conventionally measured) and 1.36 sigmas; in the group of 16 to 19 years it was 93.6 percent and 1.52 sigmas; and for the group over 27 years old, 84.9 percent and 1.03 sigma. The female sex reported 88.57 percent and 1.2 sigmas, and the male reported 93.46 percent with 1.51 sigmas. Conclusions: The satisfaction results in orthodontics, measured by conventional methods, showed acceptable percentages, but showed incompetent results when measured with sigma levels, which indicates that there are hidden problems to be identified and that they would correspond to a subsequent investigation(AU)

Lean Six Sigma and anesthesia / Lean Seis Sigma e anestesia

Abstract Background: Demands for health services have been growing sharply. Consequently, the costs of the institutions for their operational maintenance and investments also increase. The challenge of hospital management is to achieve standards of quality and safety for patients, increasing their productivity and minimizing costs. Lean Six Sigma is a well-structured methodology that aims to eliminate waste and activities that do not add value, focused on reducing process variation, eliminating the causes of the defect, and improving performance. As a result, cost reduction, higher quality, and customer satisfaction are observed. Objectives: To define Lean Six Sigma methodology and search references in the literature on its use in Health and specifically in Anesthesiology. Content: How often the waste of medicines, materials and time (rework), as well as the errors that happen in the day-to-day of the anesthesiologist are reported. Anesthesiologists must know the impact of their professional practice, with the purpose of making more appropriate choices, thus reducing the damage to the environment, improving overall health, and reducing costs with health care. The use of the Lean Six Sigma methodology is suggested to make the anesthesia field more sustainable, improving the processes without prejudice to the patient. Conclusion: Lean Six Sigma methodology is a new business management strategy in the health area. It is perfectly inserted in the current context of quality and safety to the patient; therefore, relevant in the practice of anesthesiology.

Resumo Justificativa: As demandas por serviços de saúde têm crescido de forma acentuada. Consequentemente, crescem também os custos das instituições para sua manutenção operacional e investimentos. O desafio da gestão hospitalar é conseguir conquistar padrões de qualidade e segurança para o paciente, aumentar sua produtividade e minimizar os custos. Lean Seis Sigma é uma metodologia bem estruturada que visa a eliminar os desperdícios e atividades que não agregam valor, focada na redução da variação nos processos, elimina as causas do defeito, melhora o desempenho. Como resultado, observa-se redução de custo, maior qualidade e satisfação do consumidor. Objetivos: Definir metodologia Lean Seis Sigma e buscar na literatura referências do uso da metodologia em saúde e especificamente na anestesiologia. Conteúdo: Descreve-se como são frequentes os desperdícios de medicamentos, materiais e tempo (retrabalho), bem como os erros que acontecem no dia a dia do anestesiologista. O anestesiologista deve conhecer o impacto de sua prática profissional, com o objetivo de fazer escolhas mais apropriadas e reduzir assim o dano ao ambiente, melhorar a saúde global e reduzir os custos com assistência à saúde. Sugere-se o uso da metodologia Lean Seis Sigma para tornar a anestesia mais sustentável, com melhoria dos processos, sem prejuízo ao paciente. Conclusão: A metodologia Lean Seis Sigma é uma estratégia de gerenciamento de negócio de fato nova na área da saúde. Insere-se perfeitamente no contexto atual de qualidade e segurança ao paciente, relevante, portanto, na prática da anestesiologia.

Efficiency in the operational process: reduction of incorrect entries and guarantee of compliance in the rendering of accounts / Eficiência no processo operacional: redução dos lançamentos incorretos e garantia de compliance na prestação de contas

ABSTRACT Objective To verify the impact of the Lean Six Sigma methodology in reducing incorrect entries of non-appropriated revenues and expenses. Methods Process for the review and application of the Lean Six Sigma methodology between December 2015 and September 2016, in a high-complexity general hospital in the city of São Paulo (SP). Results A total of 3,756,814 (100%) entries were audited between December 2015 and September 2016. The Sigma level evolved over the course of the process and increased from 3.44 Sigma in December 2015 to 5.92 Sigma in September 2016. Entries classified as non-appropriated revenues and expenses were brought down to 0% at the end of the study. Conclusion The use of the Lean Six Sigma methodology was efficient in reducing incorrect entries, calculating costs, ensuring compliance in rendering of accounts and accurately determining cost-outcome ratios.

RESUMO Objetivo Verificar o impacto da metodologia Lean Seis Sigma na redução de lançamentos incorretos de receitas e despesas não apropriadas. Métodos Processo de revisão e aplicação de metodologia Lean Seis Sigma, no período de dezembro de 2015 e setembro de 2016, em um hospital geral de alta complexidade da cidade de São Paulo (SP). Resultados Foram auditados 3.756.814 (100%) lançamentos durante os meses de dezembro de 2015 e setembro de 2016. O nível Sigma foi demonstrado na evolução do processo e aumentou de 3,44 Sigma, em dezembro de 2015, para 5,92 Sigma, em setembro de 2016. Os lançamentos classificados como receitas e despesas não apropriadas chegaram a 0% ao término do estudo. Conclusão O uso da metodologia Lean Seis Sigma foi eficiente na redução de lançamentos incorretos, na apuração correta de custos, na garantia de compliance na prestação de contas e na acurácia no projeto de custos e desfechos.

Development of home-based rehabilitation mode for stroke patients based on Lean Six Sigma theory / 中华全科医师杂志

The community rehabilitation model for stroke patients was developed based on the experiences of Quyang Community Health Service Center in Shanghai under the guidance of Lean Six Sigma.The validity of the process and results were evaluated by a expert group according to validity theory.The developed Manual of Home-based Rehabilitation mode for Stroke Patients in Community had good validity,which may provide guidance for stroke patients rehabilitation in the community,and also provide reference for clinical application.

Application of Lean Six Sigma theory in clinical medicine / 中华全科医师杂志

One of the effective methods to resolve the conflict between the ever-increasing medical demands and relatively limited medical resources is to improve the work efficiency of the medical institutions as well as to effectively control their operating cost through continuous reforms and improvements of the management modes in the medical industry.The Lean Management and Six Sigma Management theories which have been applied in manufacturing industry and service industry are now gradually being introduced to clinical medicine.This article systematically describes the Lean Management and Six Sigma Management theories and illustrates some examples of its application in health management renovation and the effects achieved.