Use of the Smart Lean Method to Conduct High-Quality Integrated Perioperative Management Prior to Hospitalization

Hung-Wen Tsai, Su-Wen Huang, Yin-Lurn Hung, Yu-Shan Hsu and Chien-Chung Huang
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Hung-Wen Tsai: Department of Medical Administration, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Su-Wen Huang: Department of General Affairs, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Yin-Lurn Hung: Department of Medical Administration, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Yu-Shan Hsu: Department of Medical Administration, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Chien-Chung Huang: Department of Computer & Communications Center, Taichung Veterans General Hospital, Taichung 40705, Taiwan

IJERPH, 2021, vol. 18, issue 24, 1-16

Abstract: Background: competition in the healthcare market is becoming increasingly intense. Health technology continues to evolve, so hospitals and clinics need to strengthen hospital management techniques and also adopt a more patient-centered approach in order to provide high-quality healthcare services, including a more simplified process and shorter waiting times for examinations. The Lean and Six Sigma methodologies and smart technology were introduced and implemented into the integrated perioperative management (PERIO) processes for the purpose of decreasing pre-admission management waiting time, as well as increasing the completion rate and quality of pre-admission management for surgical patients in a 1576-bed medical center in central Taiwan. Methods: in order to improve hospital admission procedures for surgical patients by shortening process waiting times, simplifying admission processes, emphasizing a patient-centered approach, and providing the most efficient service process, the present study applied the DMAIC architecture of the Lean Six Sigma. This approach allowed the patients to save time on the hospital admission process. The current workflow used value flow mapping to identify wasted time caused by unnecessary walking and waiting during the hospital admission process. Therefore, we improved the process cycle for each patient by simultaneously selecting and controlling the process for the purpose of saving time. Results: the experimental results show that the percentage of Process Cycle Efficiency (PCE) increased from 35.42% to 42.47%, Value Added was reduced from 34 to 31 min, and Non-Value Added was reduced from 62 to 42 min. The satisfaction score of the 97 pre-implementation patients was 4.29 compared with 4.40 among the 328 post-implementation patients ( p < 0.05). The LOS (Length of Stay) of 2660 pre-implementation patients was 2.49~3.31 days and for 304 after-implementation patients it was 1.16~1.57 days. Conclusions: by integrating different units and establishing standard perioperative management (PERIO) procedures, together with the support of the information systems, the time spent by patients on hospital admission procedures was shortened. These changes also improved the comprehensiveness of the preoperative preparations and the surgical safety of patients, thereby facilitating the provisions necessary for high-quality healthcare services. This in turn reduced the average length of hospital stays and increased the turnover of patients, benefiting the overall operations of the hospital.

Keywords: Lean and Six Sigma methodologies; management waiting time; optimize the admission process (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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