An introduction to Kaizen in health care

Goyal, Simran; Law, Elizabeth

doi:10.12968/hmed.2019.80.3.168

Cited by 23 publications

(12 citation statements)

References 6 publications

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“…This does not suggest that surgical techniques and quality improvement efforts are futile but rather suggests that a more systematized approach is needed to discern which changes are most effective. An alternative method would be to quantitatively measure the effect of clinically integrated small technique modifications in a large group of surgeons; this is akin to the Kaizen principles adopted in manufacturing 8,24 . The accumulated changes from these small technique modifications, which lead to measurable, incremental improvements, could then accumulate into superior outcomes.…”

Section: Discussionmentioning

confidence: 99%

Have urinary function outcomes after radical prostatectomy improved over the past decade?

Clements

Gmelich

Vertosick

et al. 2021

Cancer

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Background Changes in surgical technique and postoperative care that target improvements in functional outcomes are widespread in the literature. Radical prostatectomy (RP) is one such procedure that has seen multiple advances over the past decade. The objective of this study was to leverage RP as an index case to determine whether practice changes over time produced observable improvements in patient‐reported outcomes. Methods This study analyzed patients undergoing RP by experienced surgeons at a tertiary care center with prospectively maintained patient‐reported outcome data from 2008 to 2019. Four patient‐reported urinary function outcomes at 6 and 12 months after RP were defined with a validated instrument: good urinary function (domain score ≥ 17), no incontinence (0 pads per day), social continence (≤1 pad per day), and severe incontinence (≥3 pads per day). Multivariable logistic regressions evaluated changes in outcomes based on the surgical date. Results Among 3945 patients meeting the inclusion criteria, excellent urinary outcomes were reported throughout the decade but without consistent observable improvements over time. Specifically, there were no improvements in good urinary function at 12 months (P = .087) based on the surgical date, and there were countervailing effects on no incontinence (worsening; P = .005) versus severe incontinence (improving; P = .003). Neither approach (open, laparoscopic, or robotic), nor nerve sparing, nor membranous urethral length mediated changes in outcomes. Conclusions In a decade with multiple advances in surgical and postoperative care, there was evidence of improvements in severe incontinence, but no measurable improvements across 3 other urinary outcomes. Although worsening disease factors could contribute to the stable observed outcomes, a more systematic approach to evaluating techniques and implementing patient selection and postoperative care advances is needed. Lay Summary Although there have been advances in radical prostatectomy over the past decade, consistent observable improvements in postoperative incontinence were not reported by patients. To improve urinary function outcomes beyond the current high standard, the approach to studying innovations in surgical technique needs to be changed, and further development of other aspects of prostatectomy care is needed.

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Section: Discussionmentioning

confidence: 99%

Have urinary function outcomes after radical prostatectomy improved over the past decade?

Clements

Gmelich

Vertosick

et al. 2021

Cancer

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“…One way to facilitate change in healthcare may be to use principles of effective innovation, such as the 'Kaizen principle' [34]. Kaizen, (a Japanese word for good (zen) change (kai), implies that innovative changes should be incremental, but undertaken continuously, which leads to most successful implementation, rather than large changes implemented immediately [34]. Given that participants in our study highlighted the acceptability of receiving patients referred to them by pharmacists, implementing such a model may offer a path of least resistance.…”

Section: Discussionmentioning

confidence: 99%

Physicians Views on Cardiovascular Disease Risk Prevention Services by Pharmacists and Potential for Collaboration

Almansour

Aloudah

Alhawassi

et al. 2020

Preprint

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Background: Cardiovascular diseases (CVD) are the leading cause of mortality worldwide. Early identification and management of modifiable CVD risk factors is highly effective in preventing disease onset and/or improving outcomes in CVD. Pharmacists as highly accessible primary health professionals can assume a role in screening and risk factor management in collaboration with physicians, however such prevention services are not established practice in Saudi pharmacies. Therefore, the aim was to explore physicians’ perceptions about the utility of a role in CVD risk screening and management for Saudi pharmacists. Methods: Qualitative semi-structured interviews were conducted, audio-recorded and transcribed verbatim in Arabic or English. All transcripts were thematically analysed after translation into English if required. Results: A total of 26 physicians recruited from public hospitals and primary healthcare centres were interviewed. Most were unaware of pharmacists’ potential to undertake a role in CVD risk prevention. Although there was broad support for the concept, they recommended physician-pharmacist collaborative models, extensive provider pharmacist training and strict oversight by the Saudi Ministry of Health/other official authorities to ensure service quality and sustainability, should implementation occur. Healthcare system reform was considered key to expanding private sector (i.e. community pharmacy) involvement in healthcare as was incentivising providers and ‘marketing’ for patient acceptance. Conclusion: Physicians were positive about setting up a collaborative community pharmacist-physician CVD risk screening and management service model with the help of an authorised body within the Saudi Arabian healthcare system.

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“…This approach was considered best for finding ways to standardise processes and generate enhancement recommendations, since it has the capacity to measure the scale of a problem and identify the most obvious opportunities for continuous improvement through a priority matrix [23]. Although Japanese in origin, it has nowadays been widely applied in the standardisation and continuous improvement of multiple project-specific processes in business and social contexts, especially relating to quality and safety issues [23,24,25,26].…”

Section: Data Collection and Analysismentioning

confidence: 99%

Efficiency Management in Catch Handling Onboard Small Boats - Standardisation of Processes in Icelandic Fisheries

Karlsdóttir¹,

Cook²,

Minelgaitė³

2021

Preprint

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Small boat fishers are often the lifeblood of remote coastal communities in Iceland, contributing to employment, jobs and economic prosperity. This study conducts exploratory but highly practical research into the efficiency of onboard catch handling practices by Icelandic small boat fishers using fish handling tools called automatic jigging machines. Using applied research methods, this study researches whether standardisation of operations could be applied to make catch handling practices on small boats more time and resource efficient, leading to reduced waste, a consistently higher quality product, and potential increases in economic efficiency and sustainability. Thematic analysis, value stream mapping, flow analysis and Kaizen ideology were adopted to identify gaps and continuous improvement opportunities to standardise processes, leading to exemplary performance. Eight core recommendations are identified, seven of which are classed as straight-forward, ‘do now’ measures according to a Kaizen Priority Matrix. These include human and technological interventions in the areas of safety, organisational arrangements, hygiene, fish handling and bleeding, and cooling. Questionnaire responses reveal four main themes of importance to the sub-sector: changes in recent decades; the importance of small boat fishers; education and improvement; and the particularities of the sub-industry. The latter include the perception of a ‘race against time’ to land the catch, an issue that sometimes contributes to sub-optimal catch handling practices. Although this study has decidedly practical connotations for small boat fishers, its outcomes are also likely to be of interest to academics, particularly those focused on the organisational management of natural resources and general applications of the project management methodology and applied research methods as a means of solving practical problems in everyday life.

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An introduction to Kaizen in health care

Cited by 23 publications

References 6 publications

Have urinary function outcomes after radical prostatectomy improved over the past decade?

Have urinary function outcomes after radical prostatectomy improved over the past decade?

Physicians Views on Cardiovascular Disease Risk Prevention Services by Pharmacists and Potential for Collaboration

Efficiency Management in Catch Handling Onboard Small Boats - Standardisation of Processes in Icelandic Fisheries

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