Implementation of Lean Management Tools Using an Example of Analysis of Prolonged Stays of Patients in a Multi-Specialist Hospital in Poland

Zdęba-Mozoła, Agnieszka; Kozłowski, Remigiusz; Rybarczyk-Szwajkowska, Anna; Czapla, Tomasz; Marczak, Michał

doi:10.3390/ijerph20021067

Cited by 3 publications

(4 citation statements)

References 39 publications

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“…This concentration contributes to the elevated number of hospitals in Masovia Province compared to other regions in Poland. An influential factor driving this increased density of hospitals in the capital province is the demand for medical services, not only from its own residents but also from individuals residing in other parts of Poland who travel to the capital to access healthcare services (Zdęba-Mozoła, 2023). To identify distinct groupings among the provinces under study, taking into account the analysis of three variables: the number of hospitals in a province, the number of residents per hospital, and the number of hospitals per 1,000 km2 of area, cluster analysis methods were employed.…”

Section: Discussionmentioning

confidence: 99%

Hospital distribution in Polish provinces as a factor of smart living

Wolniak

2024

Economics &Amp; Sociology

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The primary aim of this research paper is to investigate the distribution of hospitals across different regions in Poland. It provides an in-depth analysis of hospital distribution in Poland, emphasizing the significance of taking into account factors such as population size and accessibility when assessing the quantity of hospitals as a determinant of quality of life in a smart city. This analysis is based on data concerning hospital operations in Poland spanning the years 2012 to 2021. It explores a range of indicators, including the number of hospitals per province, the ratio of hospitals per 1,000 square kilometers within a province's geographical area, and the relationship between the availability of hospitals and the GDP per capita. One noteworthy aspect of this paper is its utilization of cluster analysis to identify groups of provinces that exhibit similarities with respect to these indicators. Surprisingly, the research findings challenge the conventional division of regions into "Poland A" and "Poland B" based on wealth. Instead, the study reveals an unexpected outcome: a positive correlation of 0.81 between the number of hospitals and GDP per capita. This suggests that more prosperous provinces tend to have a greater number of hospitals available.

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Section: Discussionmentioning

confidence: 99%

Hospital distribution in Polish provinces as a factor of smart living

Wolniak

2024

Economics &Amp; Sociology

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“…The adaptation of the organisation of an ED in the form of PDSA cycles makes it possible to give a collective team dimension to flow management2 24–26 and to achieve the objective: zero stretcher patients. The combination and adaptation of the five key rules implemented (no corridor stretcher patients, forward movement, examination always available, room, huddle and the SODA plan) made it possible to obtain this result.…”

Section: Lessonsmentioning

confidence: 99%

No waiting lying in a corridor: a quality improvement initiative in an emergency department

Schmutz,

Le Terrier,

Ribordy

et al. 2023

BMJ Open Qual

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BackgroundOvercrowding in the emergency department (ED) is a global problem and a source of morbidity and mortality and exhaustion for the teams. Despite multiple strategies proposed to overcome overcrowding, the accumulation of patients lying in bed awaiting treatment or hospitalisation is often inevitable and a major obstacle to quality of care. We initiated a quality improvement project with the objective of zero patients lying in bed awaiting care/referral outside a care area.MethodsSeveral plan–do–study–act (PDSA) cycles were tested and implemented to achieve and especially maintain the goal of having zero patients waiting for care outside the ED care area. The project team introduced and adapted five rules during these cycles: (1) no patients lying down outside of a care unit; (2) forward movement; (3) examination room always available; (4) team huddle and (5) an organisation overcrowding plan.ResultsAdaptation of ED organisation in the form of PDSA cycles allowed to obtain a collective team dimension to patient flow management. Since December 2021, despite an increase in activity, no patient is placed in a lying-in waiting area outside a care zone, irrespective of their care level. Vital distress and fragile patients who need to be kept in a supine position are treated immediately. In 2022, waiting time before medical contact was <2 hours for 90% of all patients combined.ConclusionsThe PDSA strategy based on these five measures allowed to remove in-house obstacles to the internal flow of patients and to fight against their installation outside the care area. These measures are easily replicable by other management teams. Quality indicators of EDs are often heterogeneous, but we propose that the absence of patients lying on a stretcher outside a care area could be part of these indicators, and thus contribute to the improvement and safety of care provided to all patients.

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“…They mainly concern the possibility of improving and perfecting the involvement of managerial staff in the continuous improvement process [12,13]; the possibility of assessing the implementation of the lean concept in hospitals [14]; and the assessment of the degree of readiness of medical facilities to implement the lean concept [15][16][17]. Studies of Lean Hospitals often focused on literature reviews and implementations of case studies [18][19][20][21][22][23][24][25][26]. There is also a dominance of studies reporting successful lean interventions [21,[27][28][29][30][31][32][33][34][35].…”

mentioning

confidence: 99%

“…There is also a dominance of studies reporting successful lean interventions [21,[27][28][29][30][31][32][33][34][35]. The positive aspects of implementation of LM tools refer both to the economic effects (lowering the unit costs, lowering the costs of studies), as well as organizational effects, such as improving the patient flow [36][37][38][39], shortening the waiting time for procedures [22], reducing the number of unnecessary examinations or shortening the hospitalization time [23,37,40], and human effects (increasing the engagement of employees, satisfaction from implemented improvements or change of the method of work from individual to team work) [24,[41][42][43]. The latest study provides practical guidance to support the implementation of a cost-effective approach in hospital operations, with the study repeating and testing different processes in different healthcare units [17,44].…”

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confidence: 99%

Assessment of the Level of Practical and Theoretical Knowledge as a Starting Point for the Implementation of Lean Hospital Concept

Chmielarz,

Wieczorek-Wojcik,

Zdęba-Mozoła

et al. 2023

Systems

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Background: The implementation of the Lean Hospitals concept can contribute to the improvement of internal processes in healthcare organizations. The level of a management team’s knowledge is an important part of effective implementation of Lean Hospital elements in hospitals. The purpose of this article is to determine the degree of theoretical and practical knowledge of Lean Hospitals (defined for the purposes of the study as a set of lean tools) among the management teams of Polish hospitals. The authors focused on examining the discrepancy between practical and theoretical knowledge to determine which of them is less prevalent in hospitals in order to correctly establish elements of the implementation procedures, which must be improved and perfected to more effectively implement the lean concept in healthcare. Methods: The research methods used to achieve the study objectives included, respectively, an analysis of the literature on the subject and gathering of data using the Qualtrics Platform with a CAWI survey. Respondents rated their level of knowledge regarding Lean Hospital tools on a Likert scale. Basic descriptive statistics and radar diagrams were used to analyze and present the data. Statistical analysis was performed using Excel spreadsheets. Results: It was established that the vast majority of management teams in the studied hospitals had limited basic knowledge about Lean Hospitals, if any. The greatest lack of knowledge was found in the field of practical (implementation) knowledge of Lean Hospital tools. The research found no significant discrepancy between the level of theoretical and practical knowledge at the level of general knowledge and detailed knowledge relating to the knowledge of individual lean tools. The standardized work tool was rated best in terms of self-assessing practical knowledge. The worst rated tools in terms of both theoretical and practical knowledge self-assessment were Kaizen, Kanban and TPM. Conclusions: The results of the conducted studies indicate a low level of knowledge and advancement in the implementation of the Lean Hospitals concept in selected Polish hospitals. Limited knowledge of the Lean Hospital concept was established for entire management teams. A low level of knowledge was noted in both theoretical and practical knowledge. Supplementing knowledge only at the theoretical level without taking care of the practical knowledge aspect may prolong the implementation procedure or stop it completely. Therefore, based on the result of the research, it can be concluded that the first stage of lean implementation in hospitals should focus on supplementing the knowledge and preparing the employees for work in a lean culture, diverting particular attention to the practical part of the training.

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Implementation of Lean Management Tools Using an Example of Analysis of Prolonged Stays of Patients in a Multi-Specialist Hospital in Poland

Cited by 3 publications

References 39 publications

Hospital distribution in Polish provinces as a factor of smart living

Hospital distribution in Polish provinces as a factor of smart living

No waiting lying in a corridor: a quality improvement initiative in an emergency department

Assessment of the Level of Practical and Theoretical Knowledge as a Starting Point for the Implementation of Lean Hospital Concept

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