Value stream map assessment of the extended day: 23h surgery model

Ruohoaho, Ulla-Maija; Kokki, Merja; Hirvonen, Jouni; Joukainen, Sarianna; Aaltomaa, S.; Fraunberg, Mikael von und zu; Leinonen, Ville; Reijula, Jori

doi:10.1080/17508975.2018.1448253

Cited by 5 publications

(8 citation statements)

References 24 publications

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“…This study assessed the implementation of a 23‐h surgery model in a tertiary care hospital in facilities designed and built for this purpose. The new 23‐h model was sufficiently successful, as 94·4 per cent of the patients were treated in the 23‐h unit in the PACU and discharged in a timely manner.…”

Section: Discussionmentioning

confidence: 99%

“…Second, data for ED visits to other healthcare facilities 15–30 days after surgery were not collected, so some of these contacts may have been missed. Third, this study was undertaken in a new surgical building and special non‐ward 23‐h unit at KUH, so the findings are not necessarily generalizable to other hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…The implementation process of the 23‐h surgery model has been described in detail elsewhere. In short, KUH is a tertiary‐care 590‐bed teaching hospital with a catchment area of 813 500 citizens in Central and Eastern Finland.…”

Section: Methodsmentioning

confidence: 99%

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Implementation of a 23-h surgery model in a tertiary care hospital: a safe and feasible model with high patient satisfaction

et al. 2020

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Background: The 23-h surgery model consists of elective operative care with an overnight hospital stay for patients unsuitable for day case surgery. The aim of this study was to assess the success of the 23-h surgery model. Methods:This was a prospective follow-up study of patients undergoing surgery with the planned 23-h model in a tertiary-care university hospital during a 12-month period 2 years after the model was implemented. Patients were interviewed 2 weeks after surgery, and the hospital operative database and patient records were searched. The primary outcome was the success of the process, defined as discharge before 10.00 hours on the first morning after surgery. Secondary outcomes were 30-day readmission and reoperation rates, adverse events, and patient satisfaction with the process. Results: Between May 2017 and May 2018, 993 adult patients underwent surgery with the 23-h model, of whom 937 adhered to the model as planned (success rate 94⋅4 per cent). Gynaecological, gastrointestinal and orthopaedic surgery were the three most common surgical specialties. The surgical process was changed to an in-hospital model for 45 patients (4⋅5 per cent), and 11 (1⋅1 per cent) were discharged on the day of surgery. The readmission rate was 1⋅9 per cent (19 of 993), and five patients (0⋅5 per cent) had a reoperation within 30 days of surgery. Fifty-nine adverse events were noted in 53 patients (5⋅3 per cent), most commonly infection. Patient satisfaction was a median of 6-7 (maximum 7) points for various aspects of the model. Conclusion: The success rate and patient satisfaction for the 23-h surgery model was high.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Implementation of a 23-h surgery model in a tertiary care hospital: a safe and feasible model with high patient satisfaction

et al. 2020

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“…Hoidonvarauksella kutsutut potilaat saapuvat suoraan hoitoyksikköön ja poistuvat toteutetun hoidon jälkeen yksiköstä. Leikkaukseen kotoa leikkauspäivänä (Leiko) -prosessissa potilaat saapuvat toimenpideyksikköön ja kotiutuvat ennalta suunnitellusti pääsääntöisesti toimenpiteen jälkeen, suoraan toimenpideyksikön heräämötiloista joko päiväkirurgisesti (Päiki) tai seuraavana päivänä, jolloin puhutaan heräämöstä kotiin (Herko, 23 h) -prosessista [29].…”

Section: 112021unclassified

Sairaalan reaaliaikainen tilannekuva päivittäisessä johtamisessa

Mykkänen¹,

Miettinen

Siponen

et al. 2021

FinJeHeW

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Tutkimuksessa kuvataan organisaation rekisteriaineistojen avulla sairaalan reaaliaikaisen tilannekuvan muodostumista, tilannetietoisuuden ja tilanneymmärryksen syntymistä. Tiedot perustuvat organisaation rakenteisiin tietovarantoihin. Tutkimusaineistot kerättiin potilashallinnon tiedoista, työvuorosuunnitelma-ohjelmasta ja sähköisestä potilaskertomusjärjestelmästä. Aineistot analysoitiin kuvailevin tilastollisin menetelmin. Tulosten perusteella koko sairaalan ja yksittäisen yksikön reaaliaikaisen ja visuaalisen tilannekuvan muodostaminen eri tietojärjestelmistä yhdeksi kokonaisuudeksi on mahdollista. Tietoja tulkitsemalla muodostuu tilanneymmärrys, jonka avulla syntyy käsitys siitä, miten tulevaisuudessa tulee toimia. Tietojen avulla sairaalan ja yksikön toimintaa voidaan myös kehittää tukemaan eri tasoisia toimintaprosesseja ja päätöksentekoa. Sosiaali- ja terveydenhuollon sähköisiä tietojärjestelmiä tulee kehittää siten, että ne palvelevat samanaikaisesti sekä tiedon ensisijaista, että toisiokäyttöä.

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“…One last study presented an analysis, based on value stream mapping, that indicated Lean can also improve patient safety. [40]. In a nutshell, Lean has been applied only at an operational level-in specific processes within departments or units, with no integration between departments or larger impact-with generally positive results and occasionally negative perception [29].…”

Section: Lean Healthcare In Scandinavian and Latin American Countriesmentioning

confidence: 99%

Linking Lean Adoption and Implementation in Healthcare to National Cultures

Peimbert-García

Jorma²,

Cárdenas–Barrón

et al. 2021

Sustainability

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Lean Healthcare (LHC) is a widely accepted approach to improve the quality of care around the world. This research compares two studies, which evaluated the adoption/implementation of LHC in Finland and Mexico, to understand how cultural similarities/differences influence LHC implementations. Data were gathered from previous questionnaire-based studies administered to healthcare professionals in both countries. Statistics (X2, p, and Wilcoxon tests) are used to compare both studies across topics related to adoption, introduction, integration, success, and barriers of LHC projects, and results are linked to cultural dimensions. Driven by economic savings, LHC has been more adopted in Finland than in Mexico (75/13%). Upon introduction, similarities are found in the way LHC projects are conducted, high project success rate, poor level of integration, and enabling/disabling factors. Conversely, differences were mainly found in the objectives of implementing LHC. These similarities/differences are linked to national factors involving culture, social structure, uncertainty management, time orientation, and indulgence level. In particular, uncertainty avoidance, equal rights’ structure, and a feminine culture are positive for implementing Lean. These findings can be a benchmark to evaluate cultural practices. Thus, this study provides insight into how national cultures relate to LHC and determined distinctive sociotechnical aspects that influence its adoption/implementation.

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Value stream map assessment of the extended day: 23h surgery model

Cited by 5 publications

References 24 publications

Implementation of a 23-h surgery model in a tertiary care hospital: a safe and feasible model with high patient satisfaction

Implementation of a 23-h surgery model in a tertiary care hospital: a safe and feasible model with high patient satisfaction

Sairaalan reaaliaikainen tilannekuva päivittäisessä johtamisessa

Linking Lean Adoption and Implementation in Healthcare to National Cultures

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