Research On Process Optimization Of Elective Surgery Based On Lean Management

BackgroundIn recent years,the state has promulgated a number of policies requiring high-quality and efficient development of public hospitals.As a high-cost and resource-intensive department in a general hospital,the operating room undertakes an important function of surgical treatment.Surgery is generally carried out on an elective basis.Faced with the increasing number of surgeries year by year,the operating room urgently needs to improve the efficiency of the connection and optimize the connection process.In order to meet this challenge,the lean management focusing on "eliminating waste,restraining and increasing efficiency" creates conditions for optimizing the process of elective surgery.Therefore,it is of great significance to explore how to optimize the elective surgery connection process,shorten the connection time,and improve the overall operation efficiency of the operating room and the satisfaction of doctors and patients through lean management.ObjectiveBased on the lean management theory,this research takes the elective surgery connection process of a tertiary-grade general hospital in Shandong Province as the research object.Based on the analysis of the existing problems and their causes,optimization measures are formulated and implemented,and the effect of the implementation is evaluated.MethodsThrough on-site observation of 30 elective surgery procedures,questionnaire surveys on patient satisfaction,interviews with staff on problems in the management of patients,and acquisition of data on the connection time in the surgical anesthesia system,data were collected,and the process of elective surgery was analyzed.Status and problems.Use the fishbone diagram to analyze the reasons that affect the connection process,and in July-August 2021,formulate and implement lean process optimization measures.By comparing the changes of the indicators before and after the implementation of the optimization measures,the optimization effect is evaluated.Data processing and analysis were completed by Excel 2022 and SPSS 25.0 software.Results(1)The problem of the reception process:the total process of reception has 10 steps,which can be divided into 3 stages:the end of the stage to the room,the stage of leaving the room to the entry of the stage,and the entry of the stage to the beginning.The time before improvement was(57.14 ± 42.84)minutes.From the 100-level operating room,the 10,000-level operating room to the 100,000-level operating room,the average connection time of the total process has gradually decreased.The operating room temperature,psychological comfort service and operating room environment satisfaction were lower among surgical patients.The waiting time for pick-up,transfer time,preparation time in the operating room,and the difference between the actual operating time and the expected time ranged from 0-5 minutes,6-10 minutes to more than 11 minutes,and the satisfaction of surgical patients showed a gradually decreasing trend.The reasons for the low satisfaction of the staff docking station process are mainly concentrated in two aspects:lack of hardware facilities and imperfect staff management.(2)Factors affecting the process of receiving the stage:The main reasons for the long time from the end of the stage to leaving the room are:the anesthesia doctor takes a long time for anesthesia extubation;the space in the anesthesia recovery room is limited and the beds are insufficient.The main reasons for the long time between leaving the room and entering the room are:the cleaning staff,external staff and internal staff are understaffed and the transfer speed is slow during the peak period;the deep-seated reason is the lack of reasonable scheduling system and performance appraisal for external staff and cleaning staff.Mechanisms and work standard specifications and quality control measures.The reasons for the long time from leaving the stage and entering the room to the beginning are:the anesthesiologist and the surgeon enter the operating room late,the hand-washing nurse can’t grasp the timing of the stage,there is no anesthesia induction room,the anesthesia equipment is in disrepair,and the number is not complete.(3)Formulate an optimization plan for the connection process:first,optimize the anesthesia extubation,patient transfer,and anesthesia operation procedures,standardize the work responsibilities of workers and nurses,and unblock the communication channels of all parties;second,establish lean departments and management indicators system,improve the management level of the department and the professional quality of the staff;third,increase the anesthesia-related equipment,recovery room beds and transfer vehicles,carry out 6S management to improve the operating room environment,and use the noodle diagram to improve the equipment preparation process and fluid replenishment process;Fourth,Standardize the arrangement and placement of postural cushions and bed accessories,and set the order of medical records in a unified manner.(4)The effect of the optimization of the process of receiving the station:After the implementation of lean management for two months,the time of receiving the station was shortened to(46.30±27.45)minutes,and the overtime time of the nursing staff was shortened to(2.11± 0.25)h,and the difference before and after the improvement was statistically significant(P<0.05).From the end of going on stage to leaving the room and from leaving the room to entering the room,the time for receiving the stage was shortened to 7.92 minutes and 16.68 minutes,respectively,and the difference was statistically significant before and after the improvement(P<0.05).The total number of operations and the average daily number of operations increased by 8.13%and 6.37%respectively.The satisfaction of patients and surgeons increased to 85.59%and 94.55%,and the difference was statistically significant(χ2=11.216,χ2=8.549,P<0.05).Conclusions and SuggestionsApplying lean management theory to optimize the receiving process,you can find the problems and causes of the receiving process,put forward a targeted improvement plan,shorten the receiving time and the overtime time of nursing staff,increase the average daily operation times,and improve the satisfaction of doctors and patients.It has certain economic and social benefits.It can be used as a reference for other hospital operating rooms.Based on the above conclusions,this study suggests that on the basis of scientifically and rationally defining the procedure for elective surgery,optimize the procedure for all personnel,increase a certain number of operating rooms,ensure the efficiency of surgical turnover,improve the quality of service,and further improve the satisfaction of doctors and patients.Spend.