Research On Improving Pediatric Performance Based On Lean Management

BackgroundAt this stage,first of all,the performance appraisal of public hospitals in China mostly focuses on financial indicators such as income and cost accounting,ignoring non-financial indicators,and separating performance objectives from hospital strategies.Secondly,most of them only stay in the formulation of short-term objectives,with a weak concept of sustainable development.For pediatrics,the relative shortage of resources,the small number of pediatricians,the large workload,and changes in the disease spectrum have constrained the development of pediatrics;At the same time,in the context of public hospitals operating mainly on drugs and examination revenue,pediatric departments have fewer drugs,fewer auxiliary examinations,fewer fee items,and significantly lower medical income than other departments,all of which have an impact on the performance evaluation of pediatric departments.Based on the above analysis,this article takes the pediatric department of C Hospital as an example to introduce lean management in department management to improve department performance evaluation.At the same time,it analyzes the influencing factors of lean management in the implementation process,providing reference for the development of pediatric departments in other hospitals of the same type and scale.ObjectiveThis study takes the pediatric department of C Hospital as the research object to understand the current status of performance evaluation and summarize the existing problems.Then,measures to optimize performance improvement are proposed and implemented,and the effectiveness of improvement is analyzed.In addition,the influencing factors of lean management in the pediatric implementation process are analyzed,providing reference for pediatric departments of similar sized hospitals.MethodsUsing the thematic framework method to analyze qualitative interview data,summarize and analyze the problems in the performance evaluation of pediatric department at C Hospital.In the improvement stage,first of all,from the four dimensions of the balanced scorecard:finance,customers,internal processes,and learning and growth,a strategic plan for pediatric development is formulated in the form of a strategic map.Promote the implementation of strategies through 6S management,lean improvement projects,visual management,and other methods.In the effectiveness evaluation stage,taking March 2021 as the intervention point,the discontinuous time series method was used to analyze the pediatric key performance indicators,the analysis of variance was used to analyze the content of the lean implementation effectiveness questionnaire,the t-test was used to analyze the job satisfaction questionnaire,and the thematic frame method was used to sort out the qualitative interview data.Data processing and analysis are mainly conducted using Excel 2019,Stata15,and SPSS25 software.Using the thematic framework method to analyze qualitative interview data and summarize the influencing factors of lean management in the implementation process.ResultsThere are problems with performance evaluation in pediatrics:firstly,the management mode of pediatrics is mainly based on experience management,lacking clear positioning and development planning for departments;Secondly,the department environment is chaotic,the spatial layout is unreasonable,it is inconvenient to retrieve and place items,and repetitive operations often occur,which reduces the efficiency of medical work;Thirdly,the ideological solidification of department personnel.To some extent,influenced by the previous "old leads new" teaching model,it is easy to have fixed thinking and lack innovation;Fourthly,the admitted diseases are relatively single,mainly respiratory and digestive system diseases,and the development of subject business is limited.Optimization plan for improving pediatric performance:A "Lean Department" model of"Balanced Scorecard+Lean Management" was proposed to apply lean management systems to improve pediatric operational performance.The basic architecture of this model presents a building structure with a roof as the overall strategic goal of lean department construction.The main body of the house is "strategic planning and execution",which is an important path to achieve lean department construction and consists of three parts from left to right.Firstly,in the first part on the left,using the four dimensions of the Balanced Scorecard as the framework,following the implementation steps,formulate a strategic plan for the future development of pediatrics;The second part in the middle is the execution of strategy,utilizing lean related methods or tools such as lean improvement projects,6S on-site management,visual management,and standard operations to ensure the specific implementation of strategic decomposition goals.On the right is the third part,which aims to improve the operational mechanism of the department and support problem-solving and strategic execution.Clarify that the Science and Technology Committee of the department is the highest organization for department management,with a Quality and Safety Management Group,a Department Operations Group,etc.,and a dedicated person responsible,with clear responsibilities,to ensure that all work is carried out according to the plan.Pediatric performance improvement effect:Firstly,patient and healthcare staff satisfaction has increased.In terms of employee satisfaction,in terms of internal satisfaction,the satisfaction of medical staff within the department with the opportunity to independently decide how to complete work increased from 3.79 points to 3.98 points,and the satisfaction with the sense of achievement I can obtain from work increased from 3.72 points to 4.04 points;In terms of external satisfaction,medical staffs satisfaction with the reward they receive for outstanding work performance increased from 3.69 points to 3.92 points,and the improvement was statistically significant.According to interviews,the complaint rate of pediatric patients has decreased and satisfaction has increased.Secondly,optimizing the income and expenditure structure and controlling costs,the proportion of drugs continues to decrease,and the improvement is statistically significant.Thirdly,promote the development of pediatric professional disciplines.The professional classification is more clear,with a year-on-year increase of 192.6%in the number of pediatric specialized diseases,and a diversification of pediatric characteristic disease types and operational types;The number of MDTs has increased,and specialized wards such as PICU and Child Health Development Center have been established.Fourthly,optimize the department environment and layout.Fifth,the lean cultural atmosphere within the department has gradually formed,forming a department culture where all staff participate in improvement.Sixth,pediatrics has achieved varying degrees of improvement in three aspects:"single disease cost","consistency of diagnosis and treatment quality",and "timely diagnosis and treatment"(P<0.05),while the improvement effect is limited in three aspects:"rapid diagnosis and treatment","adaptability to changes in diagnosis and treatment business portfolio",and "flexibility to adapt to changes in patient numbers".Analysis of influencing factors of lean implementation:Through qualitative interviews with pediatric healthcare professionals at C Hospital,the results showed that leadership,understanding of lean related tools and technologies,teamwork and employee engagement,measurement and evaluation of results,and the current development status of the department all have an impact on the implementation effectiveness of lean management.Conclusion and suggestionThrough the analysis of the implementation conditions,design and implementation process,implementation results and influencing factors of pediatric lean management in C Hospital,the following conclusions are drawn:After the introduction of lean management in pediatrics,the "Balanced Scorecard+Lean""Lean Department" management model achieved initial results,forming a systematic department development plan and laying the foundation for the future development of pediatrics;Secondly,the implementation of lean management in the department system has effectively improved the overall performance of the department;Thirdly,the regular department operation meeting mechanism focusing on key indicators and task achievement,as well as reasonable suggestions from employees,provide a reliable mechanism for continuous improvement of department operation performance;Fourthly,promoting lean management through the system has stimulated employees’ enthusiasm for independent management;Fifth,the cognition of medical personnel has shifted from experiential management to scientific management.Lean management was recognized by the medical staff in the department,and the improvement of the whole staff took shape and formed a lean atmosphere.However,it is also challenging to maintain the improvement effect brought by lean.Lean is a process of continuous improvement.Therefore,in the future,we should expand the team composition,systematize lean training,and make lean continue to develop.Based on the above conclusions,the following suggestions are put forward:(1)Strengthen the study of lean theory and pay attention to the cultivation of lean professional talents;(2)Emphasize the cultivation of lean leadership and combine lean implementation with development strategies;(3)Full participation,real-time tracking,and continuous improvement.