Applying Lean Thinking to Improve Patient Discharge Process, Female Medical Ward 1, Buddhachinnaraj Phitsanulok Hospital
Keywords:
Applying lean concepts, Distribution process, Internal MedicineAbstract
Rapid patient discharge is a part of providing efficient and responsive service to the needs of the customer. The purpose of this study was to improve the patient discharge process in Female Medical Ward 1, Buddhachinnaraj Phitsanulok Hospital, by using the Lean Thinking Concept of Womack and Jones (2003). The sample included 32 personnel that are involved in the patient discharge process and discharge activities and the numbers of the activities in nursing service during July to September 2017. The research instruments included: 1) a table for describing the activities of the discharge process, 2) a form for value analysis of discharge activity, 3) a record form for time spent on discharge activity 4) the focus group interview guidelines regarding problems and recommendations. These research instruments were validated by three experts. The inter-rater reliability of two observers for the recorded time was 1.0. Data were analyzed using descriptive statistics
The results revealed that:
- The patient discharge process improvement applying Lean thinking in Female Medical Ward 1 consisted of five major activities and 15 minor activities which is a reduction from the original 20 minor activities for the process before improvement.
- The standard time of the improved patient discharge process applying Lean thinking in Female Medical Ward 1 was greatly reduced to 56.13 minutes from the original standard time of 247.00 minutes before improvement.
- The problems of applying Lean Thinking to improve discharge process in Female Medical Ward 1 include: 1) personnel who were familiar with the old routine discharge process 2) the usual high workload of the nurses leaves limited time to do some of the improved discharge activities 3) different understanding of personnel regarding the Lean Thinking. The recommendations included continuous supervision, supporting and assisting personnel, matching the staffing to the workload, and developing a plan to educate personnel about the concepts of Lean Thinking.
The results of this study revealed that the improvement of the patient discharge process using the Lean thinking can reduce the process and duration of the operation.
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