Improving access to health services - challenges in Lean application
Improving access to health services - challenges in Lean application
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DOI：
10.1108/ijpsm-05-2014-0066
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发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Dehe, Benjamin
中科院分区：
文献类型：
--
作者：
Cheng, Siu Yee;Bamford, David;Dehe, Benjamin
目的-医疗保健组织面临着巨大的生产力压力，正在经历重大的服务转型。本文的目的是传播精益医疗项目的研究结果，使用国家卫生服务单点接入环境作为案例研究。它展示了精益可以应用于这种类型的医疗服务设置的相关性和程度。设计/方法/方法-应用行动研究和精益工具来建立当前状态的过程，识别浪费，并根据定义的客户价值开发服务改进机会。结果-转介信息的质量被认为是一些过程浪费的根本原因和服务失败的原因。认识到与服务的客户/供应商的关系和互动的性质，可以带来更有效和可持续的服务改进机会，共同创造价值。它也认识到，并不是所有的精益原则可以适用于这种类型的healthcare setting.Practical影响-这项研究是有用的组织使用精益进行服务改进活动。本文概述了如何扩展的价值流超越组织，包括供应商可以导致改进的合作生产和生成的服务value. Origality/值-这项研究有助于服务生产率的研究，通过展示在一个新的医疗服务设置的相关性和局限性的精益应用。案例研究表明了在互惠服务设计模型中实施精益的实际挑战，并为现有的上下文模型增加了有效性。
Purpose - Healthcare organisations face significant productivity pressures and are undergoing major service transformation. The purpose of this paper is to disseminate findings from a Lean healthcare project using a National Health Service Single Point of Access environment as the case study. It demonstrates the relevance and extent that Lean can be applied to this type of healthcare service setting.Design/methodology/approach - Action research was applied and Lean tools used to establish current state processes, identify wastes and develop service improvement opportunities based upon defined customer values.Findings - The quality of referral information was found to be the root cause of a number of process wastes and causes of failure for the service. Recognising the relationship and the nature of interaction with the service's customer/supplier lead to more effective and sustainable service improvement opportunities and the co-creation of value. It was also recognised that not all the Lean principles could be applied to this type of healthcare setting.Practical implications - The study is useful to organisations using Lean to undertake service improvement activities. The paper outlines how extending the value stream beyond the organisation to include suppliers can lead to improved co-production and generation of service value.Originality/value - The study contributes to service productivity research by demonstrating the relevance and limitations of Lean application in a new healthcare service setting. The case study demonstrates the practical challenges of implementing Lean in reciprocal service design models and adds validity to existing contextual models.