Identifying and eliminating inefficiencies in information system usage: A lean perspective
Identifying and eliminating inefficiencies in information system usage: A lean perspective
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DOI：
10.1016/j.ijmedinf.2017.08.005
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发表时间：
2017-11-01
影响因子：
4.9
通讯作者：
Jaspers, Monique
中科院分区：
文献类型：
--
作者：
Blijleven, Vincent;Koelemeijer, Kitty;Jaspers, Monique
目标：信息系统（IS）规定的工作流程和IS用户的实际工作流程之间经常发生不匹配。由此造成的工作流程受阻对生产和向客户交付货物或服务的效率产生了负面影响。在医疗保健方面，阻碍工作流程可以另外有一个负面影响的安全性和有效性的护理交付给patient.Methods：本研究评估的影响，一个大型大学医院的电子健康档案系统的工作流程的医疗专业人员从精益管理废物的角度。工作流程不匹配的直接观察和后续的半结构化的医生和护士的访谈和评估方面产生的waste generated.Results：在总共241废物的表现形式，并根据8种类型的废物进行了分类。此外，还发现了已确定的废物表现形式之间值得注意的关系，其中包括每种废物发生频率的差异，某些类型的废物具有级联效应，以及由于模仿和模仿行为而导致的废物激增。从这项研究中获得的知识可以支持IS的（重新）设计，以更好地匹配工作流程，从而可能导致更安全，有效和高效的病人护理。
Objectives: Mismatches frequently occur between information system (IS) dictated workflows and actual workflows of IS users. The resulting impeded workflows negatively influence the efficiency with which goods or services are produced and delivered to customers. Within a healthcare context, impeded workflows can additionally have a negative impact on the safety and effectiveness of care delivered to patients.Methods: This study evaluates the impact of an electronic health record system of a large university hospital on workflows of healthcare professionals from a lean management waste perspective. Workflow mismatches were identified from direct observations and follow-up semi-structured interviews with physicians and nurses and assessed in terms of waste generated.Results: In total, 241 manifestations of waste were identified and classified according to 8 types of waste. Furthermore, noteworthy relationships among the identified manifestations of waste were found. These include differences in frequency per type of waste, certain types of waste having a cascading effect, and waste proliferating as a result of mimicked and routinized behavior.Conclusions: The knowledge obtained from this study can support (re) design of IS to better match workflows which may subsequently lead to more safe, effective and efficient patient care.