BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach ...BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called "lean" management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction.展开更多
<strong>Introduction:</strong> Healthcare industries have seen recent movements towards continuous quality improvement. The healthcare regulators shifted towards a market-driven approach of turning patient...<strong>Introduction:</strong> Healthcare industries have seen recent movements towards continuous quality improvement. The healthcare regulators shifted towards a market-driven approach of turning patient satisfaction surveys into a quality improvement tool for overall organizational performance. Data concerning this has remained limited in private sector in Zimbabwe. Thus, this study aims to determine patients and health workers perception about health services offered at Galen house in order to enable the institution to come up with evidence-based interventions to improve the quality of healthcare services. <strong>Methods:</strong> This was a descriptive cross sectional study. It was a mixed qualitative and quantitative study involving data collected from patients/ guardians and health workers at Galen House from January 2019 to March of the same year. Data was analysed using Microsoft Excel version 2013. <strong>Results:</strong> There were a total of 270 patients involved into the study. 173 (64%) perceived the waiting before services as good. 213 (79%) perceived the total waiting time as not long. Privacy 215 (80%) and confidentiality 223 (83%) perceived as good by patients. More than 50% of health workers perceived health services offered at Galen House as good. Staff attitude was perceived as good 191 (71%) by patients in contrary to some instance by health workers. Affordability of services was perceived as manageable. <strong>Conclusion:</strong> The total waiting time was perceived as not long at Galen House. Staff attitude was perceived differently by patients and health workers. Improving those two will contribute to more utilization of services by the community.展开更多
文摘BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called "lean" management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction.
文摘<strong>Introduction:</strong> Healthcare industries have seen recent movements towards continuous quality improvement. The healthcare regulators shifted towards a market-driven approach of turning patient satisfaction surveys into a quality improvement tool for overall organizational performance. Data concerning this has remained limited in private sector in Zimbabwe. Thus, this study aims to determine patients and health workers perception about health services offered at Galen house in order to enable the institution to come up with evidence-based interventions to improve the quality of healthcare services. <strong>Methods:</strong> This was a descriptive cross sectional study. It was a mixed qualitative and quantitative study involving data collected from patients/ guardians and health workers at Galen House from January 2019 to March of the same year. Data was analysed using Microsoft Excel version 2013. <strong>Results:</strong> There were a total of 270 patients involved into the study. 173 (64%) perceived the waiting before services as good. 213 (79%) perceived the total waiting time as not long. Privacy 215 (80%) and confidentiality 223 (83%) perceived as good by patients. More than 50% of health workers perceived health services offered at Galen House as good. Staff attitude was perceived as good 191 (71%) by patients in contrary to some instance by health workers. Affordability of services was perceived as manageable. <strong>Conclusion:</strong> The total waiting time was perceived as not long at Galen House. Staff attitude was perceived differently by patients and health workers. Improving those two will contribute to more utilization of services by the community.
