Please use this identifier to cite or link to this item: http://dspace.lib.uom.gr/handle/2159/25565
Author: Μαυρομουστάκη, Ολίβια
Title: Lean thinking application in the emergency department of Hippokration general hospital of Thessaloniki
Date Issued: 2020
Department: Πρόγραμμα Μεταπτυχιακών Σπουδών Διοίκηση Υπηρεσιών Υγείας
Supervisor: Τσιότρας, Γεώργιος
Abstract: Objectives: This study had two main aims. The first aim was to evaluate the current patient flow in the Emergency Department of Hippokratio General Hospital of Thessaloniki in terms of time metrics (both waiting time and actual time spent) in every procedure from the secretarial registry to the final hospital admission or discharge with the administration of a questionnaire to the involved patients while the second aim was, based on the questionnaire findings and interviews with the involved working staff in the ED to apply means and tools of Lean Thinking to identify potential causes of delayed patient flow and propose counter measures aiming to improve the patients’ flow in the ED. After a period of time, the applied countermeasures were evaluated in terms of time metric parameters from the involved patients in order to assess whether there was any improvement or not after the countermeasure implementation. Results: At first, an assessment of the waiting times and actual duration of all 7 procedures was made by asking 644 patients who visited the ED from January 2020 to June 2020 to full in a well-structured self-administered anonymous with multiple-choice questions. It was shown that Laboratory Testing was the one with the higher patient times both in terms of waiting (28.1 minutes) and actual duration (125.4 minutes) while for Clinical assessment, Patient triage, Secretarial registry and Patient discharge or hospitalization, the patients had to wait for at least 15 minutes for each process. The total lead time of an average patient visit at the ED was 406.6 minutes with the average no-value-added time being 119.7 and the value-added time being 287.1 corresponding to 29.43% and 70.57% respectively of the average total lead time during patient flow. After all the patient time metrics were calculated, 34 healthcare professionals, were asked about the procedures, practices, policies and methods that are applied and followed in their ED as well as what they think could be done to improve the entire patient flow with smaller time metrics. An A3 report was created based on the above observations and as a result a number of proper countermeasures were applied. Almost two months after implementation, 345 patients were asked to estimate their total waiting time during each of the previously described procedures from Secretarial registry to Patient discharge or hospitalization as well as the actual time spent for the process itself. It was revealed that every time metric parameter was significantly improved. In terms of patient waiting times, the procedures of Final Diagnosis, Imaging Analysis and Secretary Registry were the ones that showed the greatest improvement having a time improvement index of 54.5%, 49% and 45.7%. with the improvement index in the remaining procedures ranging from 21% to 38.1%. The overall average waiting time was decreased from 119.7 minutes to 78.7 minutes showing an improvement by 34.2%. In terms of actual duration, all the procedures had improvement indices from 9.8% to 32.6% with Final Diagnosis being the most improved one (32.6%) followed by Laboratory Testing and Secretarial registry (28.1% and 28.5% respectively). The total average actual duration was decreased by over 60 minutes (from 287.1 minutes to 224.4 minutes) showing an improvement of 21.3%. Conclusions: The way lean management was designed and applied in terms of the ED of Hippokration Hospital revealed promising results with significant improvement indices in patient time metrics which is representative of how much could the hospital benefit from the implementation of total lean management in this working structure.
Information: Διπλωματική εργασία--Πανεπιστήμιο Μακεδονίας, Θεσσαλονίκη, 2020.
Appears in Collections:ΠΜΣ Διοίκηση Υπηρεσιών Υγείας (Μ)

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