Journal of Hayat
حیات
Hayat
Medical Sciences
http://hayat.tums.ac.ir
1
admin
1735-2215
2008-188X
fa
jalali
1402
10
1
gregorian
2024
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29
4
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fulltext
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بررسی فرایند گردش بیمار و شناسایی فرصت های بهبود و ارتقای آن مبتنی بر مدیریت ناب با استفاده از رویکرد شش سیگما در اورژانس بیمارستان
Investigating the process of patient flow and identifying opportunities for its improvement based on lean management using the Six Sigma approach in the emergency department
مراقبتهاي پرستاري
Nursing Care
پژوهشي
Research
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">زمینه و هدف: </span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="letter-spacing:-.2pt">با توجه به اهمیت بخش اورژانس در ارایه خدمات سریع و با کیفیت، امروزه بر مدیریت ناب برای کاهش اقدامات بی­فایده و بدون ارزش افزوده در یک فرایند تأکید می­شود. مطالعه حاضر با هدف تعیین­ فرایند گردش بیمار و شناسایی فرصت­های بهبود و ارتقای آن با به­کارگیری روش شش سیگما به عنوان یکی از مهم</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="letter-spacing:-.2pt"></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="letter-spacing:-.2pt">ترین زیرسیستم­های مدیریت ناب، در اورژانس بیمارستان آموزشی منتخب کرمان انجام گرفته است</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">.</span></span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">روش بررسی:</span></span></span></span></i></b><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="letter-spacing:-.1pt">پژوهش حاضر از نوع مطالعه ترکیبی متوالی است که به­صورت کمی و کیفی در چهار ماه پایانی سال 1400 و در اورژانس تخصصی قلب و اعصاب کرمان انجام گرفت. در این مطالعه جهت کاربرد مدیریت ناب از روش شش سیگما با رویکرد </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">DMAIC</span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="letter-spacing:-.1pt"> در چهار گام و اسپاگتی چارت استفاده شد. جامعه پژوهش شامل کلیه بیماران اورژانس به تعداد 180 نفر بود. داده­ها در این مطالعه با استفاده از فرم­های محقق ساخته گردآوری و جهت تجزیه و تحلیل داده­ها از نرم­افزار </span></span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">Excel</span></span></span></i><i> </i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="letter-spacing:-.1pt">نسخه 2013 استفاده گردید</span></span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="tab-stops:163.05pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">یافتهها</span></span></span></span></i></b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">: </span></span></span></span></i><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">با بررسی فرایندها و نیز استفاده از نمودار اسپاگتی چارت، عمده­ترین مشکلات طولانی شدن مدت زمان پذیرش بیمار در بخش اورژانس قلب و اعصاب شناسایی شد. در صورت اجرایی شدن راهکار حضور نیروی پذیرش در تریاژ برای پذیرش بیماران سطح 1تا3، مسافت و زمان اضافی برای پذیرش بیمار حذف خواهد شد</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.2pt">.</span></span></span></span></i></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">نتیجهگیری: </span></span></span></span></i></b><i><span lang="FA" style="font-size:10.0pt"><span b="" style="font-family:" yagut="">استفاده از تفکر ناب در بخش اورژانس با بهکارگیری شش سیگمای ناب و اسپاگتی چارت با کوتاه­سازی فرایند ارایه خدمات، موجب بهبود جریان فعالیت بیماران، ارایه خدمات با کیفیت در اسرع وقت، کاهش زمان ارایه خدمات و در نتیجه افزایش رضایت آن­ها خواهد شد</span></span></i><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><i><span lang="AR-SA" style="font-size:10.0pt"><span b="" style="font-family:" yagut=""><span style="color:black"></span></span></span></i></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Background & Aim:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Given the importance of the emergency department in providing prompt and high-quality services, the emphasis on lean management has increased to minimize non-value-added and wasteful activities within a process. The aim of the study was to determine the process of patient flow and identify opportunities for its improvement using the Six Sigma method as one of the most important subsystems of lean</span></span> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">management, in the emergency department of the selected teaching hospital in Kerman</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Methods & Materials:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">The current research is a sequential mixed-method study conducted in 2022 within the cardiovascular and neurological emergency department in Kerman. The Six Sigma method, specifically the DMAIC approach consisting of four steps, was employed in conjunction with spaghetti charts to implement lean management principles. The research population included 180 patients referred to the cardiovascular and neurological emergency department. The data were collected using researcher-developed forms, and Excel software version 2013 was used to analyze the data</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="vertical-align:top"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"><span style="layout-grid-mode:line">Results:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.3pt">By examining the processes and using the spaghetti chart, the main problems contributing to prolonged patient admission time in the cardiology and neurology emergency department were identified. The implementation of a strategy involving the presence of admission staff during triage for level 1 to 3 patients will eliminate the additional distance and time required for patient admission</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt">.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"><span style="layout-grid-mode:line">Conclusion:</span></span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">The use of lean thinking principles in the emergency department with the implementation of Lean Six Sigma and Spaghetti Chart by streamlining the service process, will result in improving patient flow, providing timely quality services, reducing service delivery time, and ultimately increasing patient satisfaction.</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.3pt"></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"></span></span></span></b></span></span></span></span></span><br>
بهبود کیفیت, شش سیگمای ناب, بیمارستان, بخش اورژانس
quality improvement, lean six sigma, hospital, emergency department
374
392
http://hayat.tums.ac.ir/browse.php?a_code=A-10-4445-2&slc_lang=fa&sid=1
Mahmoud
Nekoei Moghadam
محمود
نکویی مقدم