Tham khảo tài liệu 'six sigma projects and personal experiences part 13', kỹ thuật - công nghệ, cơ khí - chế tạo máy phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | 9 Adapting Lean Processes for the Hospital Surgical Environment Jaideep J Pandit1 and Meghana Pandit2 Consultant Anaesthetist Senior Clinical Lecturer John Radcliffe Hospital and University of Oxford Consultant Gynaecologist Milton Keynes Hospital Foundation Trust Milton Keynes United Kingdom 1. Introduction Hospital operating theatres are a focus for cost reduction especially as expenses can run into billions of dollars in the United Kingdom s National Health Service theatres have been estimated to cost 1 billion . About 46 of patients discharged from hospital have undergone surgery Gordon et al. 1988 Audit Commission 2003 Berwick 2005 Cegan 2005 . Yet cancellation rates can reach up to 20 and waiting lists for surgery exist in many countries Gauld Derrett 2000 Buhaug 2002 Bellan 2008 . The concepts of Lean or Six Sigma thinking have shown great promise in industry because they seek to reduce variations in inputs eg in quality of raw materials or steps in manufacturing processes which increases efficiency and reduces costs. Although attempts have been made to apply these concepts to healthcare it is not proven that their introduction has made progress or reduced costs Vest Gamm 2009 Pandit et al. 2010 . Therefore these ideas may need considerable adaptation for the healthcare setting. This article focuses on three approaches to help understand the problems and therefore to solve them first the notion of matching surgical capacity to demand for surgery second the idea of what constitutes efficiency and productivity in a surgical list and third we describe how effective planning of a surgical list using quantitative data reduces over-runs and patient cancellation. Together these ideas demonstrate how Lean is suitably adapted to the existing circumstances in the surgical-anaesthetic setting. At the outset it is important to distinguish between operational strategic and tactical decision-making in relation to operating theatre management. Operational decisions concern
