Sağlık hizmet süreçlerinin yalın düşünce aracılığıyla geliştirilmesi

Hastalar sağlık hizmetlerindeki israf ve değişkenlik nedeniyle bakım süreçlerinde sorunlar yaşamaktadır. Hastaların bu problemler nedeniyle yaşadıkları rahatsızlığa rağmen, hizmet sağlayıcılar aşırı işyükü ve örgütsel kargaşa nedeniyle şikayetler ile ivedilikle ilgilenememektedir. Bu çalışmanın amacı Türkiye’de Eskişehir ilinde hizmet veren bir kamu hastanesinin Fizik Tedavi ve Rehabilitasyon servisinde yaşanan operasyonel problemlerin çözümünde yalın tekniklerin uygulanmasıdır. Süreç, yalın tüketim bağlamında hem hasta hem de hizmet sağlayıcı bakış açısından eş zamanlı olarak analiz edilmiştir. Genchi gembutsu, değer akış haritalama (DAH), bütünleşik tüketim ve tedarik haritası, A3 ve heijunka bu çalışma kapsamında kullanılan yalın tekniklerdir. Sistemin haritalandırılması örgütsel karmaşıklığın çözülmesi için fırsat sunmaktadır. Sonuç olarak, heijunka uygulaması kapsamında tasarlanan günlük ve haftalık atama algoritmaları ile hemşirelerin bilişsel yükü azaltılmıştır. Ayrıca gerçekleştirilen iyileştirmeler sonucunda hasta akış süresinde %26.84, süreç adımlarında ise %14.28 azalma kaydedilmiştir.

Anahtar Kelimeler:

Sağlık hizmeti, Yalın düşünce, Değer akış haritalama, Heijunka, A3

Improving healthcare service processes by lean thinking

Patients are getting in trouble with care processes due to waste and diversity in health care services. Although patients feel uncomfortable with these problems, service providers do not deal with their complaints promptly due to excessive workload and organizational disorder. The aim of this study is to implement lean techniques to solve the operational problems of a public hospital physical therapy and rehabilitation service in Eskisehir, Turkey. The process is analyzed both from the patient and service provider perspectives simultaneously in lean consumption context. Genchi gembutsu, value stream mapping (VSM), integrated consumption and provision map, A3 and heijunka were the lean techniques used. Mapping of the system gives the opportunity to relax the organizational complexity. Consequently, cognitive load of nurses is decreased with daily and weekly assignment algorithms designed as part of heijunka implementation. Also 26.84% of patient flow time and 14.28% of process step reduction are recorded as a result of realized improvements.

Keywords:

Healthcare service, Lean thinking, Value stream mapping, Heijunka, A3,

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