2019 № 4 The experience and results of lean manufacturing introduction in health care
The World Health Organization gives notice an increasing demand for medical service on the one hand and a tendency toward deterioration of financial conditions in the healthcare system on the other that is the cause of the main concern in modern medical management. The article is considerate feasibility of using principles and methods of lean production for the purposes of organizing practical healthcare. Analyzed the results of lean production implementation of over the past few decades, the main early successes achieved using the tools and methods of lean production, as well as the basic limitations of the application are evaluated. Special attention is given to potential roles of the leader of healthcare institutions in lean production adaptation as well as evaluating the success of a strategy. A deep analysis of modern economic indicators of lean production successful implemen- tation in medical clinics abroad is presented, the key points of the effective introduction of lean production are being updated. In additional to economic indicators, the impact of lean production implementation in medical organizations on reducing mortality rates, transmission of nosocomial infections, mortality from hospital infections, reducing waiting times for medical services (especially in the admission department) is estimated. The current task facing the health care system in the Russian Federation is updated. The main conclusion is made about a huge amount of positive results after introducing lean production, including the positive economic effect and the increase in the quality of medical care after the introduction of the principles and methods of lean production, and also the entity of lean production as a separate method of organizing processes.
2020 № 1 Implementation of principles of lean production providing paid services in a medical organization
The aim of the study is to optimize the processes leading to increasing patient satisfaction level, providing accessibility to medical services, increasing efficiency and eliminating existing temporary financial and other losses using the implementation of lean manufacturing principles and tools. The experience of organizing medical services on a paid basis allowed us to establish a patient-oriented system in the provision of primary health care to the population.. Legislative and regulatory framework governing the provision of medical services on a paid basis, guidelines for the implementation of lean manufacturing principles in medical organizations. Mathematical, analytical and descriptive methods were used. Schemes for the implementation of medical services based on optimizing the flow of created values for the patient are proposed. Changes of some indicators of the medical organization activity are analyzed. Implementation of the principles and tools of lean production leads to the solution of the problems of the current healthcare system – the effective use of the personnel potential of a medical organization, the possibility of creation additional income source for medical workers within one healthcare facility.
2019 № 6 Management in modern management in foreign health care systems(scientific literature review)
This science literature review was conducted for five-year period. It has been established that the process of improvement by lean management has more than 50 years history in industry, and the experience is best carried out, in primary health care; the main of lean management introduction in healthcare is to ensure optimal participation of medical staff in the changes; the concept of medical care in the first place has the aim of improving the quality and availability of healthcare processes; mapping is a basic tool allows to visualize the process of changes and evaluate progress; project management is a method of comprehensive changes in healthcare in which the elements of lean management are also used to ensure general increase in the efficiency of transformations. Lean management is becoming increasingly scientific and practical tool in health management nowadays.
2020 № 9 Distributed ledger technology in patient experience management
Actuality. The role of “patient experience” in assessing quality of medical services is growing as a global trend to value-based healthcare. Currently, only 11% of the Russian population positively assess the quality of medical services. Federal law
No. 256-FZ requires all public healthcare providers to conduct an independent assessment of the provision of services, but 44% of
organizations do not have such assessment, that can be caused by methodological and organizational reasons.
Purpose of the study to evaluate the prospects for digital improvement of measuring patient satisfaction using distributed ledger
technology. To analyze the literature on the topic of independent assessment of the quality of services provided by medical organizations; to analyze modern approaches to assessing patient satisfaction with healthcare providers; to assess the opportunities of improving the processes and results of satisfaction assessment using distributed ledger technology.
Materials and methods. To achieve the purpose, the authors analyzed numerous relevant Russian and foreign sources of literature. Literature review was carried out across scientific libraries as eLIBRARY, PubMed by key words. The search in open sources in
Google and Yandex was used.
Results. The complexity of “patient experience” measurement, biased assessment, ambiguity of the results obtained and the difficulty of correct interpretation require more transparent methods of measuring the value of healthcare. A decentralized platform based on distributed ledge technology may become one of the possible solutions to the problem of objective assessment of patients ‘ satisfaction with the quality of medical services. Such approach allows to form an objective dynamic multi-factor rating of processes and all other components of healthcare services.
Conclusion. The existing mechanisms for independent assessment of the quality of medical services need to be improved. Confidence in the results of the patient satisfaction measurement is one of core requirement. To make managerial decision evidence-based, it is important to evaluate the processes and patient experience along with results of healthcare services. Distributed ledger technology implemented as a dynamic multi-factor rating platform can be a logical solution for improving the quality of services and could become a part of a comprehensive IT ecosystem based on value-based approach.