2021 № 1 Applying lean manufacturing technologies to optimize ambulance operations amid the spread of COVID‑19
The pandemic of new coronavirus infection COVID‑19 has become a serious challenge for the national health
systems, including Russia, setting ambitious goals aimed at preventing the spread of infection and maintaining the availability of medical care in environment of increasing pressure. The aim of the study was to develop, based on the principles of lean production, a set of measures to increase the availability of emergency medical services for patients diagnosed with or suspected of a new coronavirus infection COVID‑19 in the Tomsk Region. Standard tools of lean manufacturing are applied to the work process of the admission department of the respiratory center in RSBHI «Medical sanitary station № 2». As a result of implementation of target state map, which provides for the optimization of process of transferring a patient diagnosed or suspected of a new coronavirus infection COVID‑19 to admission department, a positive dynamics of local (5.4 times increase in the proportion of calls completed within 15 minutes after the patient was delivered to the admission department) and system (an increase of 1.3 times in the proportion of calls with the time the ambulance team reaches the patient within 20 minutes) indicators of the ambulance service was achieved. The study confirms the effectiveness of lean manufacturing tools for optimizing the work of ambulance and allows us to recommend them for use in a pandemic and other risks of emergency.
2019 № 9 Application of lean management in medical examination of children in Tomsk region
The object of the study is the process of preventive medical examination of children of the first year of life, which can be improved on the basis of the principles of lean production. As part of a joint project of the Ministry of health of Russia and Rosatom state Corporation “Lean clinic”, which is designed to improve the efficiency of medical organizations and the availability of their assistance by introducing elements of lean production in public health institutions on a systematic basis, in the Tomsk region on the basis of a pilot medical organization – children’s clinic – a project was implemented to introduce lean technologies in the process of preventive examination of children of the first year of life, in order to minimize the loss of time when receiving medical services by the patient. The main directions of optimization: improving the productivity of the process using the mapping method; increasing the productivity of a single workplace using the 5C technique; increasing the productivity of the movement of medical staff using the Spaghetti diagram. During the project, the logistics scheme of patients and staff movement was significantly improved, and a route map was developed, which was issued to the parents of patients in the registry of the medical organization. In addition, in order to assess the effectiveness of the developed measures before the project and after its implementation, a sociological survey was conducted among the parents of children undergoing pre¬ventive medical examination, which allowed to assess the level of their satisfaction with the assistance provided. As a result of the implementation of the project on the introduction of lean technologies, it was possible to achieve the goals, in particular, to reduce by almost 3.5 times the time spent by patients on the passage of a full cycle of preventive examination, to reduce to 2 number of visits to the clinic, as well as to increase comfort of staying in the institution of patients and their parents.