Sağlık hizmet süreçlerinin yalın düşünce aracılığıyla geliştirilmesi

Yıl 2018, Cilt: 24 Sayı: 4, 739 - 748, 17.08.2018

Nurcan Deniz Feriştah Özçelik

Öz

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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