Hastaların Acil Servis Seçimi İçin Q Seviyeli Bulanık MAIRCA Yöntemi Önerisi

Yıl 2023, , 288 - 298, 31.12.2023

Burak Efe , Leyla Efe

https://doi.org/10.47112/neufmbd.2023.26

Öz

Acil serviste yalın hizmet uygulamaları sürecin iyileştirilmesini amaçlamaktadır. Acil serviste daha iyi hizmet verebilmek için hastaların hangi konularda şikâyetçi olduğunu belirlemek oldukça önemlidir. Yalının ilk aşaması olan değer kavramı hastaların belirtmiş olduğu değer kavramı olarak incelenmiştir. Bu çalışma ilk olarak hastaların acil serviste belirtmiş olduğu şikâyetleri belirlemiştir. Bu şikayetler; hastanenin temizliği ve sessizliği, güvenilir personel ve hizmet, ilk seferde doğru teşhis ve muayene, hastaların bilgilendirilmesi, hızlı ve doğru muayene, personele ihtiyaç anında ulaşabilmek, beklemelerin olmaması, ziyaret saatlerinin uygun olması, ilgili ve güler yüzlü personeldir. Bu şikayetler önerilen yöntemde kriter olarak ele alınmıştır. Kriterlerin önem dereceleri q seviyeli bulanık sayı kullanılarak uzman ekibin (1 Akademisyen,1 doktor ve 1 hemşire) görüşleri doğrultusunda hesaplanmıştır. Kriterlerin önem dereceleri belirlendikten sonra dört acil servisin sıralaması q seviyeli bulanık MAIRCA (Multi Attributive Ideal-Real Comparative Analysis) yöntemi kullanılarak belirlenmiştir. Bu çalışma yalın hizmet değer kavramının analizi için yeni bir bakış açısı sunmuş ve bu değerlerin önem derecelerine göre acil servisleri sıralayarak literatüre katkı sunmuştur.

Anahtar Kelimeler

Acil servis, MAIRCA, Q seviyeli bulanık sayı, Yalın hizmet

Q-Rung Orthopair Fuzzy MAIRCA Method Recommendation for Emergency Service Selection of Patients

Öz

Lean service practices in the emergency department aim to improve the process. In order to provide better service in the emergency department, it is very important to determine which subjects the patients complain about. The concept of value, which is the first stage of lean, was examined as the concept of value stated by the patients. This study first identified the complaints that patients reported in the emergency department. These complaints are the cleanliness and silence of the hospital, reliable staff and service, correct diagnosis and examination at the first time, informing the patients, fast and accurate examination, reaching the personnel when needed, no waiting times, convenient visiting hours, concerned and friendly staff. These complaints are considered as criteria in the proposed method. The importance levels of the criteria were calculated in line with the opinions of the expert team (1 academician, 1 doctor and 1 nurse) using the q-rung orthopair fuzzy number. After determining the importance degrees of the criteria, the ranking of the four emergency services was determined using the q-rung orthopair fuzzy MAIRCA (Multi Attributive Ideal-Real Comparative Analysis) method.

Anahtar Kelimeler

Emergency service, MAIRCA, Q-rung orthopair fuzzy number, Lean service

Kaynakça

• Ö. Efe, Yalın Hizmet/Değer Akışı Haritalama:Bir Acil Serviste Uygulanabilirliği, Yüksek Lisans Tezi, Selçuk Üniversitesi Fen Bilimleri Enstitüsü, Endüstri Mühendisliği Anabilim Dalı, Konya, 2011.
• Ö. Efe, O. Engin, Yalın Hizmet-Değer Akış Haritalama ve Bir Acil Serviste Uygulama, Verimlilik Dergisi. 4 (2012), 79-107.
• T. Alkan, S. S. Durduran, Analysis of House Selection Process with AHP Based TOPSIS Method, Necmettin Erbakan University Journal of Science and Engineering. 2(2) (2020), 12-21. doi:10.47112/neufmbd.2020.2.
• S. Ş. Kaya, K. Alaykıran, Failure Mode and Effects Analysis and an Application in the Casting, Necmettin Erbakan University Journal of Science and Engineering. 1(2) (2019), 76-89.
• M. A. Sayar, H. Z. Selvi, İ. Buğdaycı, Determination of Suruç Tent City Area by Analytic Hierarchy Method, Necmettin Erbakan University Journal of Science and Engineering. 1(1) (2019), 20-31.
• C. S. Kim, D. A. Spahlinger, J. M. Kin, J. E. Billi, Lean Health Care: What can hospitals learn from a world- class automaker?, Journal of Hospital Medicine. 1 (2006), 191-199. doi: 10.1002/jhm.68.
• T. Joosten, I. Bongers, R. Janssen, Application of lean thinking to health care: Issues and observations, International Journal for Quality in Health Care. 21(5) (2009), 341- 347. doi: 10.1093/intqhc/mzp036.
• E. W. Dickson, Z. Anguelov, D. Vetterick, A. Eller, S. Singh, Use of Lean in the Emergency Department: A Case Series of 4 Hospitals, American College of Emergency Physicians. 54(4) (2009a), 504-510. doi:10.1016/j.annemergmed.2009.03.024.
• E. W. Dickson, S. Singh, D. S. Cheung, C. C. Wyatt, A. S. Nugent, Application of Lean Manufacturing Tecniques in the Emergency Department, The Journal of Emergency Medicine. 37(2) (2009b), 177–182. doi: 10.1016/j.jemermed.2007.11.108.
• G. Büyüközkan, G. Çifçi, S. Güleryüz, Strategic analysis of healthcare service quality using fuzzy AHP methodology, Expert Systems with Applications, 38 (2011), 9407–9424. doi:10.1016/j.eswa.2011.01.103. [ C.C. Ho, Construct factor evaluation model of Health Management Center selected by customers with Fuzzy Analytic Hierarchy Process, Expert Systems with Applications. 39 (2012), 954–959. doi: 10.1016/j.eswa.2011.07.094.
• B. A. White, J. M. Baron, A. S. Dighe, C. A. Camargo Jr, D. F. Brown, Applying Lean methodologies reduces ED laboratory turnaround times, The American Journal of Emergency Medicine. 33(11) (2015), 1572-1576. doi: 10.1016/j.ajem.2015.06.013.
• N. Allaudeen, A. Vashi, J. S. Breckenridge, F. Haji-Sheikhi, S. Wagner, K. A. Posley, S. M. Asch, Using lean management to reduce emergency department length of stay for medicine admissions, Quality Management in Health Care. 26(2) (2017), 91-96. doi: 10.1097/QMH.0000000000000132.
• A. Al Owad, P. Samaranayake, A. Karim, K. B. Ahsan, An integrated lean methodology for improving patient flow in an emergency department–case study of a Saudi Arabian hospital, Production Planning & Control. 29(13) (2018), 1058-1081. doi: 10.1080/09537287.2018.1511870.
• M. Shakoor, M. R. Qureshi, S. Jaber, Applying Management Principles of Lean Manufacturing for Enhancing Efficiency and Effectiveness of Emergency Department Rooms, Jordan Journal of Mechanical & Industrial Engineering. 13(4) (2019), 291- 299.
• C. Verbano, M. Crema, Applying lean management to reduce radiology turnaround times for emergency department, The International Journal of Health Planning and Management. 34(4) (2019), e1711-e1722. doi: 10.1002/hpm.2884.
• B. Maliszewski, M. Whalen, C. Lindauer, K. Williams, H. Gardner, D. L. Baptiste, Quality improvement in the emergency department: a project to reduce door-to-electrocardiography times for patients presenting with chest pain, Journal of Emergency Nursing. 46(4) (2020), 497-504. doi: 10.1016/j.jen.2020.03.004.
• A. Daly, S. P. Teeling, M. Ward, M. McNamara, C. Robinson, The use of lean six sigma for improving availability of and access to emergency department data to facilitate patient flow, International Journal of Environmental Research and Public Health. 18(21) (2021), 11030. doi: 10.3390/ijerph182111030.
• D. Tlapa, G. Tortorella, F. Fogliatto, M. Kumar, A. Mac Cawley, R. Vassolo, Y. Baez-Lopez, Effects of lean interventions supported by digital technologies on healthcare services: a systematic review, International Journal of Environmental Research and Public Health. 19(15) (2022), 9018. doi: 10.3390/ijerph19159018.
• H. Leite, The role of lean in healthcare during COVID-19 pandemic, International Journal of Quality & Reliability Management. 40(6) (2023), 1389-1411. doi: 10.1108/IJQRM-10-2021-0353.
• S. Moffatt, C. Garry, H. McCann, S.P. Teeling, M. Ward, M. McNamara, The use of lean six sigma methodology in the reduction of patient length of stay following anterior cruciate ligament reconstruction surgery, International Journal of Environmental Research and Public Health. 19(3) (2022), 1588. doi: 10.3390/ijerph19031588.
• A. Jailani Harahap, C. Ginting, A. Nasution, A. Amansyah, The Effect of Lean Approach on Hospital Service Quality and Inpatient Satisfaction, Unnes Journal of Public Health. 12(1) (2023), 12-20. doi: 10.15294/ujph.v12i1.57692.
• A. Vanichchinchai, Relationships among lean, service quality expectation and performance in hospitals, International Journal of Lean Six Sigma. 13(2) (2022), 457-473. doi: 10.1108/IJLSS-11-2020-0210.
• E.P. Jesudason, Pushing sustainability up the surgical agenda: practical steps towards sustainable orthopaedic care, Orthopaedics and Trauma. 36(5) (2022), 274-278. doi: 10.1016/j.mporth.2022.07.004.
• R. R. Yager, Generalized orthopair fuzzy sets, IEEE Transactions on Fuzzy Systems. 25(5) (2016), 1222-1230. doi: 10.1109/TFUZZ.2016.2604005.
• R. Wang, Y. Li, A novel approach for green supplier selection under a q-rung orthopair fuzzy environment, Symmetry. 10(12) (2018), 687. doi: 10.3390/sym10120687.
• G. Wei, H. Gao, Y. Wei, Some q‐rung orthopair fuzzy Heronian mean operators in multiple attribute decision making. International Journal of Intelligent Systems, 33(7) (2018), 1426-1458. doi: 10.1002/int.21985.
• D. S. Pamucar, S. P. Tarle, T. Parezanovic, New Hybrid Multi-Criteria Decision-Making DEMATEL-MAIRCA Model: Sustainable Selection of a Location for the Development of Multimodal Logistics Centre, Economic Research- Ekonomska Istraživanja. 31(1) (2018), 1641-1665. doi:10.1080/1331677X.2018.1506706.