Possibilities of visualization as a lean method in the management of medical organizations

I.P. Pavlov Russian Medical Biological Herald

Брынза³

2020

Self Cite

Currently, the primary health care system is undergoing active reformation. Lean manufacturing technologies are being introduced into the activities of medical organizations that help reduce the loss of medical and auxiliary processes. One of the main methods of lean production is visualization, which is implemented in the operational management of a medical organization in the form of creating information centers (InfoCenters) that reflect the main parameters of the activity of a medical organization in the SQDCM system: safety, quality, order execution, costs and a comfortable environment. Criteria of safety of medical activity most relevant for the national healthcare system are parameters of epidemiological safety. A parameter most difficult for indication, but necessary for reflection of epidemiological diagnostics in the InfoCenter is the accident rate at work. Aim. Generalization of literature data on the possibility of including epidemiological safety parameters into the operational assessment of the InfoCenter. Epidemiological studies conducted in our country in medical organizations of various profiles show an increasing rate of emergency situations among the medical personnel. With this, the system of indication and identification of all emergency cases still remains imperfect, and medical personnel often hide cases of emergency situations. Conclusion. Introduction of criteria of epidemiological safety into the practical activity of a medical organization as a component of the operational management unit of the InfoCenter will contribute to the formation of functioning and constantly improving system of analysis of the activity of medical organizations, to the control of provision of medical care, and to standardization of invasive procedures to ensure epidemiological safety. The key tasks of the InfoCenter are: focusing the attention of medical organization employees on problems, prompt response to emerging problems and risks, and also ensuring effective communication of all participants of operational meetings in a single information space.

Section: эпидемиологическая безопасность как компонент блока оперативunclassified

Epidemiological safety as a component of the operational management unit of the infocenter in introduction of lean manufacturing in a medical organization that provides primary health care

I.P. Pavlov Russian Medical Biological Herald

Брынза³

2020

Self Cite

Assessment of levels of navigation systems of medical organizations from the position of lean production

Issled. prakt. med. (Print)

Брынза

2020

Purpose of the study. To evaluate the level of detail, the amount of visualized data and the levels of navigation systems of primary medical organizations.Materials and methods. The object of this study was 33 primary care medical organizations located on the territory of 7 constituent entities of the Russian Federation. The subject of the study was all the internal and external navigation elements of the MO. The assessment was based on the ALIDS checklist (version 1.0) of 72 indicators, united by five characteristics in general characteristics: architectural-planning and design solutions, transmitted information, levels and navigation elements. The “Levels” block was represented by 19 parameters with a separate assessment of the internal level (9 indicators), the intermediate level (5 indicators) and the external level (5 indicators) of navigation. For each criterion, a nominal dichotomous point score was set with the possibility, if necessary (doubt, clarification, question, etc.) of indicating an expert comment.Results. A full-time study of the navigation systems of 33 primary medical organizations found that the levels of intermediate and external visualization are not used enough. Unlike architectural and planning solutions, various levels of navigation are maximally represented in medical institutions of the Tyumen and Kaliningrad regions, Krasnoyarsk Territory. The lack of an external level of navigation contributes to the main losses of lean production: unnecessary movement, unnecessary transportation and expectations from patients and visitors. Among the objects of internal navigation, cabinets and safety signs are most often placed on the navigation elements. The maximum percentage of compliance among the intermediate navigation category has been established for the main entrances for visitors, including entrances for patients with limited mobility.Conclusion. The navigation system of a medical organization is an important part of the visualization system and one of the criteria for the quality of space. The qualimetry of navigation systems not only of medical organizations, but also of any other buildings and premises, is currently not conclusively presented. Using the author's ALIDS method of audit of navigation systems allows us to give a quantitative and qualitative assessment of the navigation elements used in medical institutions. While improving the navigation systems of existing medical organizations and designing/building new ones, especially with complex mixed or section planning, in order to reduce the main losses of lean manufacturing, it is necessary to create the most detailed and understandable general navigation schemes.

Supply of hospitals’ navigation system accessibility for various population groups from the perspective of lean production

Мазунина

Issled. prakt. med. (Print)

et al. 2021

The review is devoted to the analysis of the capabilities of modern navigation systems of healthcare facilities to supply an acceptable level of accessibility to the perception of navigation information for various categories of citizens. The hospitals’ navigation system is considered to be the most important part of the visualization system and one of the basic criteria for the quality of the space of health facilities when forming a new model of a medical organization providing primary health care in the framework of the federal project «Development of a primary health care system» of the national project «Healthcare». From the viewpoint of the management concept of lean production, the hospitals navigation system should be aimed at the complete elimination or reduction of unnecessary movements of visitors, as well as other types of basic and additional losses. The accumulated experience in implementing projects with the implementation of the concept of lean production in outpatient medical institutions of the Russian Federation suggests that a rationally designed and deployed navigation system can be an effective tool for visualization in a lean production methodology. Structural and technological solutions of an effective hospitals navigation system introducing the concept of lean production should take into account the possibility of perceiving navigation information by all population groups, including people with limited mobility: people with disabilities, people with disabilities, people with prams, etc. Technical means of informing, orienting and signaling for people with limited mobility is a complex of various technical means for providing visual, tactile, sound information, orientation in space. In addition, they indicate possible directions of movement and places of receipt of services that contribute to the accessibility, safety, information content and comfort of the healthcare facility. Modern hospitals must meet the requirements of ensuring accessibility and safety for people with disabilities and other people with limited mobility due to the implementation of a complex of architectural and planning, engineering, ergonomic, structural and organizational measures of the state program «Accessible Environment». The navigation system can be a key tool for these activities.