Search results

Healthcare organisations face significant productivity pressures and are undergoing major service transformation. The purpose of this paper is to disseminate findings from a Lean healthcare project using a National Health Service Single Point of Access environment as the case study. It demonstrates the relevance and extent that Lean can be applied to this type of healthcare service setting.

Action research was applied and Lean tools used to establish current state processes, identify wastes and develop service improvement opportunities based upon defined customer values.

The quality of referral information was found to be the root cause of a number of process wastes and causes of failure for the service. Recognising the relationship and the nature of interaction with the service’s customer/supplier lead to more effective and sustainable service improvement opportunities and the co-creation of value. It was also recognised that not all the Lean principles could be applied to this type of healthcare setting.

The study is useful to organisations using Lean to undertake service improvement activities. The paper outlines how extending the value stream beyond the organisation to include suppliers can lead to improved co-production and generation of service value.

The study contributes to service productivity research by demonstrating the relevance and limitations of Lean application in a new healthcare service setting. The case study demonstrates the practical challenges of implementing Lean in reciprocal service design models and adds validity to existing contextual models.

The purpose of this paper is to analyse whether internet forums are an appropriate source for identification of causes of dissatisfaction of patients with non-medical aspects of healthcare services.

Based on the guidelines of netnography qualitative research the authors identify relevant posts or comments on selected online forums in which web users show their dissatisfaction with healthcare services. Five popular Slovenian forums representing different interest communities have been chosen and 42 forums’ topics have been reviewed.

Online communities have an important role in exploring patient dissatisfaction. Through content analysis comments were coded into meaningful categories and subcategories.

Some comments were more explicit, while others have provided general and looser reasons for dissatisfaction, and in such cases coding and content analysis of comments was more difficult.

Contents expressed within online communities are helpful in designing improvement activities since they enable determination of concrete relevant measures aiming at eliminating and preventing the established causes of discontent, such as instituting new policies, introducing training programs, determining desired changes in culture.

Usefulness of the netnography as a qualitative method of research is confirmed through confirmation that causes of dissatisfaction of Slovenian patients, which have been identified in the authors research are similar to those identified in previous research in the field of patient satisfaction conducted in Slovenia. Results constitute a new form of researching patient dissatisfaction and expose the specific causes of patient dissatisfaction with healthcare services in Slovenia.

This paper aims to survey the literature relating to educational governance's application to healthcare. Its purpose is to establish the extent to which this type of governance is recognised by healthcare staff, and to develop an understanding of how it is defined and used.

The starting point for the literature review was an academic database search supplemented by a Google Scholar search. The results were sifted using evidence strength criteria and filtered for relevance using secondary keywords.

The educational governance in healthcare literature search indicates that this is a relatively under‐researched area. There are few attempts to define educational governance, although several authors note similarities with clinical governance. Authors cite educational governance as an important component of integrated approaches to healthcare governance, noting inter‐dependent relationships between areas such as clinical governance, organisational development and risk management.

Given the diverse academic and grey literature used for the review, it was difficult to apply conventional evidence‐strength scales, especially because most articles cited in the text are based on expert opinion rather than systematic review.

The review highlights educational governance's value to healthcare organisations and provides references for organisational staff contemplating developing this area.

The paper is the first known attempt to survey the literature relating to National Health Service educational governance.

The purpose of this paper is to highlight the importance of Lean methodology through an exhaustive literature review, and its implications and application in the service industry right from its initiation in 1990s till date.

The paper summarises the evolution of Lean in services and has systematically classified the reviewed literature in four dimensions, namely time, publisher, region and content. Further under “time” dimension, the literature is classified into Pre-Lean era, Lean awareness era, Lean Exploration era and Lean implementation era. Under the “content” dimension, the categories include theoretical foundation, frameworks/models and application/case studies.

The analysis inferred; Lean is gaining roads in services, though the research is still at nascent stage. Lean is applicable in services though transfer of Lean manufacturing principles to services has certain limitations because of the characteristics of services. The need is to focus on process difference between services and manufacturing. Respect for people and employment engagement is critical to Lean in service. The authors identified the necessity to standardise the Lean service definition, principles, and tools and to develop guidelines for structured implementation in service industry.

Though multiple databases have been taken-up but that does not assume that the literature presented in this paper is by any means comprehensive. Development of a standard model/framework for Lean services is critical for future research. Rigorous industry-specific studies, specifically in developing nations are another area for future research. Future studies could analyse the impact of join applications and possible links between Lean service and other approaches like TQM, Six Sigma, etc., with an aim of process improvement.

This paper would serve as a resource for Lean practitioners as well as researchers as a fundamental platform, contributing to Lean body of knowledge.

Service industry has special significance to the society in large. Many services including governments, public interest services, non-profit organisations, healthcare, banking, consulting, etc., has a significant share across markets. Lean being a proven methodology for successful process improvements has to be looked at from a services perspective. This paper helps in such interest.

Publications reviewing the adoption of Lean in services is scarce in literature. This paper serves as an excellent resource for research on the subject and will facilitate academicians and practitioners to objectively understand Lean in service sector.

Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran.

This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services – their frequency and severity – were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation.

Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures.

Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function.

Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.

Customer satisfaction's importance is well‐documented in the marketing literature and is rapidly gaining wide acceptance in the healthcare industry. The purpose of this paper is to introduce a new customer‐satisfaction measuring method – Reichheld's ultimate question – and compare it with traditional techniques using data gathered from four healthcare clinics.

A new survey method, called the ultimate question, was used to collect patient satisfaction data. It was subsequently compared with the data collected via an existing method.

Findings suggest that the ultimate question provides similar ratings to existing models at lower costs.

A relatively small sample size may affect the generalizability of the results; it is also possible that potential spill‐over effects exist owing to two patient satisfaction surveys administered at the same time.

This new ultimate question method greatly improves the process and ease with which hospital or clinic administrators are able to collect patient (as well as staff and physician) satisfaction data in healthcare settings. Also, the feedback gained from this method is actionable and can be used to make strategic improvements that will impact business and ultimately increase profitability.

The paper's real value is pinpointing specific quality improvement areas based not just on patient ratings but also physician and staff satisfaction, which often underlie patients' clinical experiences.