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Relationship-centered health care as a Lean intervention
Continuous improvement efforts, recognized in much literature as Lean management techniques have been used in efforts to improve efficiency in democratic health care contexts for some time to varying degrees of success. The complexity of the health care system is magnified by the sheer number of pro...
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Published in: | International journal for quality in health care 2017-12, Vol.29 (8), p.1020-1024 |
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Main Authors: | , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Continuous improvement efforts, recognized in much literature as Lean management techniques have been used in efforts to improve efficiency in democratic health care contexts for some time to varying degrees of success. The complexity of the health care system is magnified by the sheer number of processes and sub processes required to deliver value within a bureaucratic environment, while maintaining some level of compassionate and personalized care. There is inherent tension between what is required to be efficient and what is required to be caring and this conflict presses against Lean practice at the level of delivery.
Administration and care intersect at the point of the patient’s experience. In order to achieve the dual goals of improved value and lower costs, the application of Lean thinking for meaningful health care reform must acknowledge the fundamental dichotomy between the impersonal tasks required to provide health services, and human interactions. Meaningful health care reform requires an acknowledgement of this distinction, currently not recognized in literature. While administrative process improvements are necessary, they are insufficient to achieve a sustainable and caring health care system. Lean thinking must be applied differently for administrative processes and patient care encounters, because these are fundamentally different processes. In this way, Lean principles will effectively contribute to sustainable health system improvements.
Los esfuerzos continuos de mejora reconocieron en gran parte de la literatura cómo las técnicas de gestión Lean se han utilizado en los esfuerzos para mejorar la eficiencia en contextos democráticos de atención de la salud durante algún tiempo en diversos grados de éxito. La complejidad del sistema de cuidado de la salud se magnifica por la gran cantidad de procesos y subprocesos requeridos para ofrecer valor dentro de un entorno burocrático, mientras se mantiene cierto nivel de cuidado compasivo y personalizado. Existe una tensión inherente entre lo que se requiere para ser eficiente y lo que se requiere para ser cuidadoso y este conflicto presiona contra la práctica del Lean en el nivel de atención al paciente. La gestión y la atención se cruzan en el punto de la experiencia del paciente. Para alcanzar los objetivos duales de mejor valor y menores costos, la aplicación del pensamiento Lean para una reforma significativa de la atención de salud debe reconocer la dicotomía fundamental entre las tareas |
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ISSN: | 1353-4505 1464-3677 |
DOI: | 10.1093/intqhc/mzx156 |