Title: Lean healthcare methodology in nursing office

Biography:

Patricia Gadea Company is qualified in nursing from the Rovira and Virgili University in Tarragona (Catalonia). She is Professional with a Master Degree in Integral Care for Critical Patients and Emergencies and Master Degree in Bases, Procedures and Techniques Applied to the Care of Critically ill and Emergency from University of Barcelona. She has been employed as a Nurse with a demonstrated history of working in the hospital & health care industry. She was employed in Norway in postoperative area. ICU, operating room and emergencies area in Barcelona and Alicante, primary healthcare and hospitalization in Alicante. Since 2017, has been working in Lithotripsy and Endourology unit and business project management (BPM) in this area. She has had an active collaboration in the achievement of ISO and UNE certification in the Lithotripsy and Endourology Unit.  She has  international publications in BPM and she has been speaker at local conferences and courses.

Abstract

The application of Lean methodology to healthcare has shown important benefits for patients and health organizations. The purpose of this study is to evaluate the results of the application of the Lean Healthcare methodology in the nursing office in a Lithotripsy and Endourology Unit. The office process is the initial contact of the patient with the unit in which is made a treatment decision. One of the main steps in the office process was the implementation and systematization of a specialized nursing office. To evaluate it several indicators were designed and used. A specific satisfaction survey was designed and used for calculating the satisfaction index. On the other hand, the ISBAR communication tool was implemented as a safety measure for our patients. A total of 5510 office processes were included and analysed from 2014 to 2019. The initial organization and implementation of the nursing office into office process showed an improvement of the perception of information care quality. The posterior systematization of the tasks showed an improvement in the analysis of the office time. The percentage of patients that took more than 60 minutes for office visit was reduced significantly over the years until a value of 9% in 2018. The detailed analysis of the times by stages into the office process showed a reduction of the nursing office assessment time from an average of 14,56 in 2016 to 12,03 minutes in 2019. It allowed increasing a total of 346 visits more in the last year. There was a global satisfaction increase from 90% to 98%. The postoperative infectious complications and other variables were improved as a result of ISBAR implementation. The implementation and systematization of a specialized nursery office in a lithotripsy and endourological unit increases assistance quality and patient satisfaction. Lean methodology can effectively be applied to improve efficiency.