Factors Affecting Effectiveness of Patient Care Process through Lean Management in the Recovery Room of Songklanagarind Hospital: A Retrospective Cohort Study

Abstract

Objective: To determine the effectiveness and factors influencing the extension of time in the Lean patient care process in the recovery rooms of Songklanagarind Hospital.
Material and Methods: This retrospective study involved inpatients aged 15-60 years, ASA class I-II, receiving general anesthesia between January and December 2020, with a total of 2,004 cases. The patient care process utilized the Lean management concept, which was developed in the previous study and is currently employed as a cultural framework. Data were collected using a modified record form from the previous study.
Results: Found cost-effectiveness with a median total lead time (TLT) for the caring process of 45 minutes. Specifically, 19.6% of patients had a TLT of ≤30 minutes, 57.8% had a TLT of ≤45 minutes, and 42.2% had a TLT of >45 minutes. The initial oxygen use was 30.2%, reducing oxygen usage costs by 272,805 baht per year. In terms of safety effectiveness, the incidence of respiratory complications in the recovery room and within 24 hours after discharge to the ward was found to be 8.8% and 2.9%, respectively. Factors affecting cost-effectiveness were surgical site, initial oxygen use, respiratory complications, nausea-vomiting, shivering, other complications in the recovery room, and pain.
Conclusion: The Lean concept is applicable to continue adjusting healthcare work processes to reduce waste, save costs, and increase work productivity within the standards of quality and safe organization.