Effect of Lean Thinking Implementation upon Service Time at Sa-nga Nilwarangur Peritoneal Dialysis Unit, Siriraj Hospital

Abstract

This study was quasi- experimental research: one group pre post-test design with the objective of studying the effect of the application of “Lean Thinking” upon service time and satisfaction of 74 peritoneal dialysis patients in Sa-nga Nilwarankur Peritoneal Dialysis Unit, Siriraj Hospital. The data had been collected from January to December 2556 BE. Statistics used for data analysis were mean, standard deviation and paired t-test.
The study found that before the application of “Lean Thinking”, there were many wasteful activities related to the service system. Those were; time wasted in waiting for blood test results, time wasted from waiting for medicine, overlapping of work systems, redundancy of steps of work and repetitive steps in correcting the mistake. “Lean Thinking” had been applied to the work system with value, value streaming, flow, pull and perfection. After the application of “Lean Thinking” the servicing process had been modified; patients having a blood test before medical diagnosis, a double check of prescription by a medical lecturer/nephrologist and nurse, re-arranged work system to reduce overlapping steps in the service operation. The study found that after the application of “Lean Thinking”, there was a marked change in the service system, with the time required for the whole service having been reduced from 377.71 minutes to 209.8 minutes, in detail; waiting time for blood test results reduced from 92.54 minutes to 28.29 minutes, waiting time for medicine reduced from 110.73 minutes to 66.11 minutes with, a statistical significance (p<0.5). The service steps had been reduced from 17 steps to 14 steps. Patient’s satisfaction had been increased from 4.04 to 4.74 with a statistical significance (p<0.5). The research recommendations are; there should be an application of motivation theory to enhance the incentive for the patient to realize the importance and benefits of having blood tests before being diagnosed by the doctor and the practice of conformity. There should be standard procedures for the medical resident in examining the patient before having peritoneal dialysis. The
procedures should contain knowledge relating to peritoneal dialysis and related diseases,steps of operations and defects found in the system