目的 分析精益医疗管理在国外手术室优化服务中的应用,为精益医疗管理在国内手术室进一步优化服务流程提供理论参考。方法 计算机检索PubMed、Web of Science数据库,检索时限为建库到2024年11月。收集精益医疗管理优化国外医院手术室管理的应用情况。对发文数量、发文机构、作者、被引频次、关键词、精益工具的使用及改善状况进行分析。结果 共纳入文献71篇。其中,2008年—2014年发文17篇;2015年起相关文献数量逐步增加,至2024年发文54篇。高校发文9篇,医院发文62篇。从文献发表的国家地区分布来看,美国34篇、英国12篇、意大利5篇、瑞士 4篇、加拿大3篇。关键词基本呈现手术室管理与精益医疗改善领域相关的主题结合,如精益-六西格玛(lean six sigma)、质量改进(quality improvement)、手术室效率(operating room efficiency)。出现频次最高的5个精益工具分别为价值流图、鱼骨图、A3报告、PDCA循环管理和5S。结论 精益医疗研究存在发展不平衡的问题,发达国家发文数量远高于发展中国家。精益医疗有利于提高手术安全、工作效率和医患满意度。精益医疗应进一步适应实际情况,统一手术室精益管理指标,跨部门合作,令精益改善工具效用最大化,实现医疗现代化管理。
Lean healthcare management in optimizing foreign hospital operating room service process
Objective To analyze the application of lean healthcare management in optimizing services in foreign operating rooms,and provide a theoretical reference for further optimizing service processes in domestic operating rooms with lean healthcare management.Methods PubMed and Web of Science databases were searched literature about lean healthcare management in optimizing foreign hospital operating room service process.The search period was from the establishment of databases to November 2024.The number of publications,publishing institutions,authors,citation frequencies,keywords,the use of lean management tools and the improvement status were analyzed.Results A total of 71 literatures were included.Among them,17 literatures were published from 2008 to 2014,and the number of related literatures increased significantly since 2015,with 54 literatures published by 2024;9 literatures were published by universities and 62 literatures were published by hospitals.In terms of the distribution of countries and regions where the literatures were published,there were 34 literatures from the United States,12 from the United Kingdom,5 from Italy,4 from Switzerland,and 3 from Canada.The keywords basically presented the combination ofthemes related to operating room management and lean healthcare management improvement fields,such as lean six sigma,quality improvement,and operating room efficiency.The five lean tools with the highest frequency of occurrence in the 71 included literatures were value stream mapping,fishbone diagram,A3 report,PDCA cycle management,and 5S.Conclusions There is an imbalance in the development of lean healthcare management research,with the number of publications in developed countries being far higher than that in developing countries.Lean healthcare management is conducive to improving surgical safety,work efficiency,and patient-doctor satisfaction.Lean healthcare management should further adapt to the actual situation,unify the lean management indicators in operating rooms,conduct cross-departmental cooperation,maximize the effectiveness of lean improvement tools,and achieve modern medical management.