การพัฒนากระบวนการรับใหม่ผู้ป่วยบาดเจ็บที่สมองในหอผู้ป่วยศัลยกรรมโรงพยาบาลสมเด็จพระยุพราชปัว จังหวัดน่าน

Abstract

The development of a working process is important for administrators and nurses in order to provide quality nursing care and to rapidly respond to customer’s needs. The purpose of this developmental study was to develop an admission process for traumatic brain injured patients in the surgical ward of Pua Crown Prince Hospital, Nan Province, using the Lean Concept by Womack & Jones (2003). The study population consisted of 16 staff working in the surgical ward for more than 2 years. Samples for this study include activities of an admission process for traumatic brain injured patients in a Surgical Ward between August to November 2014. The research instruments included: 1) a table for describing the activities of the admission process for traumatic brain injured patients, 2) a value analysis form, 3) the record form for time spent on activities and 4) guidelines for focus group interviews regarding problems and obstacles of the admission process and recommendations for improving the admission process for traumatic brain injured patients. These research instruments were validated by three experts. The interrater reliability of two observers for which the recorded time was 1.0. The data was analyzed using descriptive statistics The results were as follows: The new admission process for traumatic brain injured patients consisted of 3 major activities and 15 minor activities which was a reduction of 5 minor activities from the previous development process. The new admission process took 53.26 minutes, which was a reduction of 40.94 minutes from the previous development process. Problems and obstacles for the development of an admission process for traumatic brain injured patients could be categorized into 3 dimensions: 1) Personnel: this included varying levels of understanding of the Lean Concept, and failure to follow the new admission process regularly due to the workload of individuals differing at varying times; 2) Implementation: this included the difficulties in coordinating meetings, and the time spent on explaining the instruments and techniques used during the development process which varied for each group; 3) Management: this included to the limitations due to the hospital budget which was insufficient for the engagement of more staff and for the purchase of inventory used to respond to patients’ needs. The recommendations included develop a plan for educating staff regarding Lean Concept, manage staffing to match the workload, and provide an adequate inventory for providing service to patients. The results of this study indicated that the development of an admission process for traumatic brain injured patients using Lean Concept can decrease the activities of the admission process and the time spent on the process. Therefore administrators can utilize the result of this study as a guideline for improving the quality of services in other departments of the organization.