Significance of the application of lean system elements in the specialised personal health care institution: staff attitude

Abstract

In order to improve the quality of healthcare services and motivate health care institutions to achieve efficiency new management methods are to be found. This article offers one of the instruments created by the author – hospital health care quality evaluation model. The model was developed during a four-stage study. 26 hospital health care quality assessment indicators, approved in Lithuania, were chosen as the basis of the study. In the first stage of the study, foreign hospital quality assessment models being practiced in other countries were analysed finding key dimensions which were later identified as quality and efficiency. In the second and third stages of the study, mathematical model for the assessment of indicators was developed. The second stage was simulated in three steps. It was firstly presumed that the maximum number of points assembled by a perfectly assessed Hospital could be 1,000 points, whereas, the lowest score possible being estimated to be – 333. During the second step, relative weight for each dimension (quality and efficiency) was calculated. Quality, as being more substantial dimension, has been given two-thirds, or 75 percent of the relative weight and efficiency accounted for one third, or 25 percent of the relative weight. The third step of the second stage consists of the calculation of value for each specific benchmark indicators assigned to the individual dimensions (quality – 15 indicators; efficiency – 11). All indicators have constant weight. The third step of the study was the assessment of size of each quality and efficiency indicator presented by a particular hospital. This size was measured in 3-point scale, where 1 point means less than the Lithuanian average, 2 – the average of Lithuania, 3 – more than the Lithuanian average. During the fourth stage of the study, the total value of points obtained by each of the 26 indicators was calculated for each hospital and hospitals were ranked from high to low scores by this total value.