ObjectiveTo analyze the application status and existing problems of value stream mapping (VSM) in improving medical services at home and abroad, so as to provide decision evidence for hospitals to apply VSM to improve medical services.MethodsUsing “value stream mapping” and “value stream” as search terms, we searched PubMed, Embase, China National Knowledge Infrastructure, CQVIP Journal Database and Wanfang Database (2009-2019), and collected relevant literature on the application of VSM to improve medical services at home and abroad. We conducted bibliometric analysis after confirming the literature according to the inclusion criteria. The standardization of application of VSM was also evaluated.ResultsOf the 299 articles retrieved, 13 studies fulfilled the inclusion criteria. The publication time of the literature was distributed between 2013 and 2019. Of the 8 foreign articles included, the regions to which the first author belonged were 4 in the United States, 1 in Ireland, Norway, Lebanon and Indonesia respectively. Of the 5 included domestic articles, the regions to which the first author belonged were 2 in Zhejiang and Shanghai respectively, and 1 in Guangdong. Of the foreign literature, 5 articles did not clearly state the sample size observed when drawing VSM, 5 articles incomplete drawing elements of VSM, and 3 articles did not show VSM. Of the domestic literature, 2 articles did not clearly state the sample size observed when drawing VSM, 3 articles had incomplete drawing elements of VSM, and 1 article did not show VSM.ConclusionsVSM is relatively more used in high-income and upper-middle income countries. The medical service improvement issues for which VSM is applied are relatively single. The standardization of the application of VSM in domestic and foreign literature needs to be improved overall.
ObjectiveTo analyze the application of visual management in foreign medical service management, and to provide a reference for lean medical management practice in China.MethodsUsing “visual management” and “visual tool” as the search terms, we searched PubMed, Web of Science, Springer Link, ScienceDirect, to retrieve relevant literature on the application of visual management tools to improve medical services in foreign countries. The number of published articles, journals, improvement objectives, measures and effects were analyzed descriptively.ResultsA total of 534 articles were retrieved. According to the inclusion and exclusion criteria, 7 articles were finally included, all of which were published in SCI journals, of which the number of articles in the United States was the highest (5 articles). Among the 7 included articles, 3 articles used face cards, 2 articles used whiteboards, 1 article used electronic Kanban, and 1 article used discharge “traffic lights”. Five articles studied the improvement of doctor-patient communication, and two studied the improvement of bed turnover rate. In the included articles, the contents of visualization mainly include the nursing goals of the inpatient, inspection plan, turnover, discharge plan, and the names and roles of medical staff.ConclusionsVisual management tools have a significant effect on promoting doctor-patient communication and improving hospital bed turnover. The application of foreign visual management tools in wards is relatively mature, and used more in promoting doctor-patient communication. Visual management tools are constantly updated, and electronic tools may gradually become a trend in the future.
Objective To analyze and explore positive emotional experiences of patients, in order to provide reference for improving the medical services. Methods Using NVivo software, praise letters from a tertiary hospital in Guangdong in 2020 and 2021 were used as the research object for three-level coding. The positive emotional experiences of patients were explored through tools such as analytic hierarchy process and node item map. Results A total of 8601 patient praise letters were received, and after screening, a total of 8128 valid texts were obtained. In 2020, there were 2570 patient praise letters, including 69 from the emergency department, 638 from the outpatient department, and 1863 from the inpatient department. In 2021, there were 5558 patient praise letters, including 203 from the emergency department, 2071 from the outpatient department, and 3284 from the inpatient department. The most praise letters were from the inpatient department, with a total of 5147 letters (63.3%). There were 2709 letters (33.3%) from outpatient department, and 272 letters (3.3%) from emergency department. The classification of patient praise letters showed that patient praise for the process and individuals were most common (77.4%). After step-by-step encoding, the valid text formed 36 third level nodes, 8 second level nodes, and 3 first level nodes. Patient praise letters mainly focused on emotional evaluation at the first level node, followed by emotional expression and emotional response. Word frequency analysis showed that in terms of positive emotional experiences, the word “thank you” had the highest frequency among patients. In terms of patient perception of service, the term “patience” had the highest frequency. Conclusions When patients express praise for medical services, they pay more attention to the personal performance of medical staff and the experience of the service process compared to the final result. In the process of hospital management, the emotions of patients should be fully considered.