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Impact of lean interventions on time buffer reduction in a hospital setting

机译：精益干预对医院环境中时间缓冲减少的影响

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This paper focuses on performance changes stemming from a series of lean interventions in a medical laboratory. This research is one of the first to link a series of lean interventions and performance over time. In a mixed-method case study, six years of patient-related throughput data, retrieved from a laboratory computer database, are analysed. Three distinct periods with significant differences in throughput time performance can be distinguished. Semi-structured interviews were held to investigate the lean interventions preceding the performance changes. Given the long-term nature of the study, the event history calendar method was applied to enhance the respondents' recall and reliability. A single lean intervention, among the hundreds that took place, was supposed to cause the main reduction in throughput times. It concentrated on improving process flow through the removal of batching, a source of artificial variability. A later major intervention, the introduction of flow-focused machinery, had mixed effects and initial performance gains were not sustained. The results show that ongoing series of interventions do not always lead to ongoing performance improvements in terms of throughput times but support theories emphasising the importance of variability reduction.
机译：本文重点介绍了由医学实验室中的一系列精益干预产生的性能变化。这项研究是最早将一系列精益干预与绩效联系在一起的研究之一。在混合方法案例研究中，分析了从实验室计算机数据库中检索到的与患者相关的六年吞吐量数据。可以区分在吞吐时间性能方面存在明显差异的三个不同的时期。进行了半结构化访谈，以调查绩效变化之前的精益干预措施。考虑到研究的长期性，使用事件历史日历方法可以提高受访者的回忆和可靠性。在所进行的数百次干预中，一次精益干预被认为可以大大减少生产时间。它着重于通过消除分批处理（人为可变性的来源）来改善工艺流程。后来的一项重大干预措施，即以流动为中心的机械的引入，产生了多种影响，并且最初的性能提升并未持续。结果表明，进行中的一系列干预措施并不总能导致吞吐时间方面的性能持续改善，但支持强调可变性降低重要性的理论。

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