IMPROVEMENT OF MUNICIPAL OUTPATIENT ACTIVITY ON THE BASIS OF LEAN TECHNOLOGIES
Authors:   Central Research Institute of Health Organization and Informatization of the Ministry of Health of the Russian Federation, Evdakov V.A. , Allenov A.M. ,   Municipal Polyclinic №210 of Moscow Healthcare Department,   Ryazan State Medical University, Artemyeva G.B. ,   Ryazan State Medical University, Lvova D.P. ,   Institute of Leadership and Health Management of Sechenov First Moscow State Medical University, Alekhin S.G. ,   Municipal Polyclinic №210 of Moscow Healthcare Department, Gushchin M.V. ,   Regional Center of Primary Medical Care Organization of Moscow Healthcare Department
Published: January 2021

Background. The world practice shows a high efficiency of lean production technologies both in the industrial and in social sectors. This determines the relevance of the research devoted to the analysis of the results of implementing a process approach based on the concept of lean produc-tion, in improving the activities of an outpatient medical organization. Aim. To identify resources of a municipal outpatient clinic in improvement of organization and effectiveness of realization of prophylactic programs, organization of work with patients and conduct of technological processes. Materials and Methods. To determine the aims of strategic development of a medical organiza-tion and identify the key trends for improvements on the basis of the concept of lean technolo-gies, SWOT analysis was used. A full-design study was conducted for assessment of the results of introduction of the concept of lean production in the period from January 2019 to December 2019, the respective parameters of the activity of an outpatient clinic were acquired and pro-cessed. The results obtained were compared with analogous results of 2018. Results. Introduction of the lean production concept helped to increase the availability of outpa-tient care, reduce the waiting time for examination and visiting medical specialists, improve the effectiveness of the health Center, increase the number of patients examined under preventive programs (+14.1%) from the planned level in comparison with the previous reporting period, from 83.0% in 2018 to 97.1% in 2019. A new form of public notification, the information flow map, has been developed and put into practice, and new standard operating maps (SOC) and standard operating procedures (SOP) have been developed and implemented. Improvement in the provision of medical care in the outpatient setting based on the concept of lean production has significantly improved several parameters of the organization: the coverage of the population with prophylactic medical examination (+14.1%) in comparison with the previous year, attraction of more individuals of the working age to the prophylactic examination: in the group of 21-39 years of age (+25.9%), in the group of 40-60 years of age (+18.9%). Conclusions. The results obtained confirm effectiveness of the concept of lean production in the improvement of the processes of medical organization providing medical care to the population in the outpatient setting. The block of presented approaches and tools of lean production may be used with taking into account adaptation to individual operating processes in a particular medical organization.