Yalın yönetim yaklaşımlarıyla hastanelerdeki sorunlara çözüm önerileri
Solutions to problems in hospitals with lean management approaches
Yazar: MÜGE YEKE
Danışman: DOÇ. DR. MURAT BASKAK
İstanbul Teknik Üniversitesi / Sosyal Bilimler Enstitüsü / İşletme Ana Bilim Dalı / İşletme Yönetimi Bilim Dalı
Derece: Yüksek Lisans, 2020
Konu: İşletme = Business Administration
Dizin: Hastaneler = Hospitals ; Sağlık personeli = Health personnel ; Sağlık sektörü = Health sector ; Yalın yönetim = Lean management

Özet:
Dünya'da ve Türkiye'de sağlık sektöründeki gelişmeler incelendiğinde, teknolojinin de gelişmesiyle birlikte, artan rekabetin sözkonusu olduğu görülmektedir. Sağlık sektöründe ayakta kalabilmek ve sürdürülebilirliği koruyabilmek, sürekli iyileştirme yöntemleriyle olanaklı gözükmektedir. Yalın yönetim sistemleri sayesinde, sağlık çalışanlarının, hastaların ve hastanenin sorunlarına çözümler geliştirilebilmektedir.
Hastaneler ve sağlık çalışanları, sorunların çözümünün zor olduğunu düşünmelerine rağmen, bu sorunların, iyileştirme yöntemleriyle basit ve çözülebilir nitelikte olduğu görülmektedir. Hastanelerde yapılan görüşmeler sonucunda yaklaşık 30'dan fazla sorun saptanmış olup olup, çözüm önerileri sunulmuştur. Yalın yönetim teknikleri, sorunların çözülmesinde yardımcı olmaktadır. Yalın felsefede birden fazla yöntem, araç ve teknik kullanılmaktadır. Kullanılan teknikler aracılığıyla, hasta, hastane ve sağlık çalışanları açısından en iyi çözümler sunulması amaçlanmaktadır.
Bekleme sürelerinin, israfların ve zaman kayıplarının azaltılması amacıyla mâliyetleri düşürmeye ve verimliliği arttırmaya yönelik yöntemler uygulanmaktadır. Yalın yönetim tekniklerinin, hizmet sektörü olan hastanelerde uygulanarak, süreçlerin kısaltılabileceği ve iyileştirilebileceği belirtilmektedir. Ekonomik olarak mâliyetlerin enküçüklenmesi, verimliliğin arttırılması ve çalışan performansının yükseltilmesi hedeflenmektedir.
Bu çalışmada, yalın felsefe yardımıyla sağlık sisteminde yaşanan sorunların, ayrıntılı bakıldığında, çözülemeyecek nitelikte olmadığı ve yalın yönetim teknikleri yardımıyla iyileştirilebileceği gözlemlenmektedir ve vurgulanmaktadır. Bu amaçla, Bağcılar Medipol Mega Üniversite Hastanesi, İstanbul Gaziosmanpaşa Eğitim ve Araştırma Hastanesi ve İstanbul Bakırköy Prof.Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi'nin tüm bölümleri incelenmiştir. Özel ve devlet hastanelerindeki çalışanlar bire-bir ve yüzyüze olarak dinlenmiş, görüşmeler yapılmıştır. Yapılan görüşmelerde 41 önemli sorun saptanmıştır. Bu tez çalışmasının sonucunda, tüm bölümler hakkında değerlendirmeler yapılarak, saptanan 41 soruna çözüm önerileri sunulmuştur. Yalın felsefe ve yalın yönetim teknikleri sâyesinde, sorunların çözülebileceği ve iyileştirilebileceği vurgulanmıştır.

Abstract:
When the developments in the health sector in the world and in Turkey are examined, there is increased competition with the development of technology. It is possible to survive in the health sector and to maintain sustainability through continuous improvement methods. Through lean management systems, solutions can be developed to the problems of health workers, patients and hospitals.
Although hospital and healthcare workers or professionals think that the solutions of the problems are simple and solvable by means of improvement methods. As a result of the interviews conducted in hospitals, approximately 30 problems were identified and solution suggestions were presented. Lean management techniques help us in solving problems. More than one method, tool and technique are used in lean philosophy. It is aimed to provide the best solutions for patients, hospitals and health workers by means of the techniques used.
In order to reduce waiting times, waste and time losses, methods have been implemented to reduce costs and increase efficiency. It is stated that the processes can be shortened and improved by applying lean management techniques in hospitals, which are the service sector. Economically, it is aimed to minimize costs, improve efficiency and increase employee performance.
When the latest developments are followed, it is observed that the importance of making improvements with lean management techniques increases in hospitals. In the world and in Turkey, especially is evident that meet the demands and expectations of health workers during the corona virus outbreak. Difficult working conditions and the application of additional working hours reduce productivity. Increasing costs and decreasing productivity pose a big problem.
It is seen that these problems can be solved with lean management techniques. The conditions experienced in hospitals are considered to be optimized in terms of doctor, patient and hospital.
In this thesis, it is aimed to solve the problems of healthcare professionals in an optimized way. Solutions to the problems in hospitals have been tried to be developed with lean management techniques.
Studies have revealed that the health sector is not given enough importance. However, due to the corona virus pandemic that has affected the whole world, the importance of health, health sector and healthcare workers has been understood more and more recently.
It is aimed to draw attention to the fact that these problems can be solved with a lean philosophy when the problems of the health personnel are listened to and given the necessary value.
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Although the patients and healthcare professionals in the hospital feel that the solution of the problems they experience is almost impossible because they are mostly exposed to violence and they think that they are not given the necessary value, it has been shown in this study that the solution is possible thanks to the techniques used.
Bağcılar Medipol Mega University Hospital, İstanbul Gaziosmanpaşa Training and Research Hospital and İstanbul Bakırköy Prof.Dr. When all departments of Mazhar Osman Mental Health and Neurological Diseases Training and Research Hospital are examined and evaluated, the problems experienced in hospitals; Fishbone method, value stream mapping method, job standardization, kaizen, 5S, kanban, red label technique and 5 cause analysis techniques were used to examine and optimize for patients, hospitals and healthcare professionals. In order to reduce wastage and time loss, reduce costs and increase efficiency, solutions were offered by using techniques. It was tried to be emphasized that by applying lean management techniques in hospitals with service sector, processes can be shortened and problems can be solved.
In this study, when the problems experienced in the health system with the help of lean philosophy are examined in detail, it is not unsolvable and it has been observed and emphasized that the problems can be improved by lean management.
For this purpose, Bağcılar Medipol Mega University Hospital, Gaziosmanpaşa Training and Research Hospital and Bakırköy Prof.Dr. Mazhar Osman Mental Health and Nervous Diseases Training and Research Hospital were examined. Private and Public hospital employees were listened to one-to-one and face-to-face so interviews were conducted.
During the interviews, about 30 problems were identified. As a result of this thesis, all departments were evaluated and solutions were carried out to the 30 problems identified. Thanks to lean philosophy and lean management techniques, it is emphasized that problems can be solved and improved.
Although the main purpose is to develop solutions to the problems in the health system, the study developed a multi-dimensional mindset, not a one-dimensional one.
In this thesis, I aim to show solution suggestions with lean manufacturing techniques, since I can take care of the healthcare professionals at the stage of problem determination, I can observe them closely, and I try to understand them by giving the necessary value to healthcare professionals.
During the Corona virus pandemic period, the value of healthcare workers was understood by all our citizens. It has been shown that the problems of healthcare professionals can be solved with lean manufacturing techniques.
In this study, when the problems experienced in the health system with the help of lean philosophy are examined in detail, it is not unsolvable and it has been observed and emphasized that the problems can be improved by lean management. For this purpose, Bağcılar Medipol Mega University Hospital, Gaziosmanpaşa Training and Research Hospital and Bakırköy Prof.Dr. Mazhar Osman Mental Health and Nervous Diseases Training and Research Hospital were examined. Private and Public hospital employees were listened to one-to-one and face-to-face so interviews were conducted.
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During the interviews, more than about 30 problems were identified. As a result of this thesis, all departments were evaluated and solutions were carried out to the 30 problems identified. Thanks to lean philosophy and lean management techniques, it is emphasized that problems can be solved and improved.