СИСТЕМЫ МЕНЕДЖМЕНТА КАЧЕСТВА ISO И LEAN В ЗДРАВООХРАНЕНИИ
DOI:
https://doi.org/10.31082/1728-452X-2020-221-222-11-12-13-21Ключевые слова:
система менеджмента качества, качество медицинской помощи, бережливый менеджмент, удовлетворенность потребителяАннотация
В настоящее время в здравоохранении Республики Казахстан и многих других стран в обязательном порядке используется стандарты ISO, а также в некоторых странах применяется система бережливого производства Lean. В Республике Казахстан Министерство здравоохранения в 2017 году выпустило методические рекомендации по внедрению бережливых технологий в организациях здравоохранения. Однако внедрение Lean технологий пока не является обязательным и не получило распространения в медицинских организациях нашей страны. В связи с этим информация о бережливых технологиях, опыте их применения и эффективности в организациях здравоохранения полезна для медицинских руководителей и работников.
Цель. Анализ литературных данных о системах менеджмента качества ISO и Lean, их сравнении, опыте применения в организациях здравоохранения и эффективности.
Материал и методы. Для анализа производился поиск информации по проблеме глубиной до 20 лет в базах данных. Поиск публикаций по теме обзора производился в базах данных Medline, PubMed/MEDLINE, PMC, EMBASE, Web of Since, а также широкий поиск через браузеры Google.com и Yahoo.com. Критерием поиска были сочетания терминов: система менеджмента качества (quality management system), здравоохранение (healthcare), бережливое производство (lean production).
Результаты и обсуждение. Приведено описание основных характеристик систем менеджмента качества ISO и Lean (бережливое производство), а также их сравнение. Дана информация о применении этих систем в организациях здравоохранения. В настоящее время в обязательном порядке система бережливого производства внедрена в организациях здравоохранения провинции Саскачеван (Канада), начато масштабное внедрение в Российской Федерации. Многие медицинские организации внедряют эту систему по собственной инициативе. В большинстве публикаций отзывы о применении Lean положительные. Тем не менее, есть также несколько критических статей о том, что опубликованные положительные отчеты не имеют строгой доказательной базы. Кроме этого невозможно сравнивать отчеты разных организаций в связи с отсутствием единой системы оценок эффективности Lean.
Выводы. Система бережливого производства находит все более частое применение в организациях здравоохранения. Большая часть отзывов говорит о ее высоком положительном эффекте. Тем не менее, вопрос эффективности требует дальнейших исследований, так как большую часть отчетов нельзя признать доказательными.
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