Shazia Sarwar Alvi, Zahid Hamid, Sidra Riaz, Muhammad Sarwar Alvi, Naila Azam.
Effect of lean daily management (LDM) system on quality of healthcare delivery in indoor setting – a pilot suudy.
Pak Armed Forces Med J Jan ;70(3):842-48.

Objective: To determine the effect of introducing Lean Daily Management (LDM) System on the quality of indoor healthcare delivery. Study Design: Quasi experimental study. Place and Duration of Study: Officer’s Family Hospital (OFH), Combined Military Hospital (CMH) Rawalpindi, May 2017 to Sep 2017. Methodology: Twelve locations in Officer’s Family Hospital were selected for introducing Lean Daily Management System. Greater Baltimore Medical Centre’s (GBMC) quadruple aim was taken as the standard for introducing Lean Daily Management. The four aims included “best health outcomes”, “best care experience”, “lowest cost” and “most joy”. Each department defined a goal for one of these four aims to achieve over the next month. Data collection was done independently in each location everyday on standard printed charts. The incidence of failure to attain the aim was recorded. Reasons of failure to achieve a goal were identified and broken down to reach the root cause. Based on this analysis an action plan was formulated to improve the results and implemented over the next month. The same aim was pursued by a department over successive months till it achieved substantial score in that area. Results: The delayed collection of lab reports in family medical unit (FMU) decreased by 66% after implementation of lean daily management system. Conclusion: Application of Lean Daily Management system in indoor healthcare improves the quality of care being provided to the patients.

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