Motivation as key factor of deploying lean technologies in medical institutions (an analytic review)
https://doi.org/10.25207/1608-6228-2020-27-4-134-148
Abstract
Aim. To assess the importance, role, methods and conditions for creating and sustaining positive motivation of medical personnel in deploying a modern management system based on lean production to optimise the production flow in medical institutions, improve quality, availability and efficiency of public medical care.
Materials and methods. The authors employed historical, bibliometric and statistical methods to analyse domestic and foreign scientific archives on lean production, motivation and motivational risks as key factors in implementing lean technologies in medical institutions.
Results. Implementation of lean production (LP) as a manufacturing management system is among key conditions for creating a new model of the medical institution. Principles of LP are applied at three interfaces: with patients, personnel and resources. Positive motivation of employees is prerequisite for accomplishing a project, which requires supervisors to know and leverage the basics of motivational management. Creation of a motivating environment for various categories of employees in developing a LP system requires taking into account the type and management culture level of a medical institution.
Conclusion. In order to create and sustain motivation for realising creative potential of the team, it is necessary to account for the motivation risks, develop and implement a motivation system differentially by employee categories and project stages. Effective motivational measures are necessarily based on a system of material and non-material incentives with clear and achievable criteria, amounts and forms valued by employees and rooted in medical and economic feedback of implementing the LP principles.
About the Authors
E. A. Perevezentsev
Privolzhsky Research Medical University
Russian Federation
Russian Federation
Egor A. Perevezentsev — Cand. Sci. (Med), Assoc. Prof., Department of Social Medicine and Healthcare Management
Minina i Pozharskogo square, 10/1, Nizhny Novgorod, 603950
tel.: +7 (906) 353-65-80
V. M. Levanov
Privolzhsky Research Medical University
Russian Federation
Russian Federation
Vladimir M. Levanov — Dr. Sci. (Med.), Assoc. Prof., Prof., Department of Social Medicine and Healthcare Management
Minina i Pozharskogo square, 10/1, Nizhny Novgorod, 603950
References
1. Gandurova E.G., Dimova O.A., Korablev V.N. The First experience of implementing the project “Lean production” in the conditions of a city polyclinic. Zdravoohranenie Dal’nego Vostoka. 2018; 3(77): 2124 (In Russ., English abstract).
2. Kasimova E.O., Stratan V.A., Krivykh E.A. Actual problem of modern health care “Lean production”. Analysis based on medical and sociological research of the children’s polyclinic of the OKB of Khanty-Mansiysk. Nauchnyj medicinskij vestnik Yugry. 2019; 2: 151–154 (In Russ., English abstract). DOI: 10.25017/23061367-2019-19-2-151-154
3. Konyakhina N.M., Kuznetsova E.A., Kartashova O.I., Yamshchikova T.V. Implementation of the project “Lean polyclinic” in the city hospital of Izhevsk.. Modern Science. 2020; 1-1: 254–257 (In Russ.).
4. Shupletsova V.A., Ivashinnikov A.V., Nyamtsu A.M., Yusupova E.Yu. Experience in implementing the project “Creating a new model of a medical organization providing primary health care” in the Tyumen region. Universitetskaya Meditsina Urala. 2019; 1(16): 142144 (In Russ.).
5. Kondratieva I.Yu., Kopteva L.N., Pereslegina I.A., Borovkova T.A. The strategy of introducing lean manufacturing in the children’s polyclinic. Meditsinskii Al’manakh. 2018; 3(54): 10–14 (In Russ., English abstract).
6. Khromushin V.A., Khadartsev A.A., Lastoveckiy A.G., Kitanina K.Yu. Evaluation of age cohorts of the population mortality on the example of Tula region for the period 2007 to 2015. Journal of New Medical Technologies. 2016; 10(3): 1 (In Russ., English abstract). DOI: 10.12737/21280
7. Fujimoto T. The evolution of production systems: Exploring the sources of Toyota’s competitiveness. Annals of Business Administrative Science. 2012; 11: 25–44.
8. Tsarenko A.S. “Lean state”: prospects for the application of lean technologies in public administration in Russia and abroad. Gosudarstvennoe Upravlenie. 2014; 45: 22–29 (In Russ.).
9. Backman Ch., Vanderloo S., Forster A.J. Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality. Health Policy. 2016; 9(120): 982–986. DOI: 10.1016/j.healthpol.2016.07.006
10. Moraros J., Lemstra M., Nwankwo C. Lean interventions in healthcare: do they actually work? A systematic literature review. Int. J. Qual. Health. Care. 2016; 28(2): 150–165. DOI: 10.1093/intqhc/mzv123
11. Kitanina K.Yu., Lastovetsky A.G. Lean management in health care. Journal of New Medical Technologies. 2018; 2: 2–4 (In Russ., English abstract). DOI: 10.24411/2075-4094-2018-16022
12. Antonova I.I., Antonov S.A., Akhmadeeva G.Ch. Features of implementing lean production in social establishments. 2014; 1: 84–87 (In Russ., English abstract).
13. D’Andreamatteo A., Ianni L., Lega F. Lean in the healthcare: A comprehensive review. Health Policy. 2015; 119(9): 1197–1209. DOI: 10.1016/j.healthpol.2015.02.002
14. Solov’ev A.A., Kopysova N.V. Patient satisfaction with the quality of medical services at different stages of the implementation of the project “Lean polyclinic” in the Tomsk region. Sibirskii Meditsinskii Zhurnal. 2018; 4: 154–157 (In Russ., English abstract). DOI: 10.29001/2073-8552-2018-33-4-154-157
15. Valiullina L.A., Zaitseva E.A. Principles implementation of lean manufacturing into the public health care system of KHMAO — Ugra. Vestnik Surgutskogo Gosudarstvennogo Universiteta. 2017; 2(16): 32–35 (In Russ., English abstract).
16. Doljenkova Yu.V., Polevaya M.V., Rudenko G.G. The new system of remuneration of labor in budget health care: analysis of practice and problems of implementation. Problems of social hygiene, public health and history of medicine. 2019; 27(4): 452–458 (In Russ., English abstract). DOI: 10.32687/0869-866X-201927-4-452-458
17. Brandao de Souza L., Pidd M. Exploring the barriers to lean health care implementation. РММ. 2011; 31(1): 59–66. DOI: 10.1080/09540962.2011.545548
18. Drivolskaya N.A. Motivation management as a tool of personnel manage. Vestnik NGUEU. 2015; 3: 185193 (In Russ., English abstract).
19. Romanova Yu.A. Vaccination in a lean clinic. 5 misconceptions that prevent reorganizing the workspace. Zamestitel’ Glavnogo Vracha. 2017; 11: 44–51 (In Russ.).
20. Sergeeva N.M. About approaches to efficiency assessment of medical organizations functioning. Mezhdunarodnyi Zhurnal Prikladnykh i Fundamental’nykh Issledovanii. 2017; 2-1: 72–76 (In Russ., English abstract).
21. Dellve L., Williamsson A., Strömgren M. Lean implementation at different levels in Swedish hospitals: the importance for working conditions and stress. International Journal of Human Factors and Ergonomics. 2015; 3(3/4): 235–253. DOI: 10.1504/IJHFE.2015.073001
22. Lönnqvist J.E., Verkasalo M., Wichardt P.C., Walkowitz G. Personal values and prosoial behavior in strategic interactions: Ds: inguishing value-ambivalent behaviors. Eur. J. Soc. Psychol. 2013; 43(6): 554–569. DOI: 10.1002/ejsp.1976
23. Dyrina E.N., Gavrikova N.A. Features of human resource management in the concept of lean production. V Mire Nauchnykh Otkrytii. 2015; 5-4(65): 1234–1246 (In Russ., English abstract).
24. Kazantseva S.M., Sungatullina L.A. Improvement of healthcare facilities by improving staff client orientation. Ekonomika i Predprinimatel’stvo. 2015; 8-2(61): 566–569 (In Russ., English abstract).
25. Kälvemark S., Höglund A.T., Hansson M.G., Westerholm P., Arnetz B. Living with conflicts-ethical dilemmas and moral distress in the health care system. Soc. Sci. Med. 2004; 58(6): 1075–1084. DOI: 10.1016/s0277-9536(03)00279-x
26. Davydova N.S., Mazunina S.D., Pozmogova N.P. Organizational and methodological issues of using lean technologies in medicine from the point of view of staff motivation and training. Vyatskii Meditsinskii Vestnik. 2020; 1(65): 74–81 (In Russ., English abstract).
27. Gorodkova S.A., Taskina E.B. Features of management decisions in the health care system based on the principles of lean production. Vestnik Zabajkal’skogo Gosudarstvennogo Universiteta. 2019; 5: 105–113 (In Russ., English abstract). DOI: 10.21209/2227-92452019-25-5-105-113
28. Abashev A.R., Abakumova A.A., Dem’yanova O.V., Gismatulina A.Kh. Improving the efficiency of personnel in a medical organization using a process approach. Kazanskii Ehkonomicheskii Vestnik. 2019; 2(40): 5–10 (In Russ., English abstract).
29. Nurbaeva G., Abdueva G., Alpeisova D. Lean manufacturing as one of the new management technologies in the health system. Journal of Health Development. 2019; 32: 60–68 (In Russ., English abstract).
30. Rusakova I.V., Chernavsky A.F., Petrova V.I., Zinkovskaya S.M. Recognition of problem areas and ways of process optimization in arranging reception work at municipal dental clinics when implementing methods of lean production. Actual Problems in Dentistry. 2018; 14(1): 110–115 (In Russ., English abstract). DOI: 10.24411/2077-7566-2018-100020
31. Kurmangulov A.A., Reshetnikova Y.S., Brynza N.S., Knyazheva N.N. Navigation system as quality assessment criterion of medical organization’s space providing primary health care. Vestnik SurGU. Medicina. 2019; 1: 39–43 (In Russ., English abstract).
32. Medvedeva V.R. Changing the thinking of employees through the prism of the concept of “lean manufacturing” as a factor that increases its competitiveness. Vestnik Kazanskogo Tekhnologicheskogo Universiteta. 2012; 15(9): 256–258 (In Russ.).
33. Longaray A.A. Ensslin, L. The Usage of MCDA in Identification and Measurement of Criteria Performance for Certification of Public Teaching Hospitals in Brazil. Production. 2014; 24(1): 41–56.
34. Ryan A.M., Tompkins C.P., Markovitz A.A., Burstin H.R. Linking spending and quality indicators to measure value and efficiency in health care. Med. Care. Res. Rev. 2017; 74(4): 452–485. DOI: 10.1177/1077558716650089
35. Murina K.A., Scherbakov D.V., Tkachenko E.S. The comparative analysis of indicators of efficiency and quality in health care. Sovremennye Problemy Nauki i Obrazovaniya. 2015; 6: 110 (In Russ., English abstract).
36. Korablev V.N., Dementeva E.L. System of indicators of medical care efficiency assessment. Dal’nevostochnyi Meditsinskii Zhurnal. 2014; 4: 94–98 (In Russ., English abstract).
37. Dudov A.S. Evolution of methods for assessing the effectiveness of the quality of medical care. Upravlenie Ekonomicheskimi Sistemami: Elektronnyi Nauchnyi Zhurnal. 2010; 4(24): 237–250 (In Russ.).
38. Svatkovsky D.V., Pereslegin I.A., Ermilova O.A., Varenova L.E. On the formation of key performance indicators (KPI) of medical organizations. ORGZDRAV: Novosti. Mneniya. Obuchenie. Vestnik VShOUZ. 2016; 2: 111–113 (In Russ.).
39. Vafin A.Yu., Fakhrutdinova E.V., Shavaliev R.F., Kulikov O.V. Human resource management strategy in regional children’s hospital. Vestnik Sovremennoi Klinicheskoi Meditsiny. 2018; 11(1): 79–85 (In Russ., English abstract). DOI: 10.20969/VSKM.2018.11(1).79-85.
40. Soboleva S.Yu., Ryabova E.V. Features of the implementation of the project “Lean polyclinic” in the aspect of changing the roles of average medical staff. Izvestiya Volgogradskogo Gosudarstvennogo Tekhnicheskogo Universiteta. 2018; 10(220): 75–78 (In Russ., English abstract).
41. Davydova N.S., Titov I.G., Sycheva E.V., Pozmogova N.P. Improving the system of motivation of medical organization personnel when implementing the principles of lean production. Universitetskaya Meditsina Urala. 2019; 1(16): 133–135 (In Russ.).
42. Breusov A.V., Fenyutina V.A., Orudzhev A.A. Optimization of the medical organization by implementing lean manufacturing. Saratovskii Nauchno-Medicinskii Zhurnal. 2019; 4: 893–897 (In Russ., English abstract).
43. Knjazjuk N.F., Sasina M.S., Kitsul I.S.,Gurshpon T.V. Diagnostics and change of corporate culture of the medical organization. Glavvrach. 2011; 4: 25–34 (In Russ., English abstract).
44. Timofeev D.A., Erugina M.V., Tsvigailo M.A., Krom I.L., Vlasova M.V. Organizational culture as workforce management factor in military medical organization. Sovremennye Problemy Nauki i Obrazovaniya. 2017; 4: 1–14 (In Russ., English abstract).
45. Zaiytseva N.V. The analysis of organizational culture as a factor of enhancing of effectiveness of strategy of management of medical organization. Sotsiologiya Meditsiny. 2013; 1(22): 30–38 (In Russ., English abstract).
46. Zimakova L.A., Ovchinnikov I.V., Sever A.S. Stages of implementation of the concept of lean production in medical organizations. Nauchnyj Rezul’tat. Ekonomicheskie Issledovaniya. 2019; 1: 20–32 (In Russ., English abstract). DOI: 10.18413/2409-1634-2019-5-10-3
47. Lastovetskii A.G., Titov I.G., Kitanina K.Yu. Evaluation the principles of lean manufacturing in medical institutions in perspective and in present. Vestnik Novykh Meditsinskikh Tekhnologii. Ehlektronnoe Izdanie. 2018; 4: 83–93 (In Russ., English abstract). DOI: 10.24411/2075-4094-2018-16082
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For citations:
Perevezentsev E.A., Levanov V.M. Motivation as key factor of deploying lean technologies in medical institutions (an analytic review). Kuban Scientific Medical Bulletin. 2020;27(4):134-148. (In Russ.) https://doi.org/10.25207/1608-6228-2020-27-4-134-148
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