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| 1 | Lean techniques for the improvement of patients' flow in emergency department显示文摘BACKGROUND: Emergency departments(EDs) face problems with overcrowding, access block, cost containment, and increasing demand from patients. In order to resolve these problems, there is rising interest to an approach called 'lean' management. This study aims to(1) evaluate the current patient flow in ED,(2) to identify and eliminate the non-valued added process, and(3) to modify the existing process.METHODS: It was a quantitative, pre- and post-lean design study with a series of lean management work implemented to improve the admission and blood result waiting time. These included structured re-design process, priority admission triage(PAT) program, enhanced communication with medical department, and use of new high sensitivity troponin-T(hsTnT) blood test. Triage waiting time, consultation waiting time, blood result time, admission waiting time, total processing time and ED length of stay were compared.RESULTS: Among all the processes carried out in ED, the most time consuming processes were to wait for an admission bed(38.24 minutes; SD 66.35) and blood testing result(mean 52.73 minutes, SD 24.03). The triage waiting time and end waiting time for consultation were significantly decreased. The admission waiting time of emergency medical ward(EMW) was significantly decreased from 54.76 minutes to 24.45 minutes after implementation of PAT program(P<0.05).CONCLUSION: The application of lean management can improve the patient flow in ED. Acquiescence to the principle of lean is crucial to enhance high quality emergency care and patient satisfaction. | HY Chan SM Lo LLY Lee WYL Lo WC Yu YF Wu ST Ho RSD Yeung JTS Chan | 2014 | World Journal of Emergency Medicine2014，5，1： | 6 |
| 2 | Common variation in the LMNA gene (encoding lamin A/C) and type 2 diabetes - Association analyses in 9,518 subjects显示文摘 | Owen, KR Groves, CJ Hanson, RL Knowler, WC Shuldiner, AR Elbein, SC Mitchell, BD Froguel,P Ng, MCY Chan, JC Jia, WP Deloukas, P Hitman, GA Walker, M Frayling, TM Hattersley, AT Zeggini, E McCarthy, MI | 2007 | 中国生物学文摘2007，21，11： | 2 |
| 3 | The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma显示文摘 | Rosenwald A Wright G Chan WC | 2002 | N Engl J Med2002，346，25： | 1 |
| 4 | Outcome prediction of emergency patients by noninvasive hemodynamic monitoring 显示文摘 | Shoemaker WC Wo CCJ Chan L | 2001 | Chest2001，11，： | 1 |
| 5 | The role of conservative treatment in idiopathic granulomatous mastitis 显示文摘 | Lai EC Chan WC Ma TK | 2005 | Breast J2005，11，： | 1 |
| 6 | Protein chip array pro- {ilinganalysis in patients with severe acute respiratory syndrome identifiedserum amyloid a protein as a biomark- er potentially use{ul in monitoring the extent of pneumo- nia显示文摘 | Yip TT Chan JW Cho WC | 2005 | Clin Chem2005，51，1： | 1 |
| 7 | Adenosquamous/squamous cell carcinoma of the gallbladder 显示文摘 | Chan KM Yu MC Lee WC | 2007 | J Surg Oncol2007，95，2： | 1 |
| 8 | Protein chip array profiling analysis in patients with severe acute respiratory syndrome identified serum amyloid a protein as a biomarker potentially useful in monitoring the extent of pneumonia 显示文摘 | Yip TT Chan JW Cho WC | 2005 | Clin Chem2005，51，1： | 1 |
| 9 | Acute vertebral body compression fractures:discrimination between benign and malignant causes using apparent diffusion coefficients显示文摘 | Peh WC Tsui EY | 2002 | Br J Radiol2002，75，891： | 1 |
| 10 | The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma显示文摘 | Rosenwald A Wright G Chan WC | 2002 | N Engl J Med2002，346，： | 1 |
| 11 | Quantum dot bioconjugates for ultrasensitive nonisotopic detection显示文摘 | Chan WC Nie S | 1998 | Science1998，281，： | 1 |
| 12 | Elucidating the mechanism of cellular uptake and removal of protein-coated gold nanoparticles of different sizes and shapes显示文摘 | Chithrani BD Chan WC | 2007 | Nano Lett2007，7，6： | 1 |
| 13 | Determining the size and shape dependence of gold nanoparticle uptake into mammalian cells显示文摘 | Chithrani BD Ghazani AA Chan WC | 2006 | Nano Lett2006，6，4： | 1 |
| 14 | Epidemiologic risk profile of infection with different groups of human papillomaviruses 显示文摘 | Chan PK Ho WC Wong MC | 2009 | J Med Virol2009，81，9： | 1 |
| 15 | Probing the cytotoxicity of semiconductor quantum dots显示文摘 | Derfus A M Chan WC W Bhatia S N | 2004 | Nano Lett2004，4，1： | 1 |
| 16 | Systematic investigation of pre- paring biocompatible, single, and small ZnS-Capped CdSe quantum dots with amphiphilic polymers 显示文摘 | Anderson RE Warren Chan WC | 2008 | ACS Nano2008，2，7： | 1 |
| 17 | Determining the size and shape dependence of gold nanoparticle uptake into mammalian cells显示文摘 | Chithrani BD Ghazani AA Chan WC | 2006 | Nano Lett2006，6，4： | 1 |
| 18 | Isolation and characterization of two degradation products derived from the peptide antibiotic nisin显示文摘 | Chan WC Bycroft BW Lian LY | 1989 | FEBS Lett1989，252，： | 1 |
| 19 | The use of molecular profiling to predict survival after chemotherapy for diffuse large-B- celllymphoma显示文摘 | Rosenwald A Wright G Chan WC | 2002 | N Engl J Med2002，346，25： | 1 |
| 20 | The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma 显示文摘 | Rosenwald A Wright G Chan WC | 2002 | N N Engl J Med2002，346，25： | 1 |
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