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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 | Classical conditioning and retention in normal and mutant Drosophila melanogaster显示文摘 | Tμlly T Quinn w G | 1985 | J Comp Physiol A1985，157，2： | 1 |
| 3 | Complete mitochondrial DNA sequences of the threadfin cichlid(Petrochromis trewavasae)and the blunthead cichlid(Tropheus moorii)and patterns of mitochondrial genome evolution in cichlid fishes显示文摘 | Fischer C Koblmüller S Gülly C | 2013 | PLoS One2013，8，67： | 1 |
| 4 | Relations between the mesiodistal crown diameters of the primary and permanent teeth of HongKong Chinese 显示文摘 | Yuen KKW Tang ELK So LLY | 1996 | Arch Oral Bio1996，41，： | 1 |
| 5 | Guide-lines for the management of aneurism al subarachnoid hemorrhage:a statement for healthcare professionals from a special writing group of the Stroke Council,Ameri-can Heart Association显示文摘 | Bederson J B Conno lly E S Batjer H H | | 0，，03： | 1 |
| 6 | Serial changes of mean plate let volume in relation to Killip Class in patients with acute myocardial infarction and primary percutaneous coronary intervention 显示文摘 | WANG XY YU llY GHANG YY | 2015 | Thromb Res2015，135，4： | 1 |
| 7 | Prim ing for enhanced alveolar fibrin deposition after hemorrhagic shock role of tumor necrosis factor显示文摘 | Fan J Kapus A Lly H | 2000 | Am J Respir Cell Mol Biol2000，22，4： | 1 |
| 8 | Design and analysis of single-factor experiments:Analysis of variance of the effect of rice husk ash and commercial fil ers in NR compounds显示文摘 | Costa HM Ramos VD Visconte LLY | | 0，，： | 1 |
| 9 | Microfluidie conductimettic bioreaetor显示文摘 | Lly H O Chan C Y Cheng A F B | 2000 | Antimicrob Agents Chemother2000，44，1： | 1 |
| 10 | On the adaptive value of physiological in tegration in clonal plants 显示文摘 | Caraco T C K lly | 1991 | Ecology1991，72，： | 1 |
| 11 | q'ne role of the corrrplement cascade in ischeirfia/reperfusion injury:itrrplications for neuroprotecfion 显示文摘 | D' Ambrosio AL Pinsky DJ Conr lly ES | 2001 | Mol Med2001，7，6： | 1 |
| 12 | Risk stratification in providing inter-facility transport: Experience from a specialized transport team显示文摘 | LLY Lee WYL Lo KL Yeung E Kalinowski SYH Tang JTS Chan | 2010 | World Journal of Emergency Medicine2010，1，1： | 1 |
| 13 | Condensed phase relations in the system ZrO2-WO2-WO3 and HfO2-WO2-WO3显示文摘 | SCROGER MG PHILIPS B | 1967 | J Am Ceram Soc1967，50，2： | 1 |
| 14 | The ObJectives for the mech&nic&l ev&lu&tion of spin&l instrument&tion h&ve ch&nged显示文摘 | McN&lly DS | 2002 | Eur Spine J2002，11，2： | 1 |
| 15 | Psychosocial experiences of cardiac patients in early recovery:a community-based study显示文摘 | Dixon T Lim LLY Powell H | 2000 | J Adv Nurs2000，31，： | 1 |
| 16 | Inhibition of NF-kappa B activity in mammary epithelium increases tumor latency and decreases tumor burden显示文摘 | Conne lly L Barham W Onishko HM | 2011 | Oncogene2011，30，12： | 1 |
| 17 | Repeated genomic transfers from echovirus 30 to echovirus 6 lineages indicate codivergence between co-circulating populations of the two human enterovirus serotypes显示文摘 | Bai lly JL Mirand A Henquell C | | 0，，2： | 1 |
| 18 | Antizyme overexpression in transgenic mice reduces cell proliferation, increases apoptosis, and reduces N-Nitrosomethylbenzylamine-induced forestomach carcinogenesis 显示文摘 | Fong LLY Feith DJ Pegg AE | 2003 | Cancer Res2003，63，14： | 1 |
| 19 | Biodegradable collagen patch with covalently immobilized VEGF for myocardial repair显示文摘 | Miyagi Y Chiu LLY Cimini M | 2011 | Biomaterials2011，32，5： | 1 |
| 20 | Maternal nutrient re-striction between early and midgestation and its impact upon appetite regulation after juvenile obesity显示文摘 | Sébert SP Hyatt MA Chan LLY | 2009 | Endocrinology2009，150，2： | 1 |
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