PDF(Pubmed)
Abstract：
Healthcare makes a significant contribution to the social, economic and environmental benefits of communities. It is correspondingly a significant employer and consumer of both energy and consumables, often at high costs. Lean, a quality improvement methodology focuses on the elimination of non-value add (NVA) activities (steps that do not add value from the perspective of the customer) to improve the flow of people, information or goods. Increasingly, Lean thinking is evolving from its initial focus on eliminating NVA to a more holistic approach that encompasses sustainability. However, little work has been undertaken intentionally, including environmental sustainability outcomes in Lean healthcare interventions. Realist review methodology facilitates an understanding of the extent to which an intervention works, for whom, in what context, why and how, and has proven useful in research relating to Lean interventions in healthcare settings. This protocol provides details for a realist review that will enable an understanding of the specific contexts in which certain mechanisms are activated that enable the inclusion of environmental sustainability outcomes in the design of Lean healthcare improvement interventions.
摘要：
医疗保健对社会做出了重大贡献，社区的经济和环境效益。相应地，它是能源和消耗品的重要雇主和消费者，往往成本很高。精益,质量改进方法侧重于消除非增值（NVA）活动（从客户角度来看不增加价值的步骤），以改善人员流动，信息或货物。越来越多,精益思想正在从最初的消除NVA的重点演变为涵盖可持续性的更全面的方法。然而,很少的工作是故意进行的，包括精益医疗干预中的环境可持续性结果。现实主义审查方法有助于理解干预工作的程度，为谁,在什么背景下，为什么和如何，并且已被证明在医疗保健环境中与精益干预相关的研究中很有用。该协议为现实主义者的审查提供了详细信息，该审查将使人们了解某些机制被激活的特定环境，从而将环境可持续性结果纳入精益医疗改善干预措施的设计中。
