Tez Türü: Doktora
Tezin Yürütüldüğü Kurum: İstanbul Üniversitesi-Cerrahpaşa, Lisansüstü Eğitim Enstitüsü, Hemşirelikte Yönetim Anabilim Dalı Başkanlığı, Türkiye
Tez Danışmanı: Feride Eşkin Bacaksız
Tezin Onay Tarihi: 2024
Tezin Dili: Türkçe
Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
Özet:
Objective: The study aimed to conduct research on the experiences, opinions, and suggestions of nurses regarding lean healthcare and to propose a model for lean healthcare in nursing management.
Method: In qualitative design, data were collected between August 2021 and June 2022 with individual semi-structured interview forms. The population of the research consists of nurses from two hospitals in Bursa province with lean health experience and three hospitals in Çanakkale province without experience. The research sample consisted of 40 nurses determined with maximum diversity; different semi-structured forms were used in interviews of nurses and nurse managers. The data obtained from the interviews were coded in three cycles by using the MAXQDA analysis program and various analysis methods were used.
Findings: As a result of the analyses, the themes of problems, wastes, continuous improvement, and value were found; categories and codes were discovered related to these themes. In addition to the known wastes in lean healthcare, five more wastes were identified, and out of a total of 12 wastes, off-task work waste was reported the most. It was also observed that the group without lean experience reported more wastes and problems than the group with lean experience, except for the waste of unnecessary material movement. Lack of personnel is the most reported problem and its relation with many problems and wastes is noteworthy. Various lean techniques and practices were included in the theme of continuous improvement, and the inexperienced group knew and performed without realizing these were identified. Nurses identified the value, which is the main focus of lean management, as care and treatment. In the last stage; the themes, categories, and codes were presented in a stepwise manner within the lean house model.
Conclusion: Considering the scarcity of lean healthcare practices in Turkey, as a result of the exploratory nature of this research, the model proposal including additional waste suggestions and problems makes important contributions to the literature. Moreover, it is understood that deficiencies such as lack of personnel and material can also lead to waste. Managers have important leadership roles in the lean nursing journey, and research findings have been reached to guide them in this regard.
Keywords: lean management, lean healthcare, lean nursing, wastes, lean house