Investigation of the effect of digitalization on time spent in nursing practce and patient safety with lean hospi̇tal approach

The aim of this study is to examine the effects of nursing practices, which are free of wastes such as time, movement, cost and error with digitalized workflows, on patient time, patient and employee safety with a lean approach. The study is an observational study of descriptive type. In this study, Gemba Walk, Value Stream Mapping and Seven Wastes Table which are lean techniques for analysis were used. In addition, the Work Analysis Chart and Sociodemographic Data Form prepared by the researcher was used. The study included 15 nurses working in two different internal medicine clinics of a state hospital in Bolu. One of the internal medicine clinics uses digital applications in nursing work processes, while the other uses digital applications in a limited way. In the data analysis, value stream mapping method was used. For the current situation, the system criteria were measured as L/T 24 hours, value adding time 17.5 hours and time that does not add value is 6.5 hours in the partial digital clinick. For the current situation, the system criteria were measured as L/T 24 hours, value adding time 19.6 hours and time that does not add value is 4.4 hours in the digital clinick. Redundant production, stock, waiting, processing, movement, transport and defects foci determined for both clinics are placed in seven waste tables. Heijunka, kaikau, 5S, kanban, jidoka, andon and poka yoke which are lean methods have been proposed to improve. System criteria for future status L/T 8 hours, value adding time 7.5 hours and time that does not add value was estimated as 0.5 hour. As a result, it has been seen that digital applications will improve nurse workflows, increase the time allocated to direct patient care, decrease in the time spent on documentation, increase in patient, employee safety and satisfaction, thus wasting becomes value. It was concluded that the use of lean philosophy in the analysis and improvement of processes in nurse workflows would be beneficial.