NPITxt, a 21st-Century Reporting System: Engaging Residents in a Lean-Inspired Process.
Operational waste, or workflow processes that do not add value, is a frustrating but nonetheless largely tolerated barrier to efficiency and morale for medical trainees. In this article, the authors tested a novel reporting system using several submission formats (text messaging, e-mail, Web form, mobile application) to allow residents to report various types of operational waste in real time. This system informally promoted "lean" principles of waste identification and continuous improvement. In all, 154 issues were submitted between March 30, 2011, and June 30, 2012, and categorized as closely as possible into lean categories of operational waste; 131 issues were completely addressed with the requested outcome partially or fully implemented or with successful clarification of existing policies. A real-time, voluntary reporting system can effectively capture trainee observations of waste in health care and training processes, give trainees a voice in a hierarchical system, and lead to meaningful operations improvement.
University of California at Los Angeles, Los Angeles, CA Greater Los Angeles VA, Los Angeles, CA National Quality Scholars Program, Greater Los Angeles VA, Los Angeles, CA praja@mednet.ucla.edu.
Pushpa V
PV
Raja
University of California at Los Angeles, Los Angeles, CA Greater Los Angeles VA, Los Angeles, CA.
Michael C
MC
Davis
University of Southern California, Los Angeles, CA.
Alicia
A
Bales
UCLA Departments of Medicine & Neurosurgery, UCLA Hospitals, Los Angeles, CA.
Nasim
N
Afsarmanesh
D004282:Documentation; D017598:Efficiency, Organizational; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards; D013997:Time Factors; D057188:Workflow
lean; operational improvement; quality improvement; residency; waste identification