Browsing by Author "Joubert, Bronwyn"

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    Towards a healthcare performance assessment framework : a review
    (South African Institute for Industrial Engineering, 2018) Joubert, Bronwyn; Bam, Wouter
    Improving health is the fundamental goal of all health systems, and with an evident gap between the potential of the public health system and its performance, bettering the services that provide care is critical to achieving this goal. This gap creates a need to identify and understand what drives performance so as to be able to assess how the potential can be reached. Thus, this research investigates the key inputs into a performance assessment framework and develops a core set of performance dimensions that is inclusive of all the factors that affect performance.
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    Towards the sustainable implementation of lean in hospitals
    (Stellenbosch : Stellenbosch University, 2023-03) Joubert, Bronwyn; Bam, Wouter Gideon; Louw, Louis; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: To meet increasing demands for delivering care with fewer resources, leaders of healthcare organisations are continually looking for ways to optimise healthcare operations and processes. Following significant success in improving quality while reducing costs in the manufacturing industry, healthcare facility managers started implementing “lean thinking”, a management philosophy focused on continuous improvement. While lean success in healthcare has been widely reported, there are also frequent cases where healthcare facilities revert to the pre-implementation state after some time. An initial investigation into the application of lean in hospitals revealed a lack of holistic lean implementation and correctly targeted assessments as contributing factors to unsustainable implementation. However, there is a lack of knowledge of the supporting organisational factors required to support a holistic implementation long-term, and thus the factors that need to be assessed for implementation. Therefore, to foster sustained improvement outcomes, the primary aim of the research was to contribute toward an improved theoretical understanding of how to ensure lean’s implementation in hospitals is sustained. The secondary aim to guide the practical application of these findings was to develop an artefact that encapsulates the improved understanding and supports its implementation in hospitals. A narrative literature review of lean and its application in hospitals was executed to explore the problem and develop objectives for a solution. It motivated the problem of incomplete and unsustainable implementations of lean and the lack of knowledge on how it can be achieved. Additionally, it identified the need for an assessment tool to determine the extent to which activities that would support this are being implemented. Systematic literature reviews were executed to answer the research questions. The factors that have been found to impact lean sustainability in hospitals were gathered, analysed, and synthesised to realise a collection of practices that aid the sustainability of lean in hospitals. Thereafter, a second systematic review of existing approaches to leanness assessment was executed to gather the practices required to implement lean holistically and to consider the possible approaches to structuring the assessment tool being developed. The findings from the two reviews were then considered to develop a preliminary sustainable lean assessment tool (SLAT). A Delphi study was executed on the preliminary tool to verify and validate it. The tool was iteratively refined until the evaluation criteria were all satisfied, resulting in the final version of the tool. The resulting SLAT presents a tool consisting of all the practices required to sustainably transform into a lean hospital that hospitals can use to prioritise those needing improvement.