Introduction: The challenge for healthcare among nursing staffs working in emergency department (ED) is increasing, particularly in the period of COVID-19 pandemic, which causes overcrowding and workloads facing many patients and additional infection control measures. Implementation of Lean management in healthcare can improve care capacity (e.g. reducing unnecessary waste in the production process, procedure times, and length of hospital stay), avoiding overloading of nursing staffs and improving satisfaction and retention rates of new working staffs. The present study aims to apply Lean Management in ED nursing staffs and examined the role of the professions in this process.

Methods: We recruited 28 ED nursing staff at a regional hospital in April 2023. A project team applied the principles of Lean Management, including developing a care process flowchart to comprehensively identify clinical work issues, increasing nursing staffs in the observation unit, procuring auxiliary bed-assisting devices, and adjusting floor guidance lines, and conducting implementation improvement measures (e.g. digitizing medical records, adjusting the call system, modifying the prescription printing method, automated vital signs uploading system e.g.). The job satisfaction and retention rates of new nursing staffs were obtained initially and re-evaluated after implementation of Lean management in the end of December 2023. 100-point scale was used to evaluate job satisfaction with 0 and 100 indicating extremely dissatisfied and extremely satisfied, respectively.

Results: We included participants (n=28) aged 38.46 years, 89.3% of whom were female. A working experience of 12.75 years is the average. At baseline, job satisfaction was 60.1 and the retention rate of newly hired nursing staffs was 0% (all two new staffs quit job). By December 2023, job satisfaction with the workflow increased to 70.4, and the retention rate for newly hired hires improved to 75% (three out of four newly hired staffs remained in the job).

Conclusion: The study found Lean management may improve job satisfaction and retention rates of newly hired nursing staff.

 

Disclosure of Interest: None Declared

 

Keywords: emergency departments, Lean Management, Nursing Staff's Satisfaction