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SOC 222 > Nursing > Flashcards

Nursing Flashcards

1
Q
A
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2
Q

(5) Job related actions to enhance position in medical labor force/achieve status of profession

A

1) shift to univeristy training
2) taking over physicians dirty work
3) use of managerial ideology
4) taking control of technology
5) unionizing

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3
Q

Occupation in crisis

A

Nurses

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4
Q

Impact of cutbacks on Doctors vs. Nurses

A

doctors have always been relatively privileged group - still had to work harder (reported increased stress) but incomes have remained high

Nurses have received the most pressure yet earn the same as national avg income

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5
Q

in 2012, average annual income of:

a) GPs
b) specialists

A

a) 180k
b) 350k

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6
Q

History of nursing begins with?

A

Florence Nightingale

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7
Q

Florence Nightingale

  • background before Crimean war
A

born into relatively wealthy family in 1820

  • strong-willed woman
  • despite her familys strong objections to working as a nurse, she studied HC anyways
  • became director of nursing home in England where she transformed it into an efficient little hospital
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8
Q

Nightingale effectively transformed nursing from… into…?

A

FROM occupation restricted to untrained nuns/charity workers INTO genuine occupation requiring vocational education

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9
Q

Nightingale is famous for her work in? (years?)

A

the Crimean War (1853-1856)

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10
Q

What was the nickname Nightingale earned in the Crimean war? For what reason?

A

Lady with the Lamp

- for her nightly rounds of checkin on patients with her lamp

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11
Q

When Nightingale and her group of nurses first arrived in Crimea, how were they recieved?

A

met with hostility from doctors there

(doctors were obsessed about maintaining control/a monopoly over HC)

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12
Q

How did Nightingale respond to the doctors hostility? (3 pts)

A

reassured them that nurses were not competition and were strictly there to obey the doctors orders & do women’s work (cooking & cleaning)

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13
Q

How did Nightingale make a difference by cooking & cleaning in the Crimean War (1853-1856)?

A

by taking over cooking & cleaning, she was able to introduce proper standards of nutrition & sanitation which was previously ignored by male doctors - mortality rates declined sharply

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14
Q

One famous case where Nightingale helped improve sanitation

A

persuaded military officers to go upstream & found dead horse spewing bacteria - convinced them to move it

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15
Q

Florence Nightingale -After Crimean War

A

took heavy toll on her, ill & bed-ridden most of her life

  • became public heroine & used her fame to write about nursing, engage in political activism & organizational work that laid the foundation for modern nurse training
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16
Q

First Nursing School in Canada

A

St.Catharines

  • established in 1874 in Ontario
  • based on Nightingales model of nursing
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17
Q

Nursing - occupation for women

A

virtually only paid occupation for women

  • therefore it was very attractive for those who wanted an education & career (middle-class women)
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18
Q

# of nursing schools in Canada in…

a) 1900
b) by 1909
c) by 1930

A

a) 20
b) 170
c) 220

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19
Q

The first 30 years of the 20th Century were known as the period that..

A

saw the greatest expansion in nursing

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20
Q

Impact of the Flexner Report on Nursing

A

following the recommendations of the Flexner report, the 1st university degree program in nursing was established in 1919 at UBC

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21
Q

1900s: # of nurses vs doctors

A

200 nurses compared to 5,000 doctors

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22
Q

1930: # of nurses vs doctors

A

30,000 nurses compared to 10,000

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23
Q

After 1930, what happened to the rate of growth of nursing?

A

declined

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24
Q

Despite the decline in the rate of growth of nursing after 1930, Throughout the 20th Century…

A

nursing maintained average annual increase of 50%

- compared to less than 10% for doctors

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25
Q

By 2006, How many registered nurses in Canada? What % were women?

A

320,000

94% women

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26
Q

Nurses made up __ of all HC providers becoming the…

A

2/3

single largest profession in Canada

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27
Q

In economic terms, the expansion of nursing allowed…

A

Canadian women to get back into labor market from which they had been virtually squeezed out of by late 19th century

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28
Q

Routes for Economic Independance for women in early 20th century? (2)

A

1) Inheritance
2) nursing

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29
Q

Despite being the only route to independance (apart from inheritance) for women, there were still drawbacks/limitations to nursing.

A

hard road to travel

only gave limited form of independance

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30
Q

Although Nightingale herself was strong & independent, her teaching methods demanded…

A

strict obediance to male doctors

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31
Q

Argument about Nightingale’s teaching methods

A

some say she did a disservice to women

  • but may have been the only way to be accepted & overcome the hostility of male doctors
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32
Q

Only way that nursing could be accepted by doctors was if…

A

they defined themselves as an AUXILLARY OCCUPATION to that of doctors (a supplementary occupation)

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33
Q

The general attitude about nursing by male doctors

A

women were still doing women’s work, just in a hospital setting

  • which was acceptable to male docs at the time
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34
Q

Connection b/w Patriarchal relations that existed in Victorian family/society & HC

A

the patriarchal relations that existed in Victorian society/family (era: 1837-1901) were reproduced within the hospital

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35
Q

The Patriarchal (male-dominated gender) relations that existed in Victorian society/family were reproduced within hospital, creating…

A

a new gender division of labor in HC

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36
Q

Men providing cuts & chemicals (surgery & drugs) & women providing nutrition & sanitation was a reasonable division of labor. However, the problem was..

A

men ended up taking most of the money & power but the women did most of the work

  • particularly nursing students
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37
Q

Early 20th Century - Nursing students

A
  • treated like slave laborers
  • work consisted of hard manual labor (washing floors/windows, changing beds, cooking)
  • forced to work 12-16 hours/day in hospital WITHOUT pay
  • only received training, room and board
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38
Q

When did Nursing students get paid?

How much compared to average male wage?

A

Only after they had graduated & recieved their Nursing Diploma

  • only 1/2 of average male wage
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39
Q

Nursing students training consisted of..

A

mostly on-the-job training which consisted of working hard while being supervised by small permanent staff of grad nurses

  • no time for actual study/theory
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40
Q

How long to finish a Nursing Degree in the early 20th century?

A

2-3 years

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41
Q

How did the hospitals benefit from nursing students in the early 20th century?

A

provided hospitals with rotating pool of cheap labor

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42
Q

After graduation, where would nurses work?

A

some worked as private nurses but increasings #s found jobs in hospitals

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43
Q

The explosive growth of nursing schools was greatly motivated by?

A

the desire of hospital administrators & doctors to have cheap labor

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44
Q

What effect did permanent nursing staff have on hospitals?

A

no more cheap labor

  • less motivation for growth of nursing profession
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45
Q

How did nursing change hospitals in early 20th Century compared to 19th century?

A

19th century - hospitals were places people only went to die

20th - changed hospitals into hygienic centers of care & recovery which

changed public image of hospitals

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46
Q

Nursing made major contribution to… yet?

A

medical profession & doctors reputation yet still they were heavily exploited

paid virtually nothing for a lot of work

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47
Q

As the # of nurses rose, they begin to..

A

fight for their rights

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48
Q

Nurses realized the only way to get better wages & working conditions was through (2)?

A

self-organization & collective action

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49
Q

1908 - established?

A

Canadians Nurses established Canadian National Association of Trained Nurses (CNATN)

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50
Q

1924

A

reorganization CNATN and renamed as Canadian Nurses Assocation

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51
Q

Canadian Nurses Association - significance today

A

still remains main organization that represents nurses interests today

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52
Q

First goal of CNATN in 1908

A

establish provincial registries of qualified nurses -only these nurses could practice nursing

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53
Q

1910

A

began to set up registries & nurses became known as RNs

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54
Q

Through the process of registering nurses.. the nursing profession tried to…

A

gain monopoly on role of assistant caregiver but never been as successful as doctors in achieving a monopoly

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55
Q

By WW2 (1939-1945). organization of Nurses

A

organized enough to gain some concessions - gained 8 hour day

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56
Q

1950 - nurses income

A

nurses pay was 60% of avg national income

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57
Q

by 1980 - nurses income

A

risen to avg national income - mostly due to pressure from nurses

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58
Q

In addition to pushing for better wages & working conditions, Nurses also demanded?

A

real education and not just on-the-job training

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59
Q

1964 - Nursing

A

Hall report - Royal commission looking into HC delivered report that was critical of nursing education in Canada

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60
Q

The Hall Report of 1964 recommended what change to nursing?

A

seperation of nursing training from hospital demands for nursing services

(nursing education should be seperate from training)

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61
Q

How did the government respond to the Royal Commission’s recommendations of seperating nursing education from training?

A

in late 60s/early 70s → nursing education moved away from hospital schools into newly created diploma programs in universities

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62
Q

What aspects of Nursing were significantly improved after the government responded to the Royal Commissions recommendations?

A

skills & standards

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63
Q

What other change did the government make other than to nursing education?

A

changed immigration policy to attract more nurses

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64
Q

As a result of the change in Canadian immigration policy…

A

over 20,000 nurses immigrated to Canada - mostly from Britain

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65
Q

Britain’s NHS

A

Britain’s National Health Service/System (NHS) was more advanced & developed than Canada’s HC system

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66
Q

NHS - impact on Canadian HC

A

Canadian government deliberately tried to upgrade nursing standards & increase # of nurses

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67
Q

The government’s attempts to upgrade nursing standards & increase # of nurses by changing immigration laws was part of..

A

overall policy of Canada to establish Medicare by copying Britain’s NHS

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68
Q

Time period that saw considerable expansion in # of nurses

A

1960s & 1970s

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69
Q

The expansion in the # of nurses in 60s & 70s was accompanied by..

A

a growing division of labor

70
Q

Nursing saw an increase in (3) things

A

1) specialization
2) fragmentation
3) hierarchization

71
Q

Nursing began to generate its own __ ___

A

auxilliary occupations

(therapists, dieticians, orderlies, technicians)

72
Q

specialization of nursing

A

some nurses took more education to upgrade their qualifications & specialize in one area of nursing

  • realized pay only increased marginally
    (still 3/4 of nurses are general duty nurses)
73
Q

While there were some changes in nursing, more changes changes occured where?

A

at bottom of occupational ladder- auxiliary occupations

74
Q

How did hospital administrator try to cut nurses wage bill after they had just gotten their wages increased?

A

replaced many nurses with registered nursing assistants (1970s)

  • when RNAs got organized & pushed for higher wages, they were replaced with nursing attendants (1980s)
75
Q

The replacement of nurses with registered nursing assistants & then nursings attendants demonstrates…

A

class struggle in action which is seen in any area of the economy

  • cycle that is built into capitalism
76
Q

Despite all these changes to the Nursing field, what remained constant? How?

A

Ongoing feminization of HC system

  • by 1990s, 2/3 of HC system workers were nurses (90% women)
  • nearly 80% of all HC workers = women
77
Q

Despite the increasing proportion of women in the HC system..

A

women’s influence & power has not grown in proportion to their #s

78
Q

in the late 80s/90s, how were hospital bills broken down?

A

into thirds

1/3 for doctors

1/3 for nurses

1/3 for administrative & support staff

79
Q

Nursing expanded greatly in 60s & 70s, but in 80s & 90s, there was a major increase in..

A

administrative staff

80
Q

(2) reasons for the major increase in administrative staff in hospitals

A

1) certain support services were removed from nursing & subcontracted to private companies
2) growth & change in kind of hospital administrators

81
Q

80s → certain support services removed from nursing

A

hotel services (cooking, cleaning, laundry, catering) were no longer nurses responsibility & hospitals subcontracted these to private companies

82
Q

What was the beginning of privatization of HC

A

subcontracting private companies for hotel services

83
Q

Growth & change in in kind of hospital administrators

A

in 5 years (1981-86), # of HC administrators grew by over 2/3s

- hospitals began to hire administrators outside of HC field-

mostly managers from private sector who had an education in management & not HC

84
Q

Before the 80s, who were hospital administrators?

A

mostly doctors or other HC workers that had climbed administrative ladder internally

85
Q

by 1993.. HC administrators characteristics

A

1/3 of HC administrators had NO HC experience

  • mostly men
  • business degree/experience in management
86
Q

Changes in control/influence due to the new kind of hospital administrators

A

doctors lost control of hospitals

  • womens influence decline
87
Q

How did these new hospital administrators view their job & how did this affect working in the hospital?

A

saw their job as the same kind they had in private sector

  • pressure workers work as hard as possible
88
Q

Why did most of pressure from hospital administrators fall on nurses?

A

doctors were still seen as relatively privileged group, middle-class professionals who deserved to not be pushed as hard

89
Q

Managerial structure emerged in hospitals

A

private administrators > doctors > nurses & auxiliaries

90
Q

To the hospital administrators, nurses were seen as..

A

the working class of the HC system which management has always pushed to work harder

91
Q

How did Hospital administrators push nurses to work harder??

A

through the process of deskilling

92
Q

deskilling

A

breaking down jobs into simple tasks so highly paid experts can be replaced with less-skilled cheaper workers

93
Q

(2) advantages of deskilling for management

A

1) increased control over workforce
2) saves $$ by decreased wage bill

94
Q

Deskilling - first noted in academic terms by..

A

Chares Babbage in early 19th Century

→ known as Babbage Principle

95
Q

Other terms for deskilling

A

late 19th century → Fordism (Henry Ford)

early 20th→ Taylorism (named after Frederick Taylor who invented time & motion studies & scientific management)

late 20th→ Mcdonaldization

96
Q

Terms for Deskilling within the field of HC

A

Managerial Ideology

Case-mix grouping

Total Quality Management (TQM)

97
Q

Why should TQM be called Totalitarian Quality Management? (as opposed to total quality management)

A

because it introduces total control over nurses work

totalitarian (def’n) - system of government that is centralized, dictatorial & requires complete subservience to the state.

98
Q

What were nurses told that TQM do?

A

provide greater autonomy

make jobs easier by improving job effeciency

help to assess staff needs - hopefully to decrease workload of nurses

99
Q

What did TQM actually do?

A

breaks down nursing into specific jobs & assigning specific amounts of time for each task (based on polls asking nurses how much time they needed for each)

  • allowed administration to cut amount of time allowed for each job to force nurses to work harder/faster & save money by not hiring more nurses
100
Q

Origin of TQM relating to the negative consequences of TQM

A

TQM was taken from factory work where assembly lines can be standardized to improve efficiency

  • However, people are not machines & HC cannot be standarized because it wouldnt account for personal differences
101
Q

How does the standardization of HC by TQM affect nursing care how?

A

left nurses without enough time so that they were constantly falling behind on tasks - made decision making difficult b/c they had less time to make possibly life-or-death choices

102
Q

Quality of Care given by nurses after TQM introduced

A

of mistakes increased

of people harmed increased

- because they did not have enough time

103
Q

TQM’s attempt to standardize HC had negative effects on…

A

the patients & the nurses

104
Q

Study by Canadian Institute for Health Information (2004)

  • main finding
A

over 5 million CDNs reported they or member of their family had been harmed by medical errors in hospital

105
Q

Study by Canadian Institute for Health Information (2004)

  • statistics given (5)
A
  • 1 in 9 reported receiving incorrect meds/dosage
  • 1/9 adults & 1/11 children contracted infection in hospital
  • 1/81 newborns suffered birth trauma
  • 1/~1000 seniors suffer hip fracture
  • 1/~7000 reported having foreign object left inside them after procedure
106
Q

TQM treats nurses as if they were?

A

interchangeable components on assembly line

107
Q

How has TQM resulted in a lack of continuity of HC?

A

different nurses do different jobs on same patient → unable to learn patients overall health situation so nurses can’t treat patients like individual with individual needs

108
Q

TQM is the ultimate extension of?

& denial of?

A

extension of male mechanical model

& denial of traditional holistic female approach to HC

109
Q

TQM turned the continuous process of care into?

A

series of compartmentalized cures that were about seeing to a patients minimum needs

110
Q

TQM also eliminated what side of HC?

A

subjective side of HC - part of nurses work called emotional labor

111
Q

Explain how private sector administrators view HC & how that is reflected in their management.

A

administrators deal with balance sheets, numbers & money

  • the comfort that nurses provided is invisible & seen as a waste of time that must be eliminated to increase speed**, **efficiency** & **decrease cost
112
Q

How does TQM treat

a) nurses
b) patients

A

a) as if they were uneducated unskilled labourers who have to be told what/how/when to do things
b) treats patients in a standardized manner

113
Q

In Sociological Terms, professionals want control over their own __ __

A

labor process

114
Q

TQM has greatly increased level of ___ that nurses experience from their jobs

A

alienation

115
Q

How has TQM affected quality of care given by nurses?

How has this affected hospital in last 30 years?

A

has forced them to do their jobs badly bc they do not have enough time or resources

  • health, sanitation & nutrition levels declined over last 30 years
116
Q

In general, how has TQM affected nurses?

A
  • cause nurses to blame themselves/other nurses
  • increases levels of stress
  • physical** stress of **overwork
    • psychological stress of not being able to do jobs properly*

- rise in work-related injuries & illnesses for nurses

117
Q

By the late 1990s, as a result of TQM, nursing has become known as..

A

the sickest profession in Canada

118
Q

Nursing - Sickest Profession in Canada - Example

A

1997 - sick leave average

CDN = 1 week

nurses = just over 3 weeks

119
Q

Nurse Burnout

A

in 1990s, as a result of TQM - many nurses quit because they couldn’t take the pressure

120
Q

Why is the phenomenon known as Nurse Burnout only happening in the later 20th Century?

A

in the late 19th/early 20th Century, nursing was really the only acceptable & paid job for women

  • now, women have many other options
121
Q

2000 - Canadian Nurses Association study found..

A

~ 1/3 nurse graduates left canadian nursing within 5 years of graduating

  • 20% quit altogether

- 10% went to USA to work in private sector (paid more)

122
Q

What decade saw a sharp decline in the # of applicants & graduates of nursing schools?

A

1990s

123
Q

Nurses graduated in Canada in 1999 vs. 2000

A

1999: ~9000

2000: <5000

124
Q

How did Nurses try to fight back against the increasing stress put on them? (3)

A

in late 1980s, Nurses Union proclaimed TQM was endangering patients life through pressure putting on nurses

  • Provincial Nurses Unions took a stand on SAFETY TO PRACTICE issues
  • went on strike
125
Q

First Wave of Nursing Strikes

A

bc they were being completely ignored, wave of nursing strikes swept across Canada in late 80s/early 90s

126
Q

late 80s/early 90s - Nursing Strikes

A

1988- SK & AB

1989 - BC & Quebec

1991 - Manitoba (longest strike)

127
Q

What was the result of the Nursing strikes?

A

a professional responsibility clause was added to nurses contracts that established channels for nurses to express their grievances

128
Q

2nd wave of nursing strikes - when?

A

late 90s/early 2000s - every province in Canada

1999- SK

129
Q

How did SK government respond to SK nurses going on strike

A

NDP gov met nurses w/ great hostility despite being party of the working class

  • ready to enact back to work legislation

- used courts to threaten unions with fines & leaders with prison time

130
Q

Throughout the 2000s, nurses have been ___, ___ & ____

A

overstressed

over-supervised

over-worked

131
Q

2003 Statistics - Nurses Overtime

A

CDN nurses worked over a quarter million overtime hours in a week

  • equivalent to work of 7,000 full-time jobs a year
132
Q

2005 - Study on Ontario Nurses - findings

A

58% of nurses & 66% of junior nurses experiencing symptoms of nurse burnout

  • 1 in 3 nurses under 30 plan to quit
  • 1 in 3 over 50 plan to retire early
133
Q

2005 Study on Ontario Nurses

  • Symptoms of nurse-burnout (5)
  • reasons for symptoms of nurse-burnout? (3)
A
    • depression, emotional/physical exhaustion, physical illness & growing cynicism of job*
      1) work overload
      2) lack of fairness in workplace
      3) lack of empowerment (increasing supervision & not in control)
134
Q

How does TQM put more pressure on nurses to quit?

A

their job involves making life-or-death decisions

  • mistakes increasing b/c of lack of resources/time/people
  • worries nurses b/c patient life & health is compromised
135
Q

How has SK addressed this issue of nurse burnout?

A

In 2012, Premier Brad Wall announced that SK will once again lead way for Canada in improving HC (just like TD did) → 1st province to introduce LEAN Management

136
Q

LEAN Management in SK

A

in 2012, SK government signed 4 year contract with Seattle-based company John Black & Associates

  • pay 40 million over 4 years to teach LEAN management techniques in over 1,000 HC facilities
137
Q

Origin of LEAN

A

Japan

138
Q

Sensei (meaning)

A

one who has gone this way before

  • voice of experience
  • teacher
139
Q

How did the public view LEAN?

A

initially well until 2014

  • was criticized for 40 million $ price tag
  • Cam Broten of NDP called lean a “cult”
140
Q

How has SK Premier defended Lean & its 40 million dollar cost?

A

says that LEAN management has already more than paid for itself

  • by eliminating waste & improving efficiency, has saved:
  • 35 million in blood services
  • 16 million in design of new hospitals in Saskatoon & Moosejaw
  • millions more in 100s of small savings in HC facilities all across province
141
Q

How was lean created?

A

Toyota automobile corp.

  • the term was coined by American Analyst John Krafcik who wrote article about Toyota in 1988
  • introduced idea of LEAN to the west
142
Q

Toyota - History

A

founded in 1930s as small family business

-has since grown to be the 5th largest corporation

143
Q

The Toyota Way - History & Basis

A

based its production on assembly line techniques pioneered by Henry Ford In USA

  • concerned with efficiency & elimination of waste by standardized & simplified production process
  • an extension of Fordism & based on Taylorism (time & motion studies)
  • Flow System -production should flow smoothly - no bottle necks or unused resources
  • aka Just in Time system - each person finished their part of job just in time for next person to take over
  • dont need lots of backup inventory (save $$)
144
Q

The Toyota Way Philosphy

(6) points
- culture
- philosophy
- emphasizes
- decision-making

-

A
  • establishing culture where everyone is committed to always looking to improve process
  • managerial philosophy

- emphasizes teamwork & mutual respect between management & employees

  • decisions reached by consensus

- regular meetings to look for ways to do things better

  • work as team, come to think of as team
145
Q

How does the Toyota Way differ from standard manager-worker relationships

A

management regularly consults workers & gets feedback

  • workers are involved in decision-making process & their opinions are respected
  • makes them feel like it is their company so they want to be more efficient & finds ways to do job better
146
Q

What does Toyota literature say is the primary reason behind their time-saving techniques?

A

these time-saving techniques are by-products of the positive attitude, teamwork, mutual respect & culture of improving workforce

147
Q

Why is the Toyota Way unsuccessful for many companies over the longterm?

A

most managers dont think/dont want to think this way - they beleive that managers should give orders & workers should obey (top-down manner)

  • rather than set up meetings, they hire Sensei’s to tell workers what to do which makes workers angry, decreases morale & makes workers less engaged
148
Q
A
149
Q

(5) Job-related actions

A
150
Q

Top-down manner of LEAN in HC

A

techniques implemented without consulting workers

  • nurses are expected to learn japanese terminology on top of their job
  • alienates workforce
151
Q

The top-down arrogance eliminates chances of?

A

from the beginning, eliminates chances of creating a teamwork attitude & gaining workforce support

152
Q

Why is the experiment of introducing LEAN into HC inevitably going to lead to problems ?

A

LEAN was invented in factory setting to provide goods not services

153
Q

Problems with LEAN in HC Setting (3)

A

1) standardization
2) Flow/Just in Time
3) Eliminating Unused Inventory

154
Q

1) Standardization

A

LEAN works by standardization → can’t standardize people → need customized/individualized care

155
Q

2) Flow/Just in Time

A

in factory setting, production slowed/temporarily halted - may lose $$ but overall system still making money In HC → If one person doesn’t do their job on time - endangers peoples lives

156
Q

3) Eliminating Unused Inventory

A

in factories, production & supply needs are fairly predictable - can just order supplies if needed In HC → needs are not predictable & goods needed right away or patients can die

157
Q

April 2014 - SK Survey

A

50% of nurses said quantity & quality of supplies available have declined since LEAN - vital equipment missing & meds unavailable

158
Q

The Governments real motivation behind LEAN

A

to save money

159
Q

What evidence backs up the idea that the Government only introduced LEAN to save money and not improve HC?

A

**Nurses Survey (April 2014) **

before LEAN, prov. gov. increase HC budget by 7-10% but now after LEAN → only 3-4% annual increase

- July 2014 Report

160
Q

July 2014 - Report

published by independent assessor of HC system

Conclusions?

A

Wall gov. has neglected HC facilities

  • need to spend 2.2 billion $ just to provide essential repairs to existing HC buildings that are falling apart

- 87% of HC facilities rated poor-fair

161
Q

LEAN implentation timeline

A

2012 - contract signed

2013 - introduced at start of this year

162
Q

Tracy Zambory

A

President of SK Union of Nurses

163
Q

Change in SUN’s opinion of LEAN

A

2013: LEAN leading to “many commendable changes”

Within 1 year (early 2014): already became obvious that only purpose of changes was “budgetary savings” & these changes had “little impact on direct care at bedside & patient outcomes”

  • does not fit into safe nursing practice
164
Q

Positive Change of LEAN (4)

A

1) inventory management
2) waste reduction
3) saving $$
4) undo certain steps of TQM - sped up delivery of HC

165
Q

SUN Survey

A

Found HC has sped up form before LEAN (2012) to after LEAN (2013)

  • also increase in critical incidents faster not safer
166
Q

What is the only way that LEAN could work in HC?

A

If LEAN was really done Toyota Way

  • regular meetings & consultations b/w docs, nurses & hosp admin - IF so → give front-line HC workers more input & reduce input of admin
167
Q

LEAN done the SK Party Way

A

not about improving HC

  • about saving prov. gov. $$ & increasing power & control over front-line HC workers
168
Q

What can LEAN not do?

A
  • deliver on its promises of better HC
  • gain support of nurses
169
Q

LEAN as a fad

A

enthusiasm has waned, eventually will fade away when next fad comes along

170
Q

Cycle of HC Fads

A

TQM, LEAN… - always about reducing costs & increasing control

SOC 222 (13 decks)

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