Abstract
Background: Lean system program is essential to help emergency department (ED) nursing staff abhors time waster, add value to the service they are producing and to improve performance of their roles. Aim: Determine effect of lean system program on nursing staff performance for eliminating time wasters at Tanta University emergency hospital (TUAH). Subjects and Method: Setting: ED at TUEH. Subjects: ED nursing staff (N= 95). Tools: (1) Structured questionnaire to assess nursing staff knowledge (2) Assessment of time waster (3) Nursing staff practice to eliminate time waster observational checklist. Results: Preprogram only 7.4 of ED nursing staff showed good total knowledge about lean system compared to 88.4% immediately post-program and 81.1% in the follow-up phase. Nursing staff 55%,53%, 44%, ,43% reported respectively that motion, inventory, over-processing, defect and overproduction as their high time waster. Also, nursing staff 32%.31% reported respectively that waiting and transportation as high time waster. Preprogram no head nurses or staff nurses showed satisfactory level of practice to eliminate time waster but at post program the head nurses 88.4%, and 81.1 of staff nurses showed satisfactory practice. But at follow up, few of nursing staff showed satisfactory practice for eliminating time waster. Conclusion: Preprogram nursing staff at (TUEH) were at low level of knowledge and unsatisfactory practice to eliminate time waster, they significantly improved post program and have good knowledge and satisfactory practice, but at follow up they significantly relapsed back. Recommendation: Conduct periodical regular training programs for nursing staff about lean systems.