手術室の働きやすさ改革

Reformed Operating Rooms as a Comfortable Working Place

はじめに

　本特集のテーマは “手術室の効率的な運営と医療経済” である。まず，なぜ本論文において働きやすさ改革について述べるのかを説明する。働きやすさと企業業績には正の関係があることが示されている^1）。企業における効率というのは，業績を労力で割った数値 “効率＝業績/労力（①）” である。前述の報告を式で示すと，“働きやすい＝業績上昇（②）” となる。①，②より労力が同じであれば，働きやすいと効率が良くなることを示すことができる。

　At our institution, we have received direct guidance from Kaizen experts from Toyota Motor Corporation for improving our operating room（OR）environment. Kaizen is often misunderstood as merely a method to eliminate waste, but its true essence lies in identifying and eliminating difficult or inefficient tasks for staff. By doing so, waste is naturally reduced. To facilitate this process, we introduced a “Problem Identification and Solution Sheet” posted in the OR, allowing staff to record issues as they arise. Over a 2-year period, 147 issues were documented on this sheet：44 by anesthesiologists, 74 by nurses, and 29 by nurse assistants. These were categorized into system-related（29）, equipment-related（78）, and environmental（39）issues. Each issue was addressed using the 4S principles：Sort, Set in order, Shine, and Standardize. This approach, already widely accepted in both industry and healthcare, has contributed to reduced costs, improved space utilization, and decreased potential errors. Given the limited availability of skilled personnel, it is essential to create a work environment where both novices and experienced staff can function effectively. Rather than shifting difficult tasks unchanged, task shifting should be an opportunity to re-evaluate and redesign workflows. We advocate for promoting “ease-of-work reforms” alongside broader workstyle reforms.