Process Improvement in a Cancer Outpatient Chemotherapy Unit using Lean Healthcare

Coelho, Stela Maris; Pinto, Carlos Frederico; Calado, Robisom Damasceno; Silva, Messias Borges

doi:10.3182/20130911-3-br-3021.00047

Cited by 16 publications

(12 citation statements)

References 6 publications

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“…[5] Several challenges may affect the quality of care provided; overcrowding is considered one of the most common challenging components, especially in outpatient settings. [16] Moreover, overcrowding and an increase in demand with limited resources, such as electronic appointment systems and waiting area capacity, may negatively impact the patient experience and increase their suffering. [1617] In addition, numerous articles have studied the effectiveness of lean methods in decreasing waiting time and improving workflow by eliminating wasted processes and redesigning the booking system.…”

Section: Introductionmentioning

confidence: 99%

Improving the Workflow Efficiency of an Outpatient Pain Clinic at a Specialized Oncology Center by Implementing Lean Principles

Hroub

Obaid

Yaseen

et al. 2019

Asia-Pacific Journal of Oncology Nursing

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Objective: Adult outpatient oncology pain clinics face many challenges due to the increased number of patients, the restriction of electronic appointment systems, overcrowding, waiting time, and patient dissatisfaction. This project aimed to improve clinic time efficiency, decrease clinic waiting time, and improve patient satisfaction. Methods: Lean thinking concepts and their tools, for example, value-stream mapping and value added (VA)/non-VA (NVA) analysis were used. Electronic appointment system slots were stratified based on patient visit type. A total of 187 patients were included in a time-motion survey at three different occasions: preintervention ( n = 67) and two consecutive quarter postintervention time points ( n = 64, n = 56). Simultaneously, patient satisfaction was reported quarterly by a quality management office. Results: The pain clinic workflow became more efficient; the mean clinic waiting time decreased from 72.5 min at preintervention to 19.5 and 21 min at the two postintervention quarters, respectively. Moreover, patient satisfaction improved from 75% at the preintervention to 100% and 96.7% at the two postintervention quarters. Conclusions: Redesigning the process of an electronic appointment system using lean thinking considerably decreases patients’ waiting time, improves patient satisfaction, improves resource utilization, allows proper scheduling based on patient visit types, eliminates unnecessary waste processes, and reallocates health-care providers’ time toward direct, individualized patient care.

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Section: Introductionmentioning

confidence: 99%

Improving the Workflow Efficiency of an Outpatient Pain Clinic at a Specialized Oncology Center by Implementing Lean Principles

Hroub

Obaid

Yaseen

et al. 2019

Asia-Pacific Journal of Oncology Nursing

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“…Finally, Coelho et al present evidence of process innovation in health processes, for example, they reduced the cancer outpatient chemotherapy process cycle time from 2 h to 30 min [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…Two hundred and three (203) papers distributed in 120 journals were found to meet the inclusion criteria. In Latin America, Brazilian authors such as Coehlo et al (2015) present a case study of process improvement, in which the performance improvement of the total workspace was 75% and the reduction in waiting for patient care went from 2 h to 30 min [ 57 ]. Coelho et al (2015) also point out that Lean and Kaizen’s efforts can eliminate at least three hours a day of overtime in hospitals in Brazil.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Applying Lean in Process Innovation in Healthcare: The Case of Hip Fracture

Morales-Contreras

Chana-Valero

Suárez‐Barraza

et al. 2020

IJERPH

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Academic literature and practitioners acknowledge that there is a need to improve efficiency and service quality in the healthcare industry. In Spain, osteoporotic fractures represent a great cost in socio-economic and morbi-mortality terms, hip fracture being the surgical pathology with the second highest consumption of resources. The research questions that govern this study concern the use of Lean principles to identify waste, and an evaluation of the application of an innovative approach in the hip fracture surgery process. A research design based on a case study and action research was developed. Findings relate to (i) the identification of the main types of waste or muda (being the most frequent delay, transportation, over-processing and defects); (ii) the analysis of existing processes based on a Lean approach (identifying opportunities for improvement as a reduction of the number of steps and participants, improving communication, automation, standardization, etc.); and (iii) the application of an innovative process based on the Lean approach and action research in the healthcare industry. This research provides insights for academia, practitioners, management, and society: waste identification and process redesign helps to continue the improvement of operations, increase efficiency, reduce costs, and enhance services, providing benefits to patients, families, hospital employees, and the healthcare system.

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“…The color red denotes the critical density, for which the default value is set as 1.5 pedestrians/m 2 . Hospital administrators thus can quickly understand the utilization rate of the space for further planning, since an overcrowded chemotherapy space will affect service quality [ 27 ]. Furthermore, the proposed system can provide more realistic simulation processes for administrators by importing the three-dimensional aspects converted from BIM models.…”

Section: Demonstrationmentioning

confidence: 99%

Constructing Constraint-Based Simulation System for Creating Emergency Evacuation Plans: A Case of an Outpatient Chemotherapy Area at a Cancer Medical Center

Lin

Yien³

et al. 2020

Healthcare

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Making emergency evacuation plans for disaster prevention is always a high priority for hospital administrators to ensure the safety of patients and employees. This study employs the outpatient chemotherapy area of a cancer medical center as an example, and its area involves professional medical care and relatively complex human group behaviors. Hence, it is necessary to simulate evacuations in advance to formulate a special evacuation plan. To achieve this task, a constraint-based simulation system is developed with three major processes: defining spatial and activity constraints, agent-based modeling, and optimizing resource allocation. The spatial boundaries are converted from a three-dimensional model in the Building Information Modeling (BIM) to conduct a visualized simulation. Based on the spatial boundaries, the activities of the agents are set to obey the process specified by work studies. Finally, the Monte Carlo method is employed to simulate the stochastic rescue behaviors of nurses during disasters to determine the fittest resource allocation with the shortest evacuation time for different numbers of patients. The results reveal that the proposed system can output a suggested list of resource allocations and visualized results for administrators when making evacuation plans such that all the people in the area can be safely evacuated.

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Process Improvement in a Cancer Outpatient Chemotherapy Unit using Lean Healthcare

Cited by 16 publications

References 6 publications

Improving the Workflow Efficiency of an Outpatient Pain Clinic at a Specialized Oncology Center by Implementing Lean Principles

Improving the Workflow Efficiency of an Outpatient Pain Clinic at a Specialized Oncology Center by Implementing Lean Principles

Applying Lean in Process Innovation in Healthcare: The Case of Hip Fracture

Constructing Constraint-Based Simulation System for Creating Emergency Evacuation Plans: A Case of an Outpatient Chemotherapy Area at a Cancer Medical Center

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