Lean transformation framework for treatment-oriented outpatient departments

Abstract

Long wait times and low resource utilisation are the most critical issues in treatment-oriented outpatient departments. While Lean has been utilised to resolve similar issues in healthcare, the literature provides no structured means of implementing Lean in outpatient departments. This study establishes a Lean transformation framework to identify a balanced patient demand by determining proper patient compositions, to schedule non-specialists to increase resource utilisation, and to level patient schedule throughout the day to reduce wait times. This framework includes a series of activities and Lean tools that are specifically adapted for use in outpatient departments. A case study is presented to illustrate the implementation of the proposed framework and its possible impacts, using data from a community hospital oncology department in Montreal, Canada. Results suggests that this framework reduces patient visit time by 36% and increases daily treatments by 39% and utilisation of chemotherapy chairs by 22%, with a possibility to implement a one-day treatment regime. The proposed framework can assist treatment-oriented outpatient departments to overcome their operational challenges and to serve as an effective guideline in their Lean transformation.