Applying Value Stream Mapping to Improve the Delivery of Patient Care in the Oncology Day Hospital

Abstract

Improving the delivery of patient care is an ongoing challenge in the National Health Service (NHS). This challenge is not insignificant in the process of chemotherapy administration for oncology patients. The present research is motivated by a public Spanish hospital in which oncology patients receive medical care in the Oncology Day Hospital (ODH). At the ODH, oncology patients receive different health services by different specialists on a single day. Any discoordination in patient flow will contribute to longer waiting times and stays in the ODH. As oncology patients tend to have special health conditions, any extra time in the hospital is a source of risk and discomfort. This study applies value stream mapping methodology in a Spanish ODH to improve this situation, reducing hospital waiting times and shorting the length of stay. For that purpose, the path of the oncology patients is mapped and the current state of the system is analyzed. Working at takt time and levelling the workload are proposed for improving the working conditions for healthcare personnel. As a result, the quality of service for oncology patients who need a well-defined care profile is improved. The singular characteristics of the Spanish NHS make it challenging to implement new ways of working, so this study has significant theoretical and managerial implications offering directions in which improvement is possible.

Lean Perspectives in an Organizational Change in a Scientific Direction of an Italian Research Institute: Experience of the Cancer Institute of Bari

“…During the mapping, the team members used paper material to take notes and identify the importance, timing, and lead time of the sub-process activities and the sub-processes. Those principles are correlated to the creation of a Value Stream Map (VSM), the starting point of any Lean implementation [17], including in healthcare practices [18][19][20]. VSM allows us to have a clear picture of the trend of the value flow before making any Lean implementations and noting any activities that do not bring value and only generate waste.…”

Lean Healthcare Contributions to Sustainable Development: A Case Study in a Central Sterile Supply Department

“…Among the practices used in hospitals, visual management, value stream mapping, daily management routine, Kaizen Event, and the 5S Program stand out (ARAÚJO et al, 2017;TORTORELLA et al, 2016;VIDAL-CARRERAS et al, 2022). From this, significant benefits can be observed, such as the reduction of lead time, the time of hospitalization, and stay in the hospital environment (COSTA et al, 2017;VIDAL-CARRERAS et al, 2022), through the elimination of different types of waste associated with these processes (ZEPEDA-LUGO et al, 2020).…”

“…Among the practices used in hospitals, visual management, value stream mapping, daily management routine, Kaizen Event, and the 5S Program stand out (ARAÚJO et al, 2017;TORTORELLA et al, 2016;VIDAL-CARRERAS et al, 2022). From this, significant benefits can be observed, such as the reduction of lead time, the time of hospitalization, and stay in the hospital environment (COSTA et al, 2017;VIDAL-CARRERAS et al, 2022), through the elimination of different types of waste associated with these processes (ZEPEDA-LUGO et al, 2020). For instance, the research carried out by Costa et al (2017), adopted Lean philosophy practices in a hospital and resulted in increased patient satisfaction and reduced process costs by optimizing the use of sterilization machines and the sizing of material and medication inventories.…”

“…Except for Q1, all solutions are associated with this SDG.Notably, 8.3, 8.4, 8.5, and 8.8 stand out, which involve increased productivity supported by innovation and technologies, as well as the promotion of decent work policies and safe environments. In this sense, for example, workload balancing (PP2) helps to distribute the demand among employees, reducing overload (VIDAL-CARRERAS; GARCIA-SABATER;MARIN-GARCIA, 2022). Standardizing the handling of steam sterilizer loads (E1) and modifying the layout (L1) also contribute to a safer environment(GRABAN, 2013; COSTA et al, 2015).Goal 9: industries, innovation and infrastructure -build resilient infrastructure, promote sustainable industrialization and foster innovation.…”