Lean methodology improves efficiency in outpatient academic Gynecologic Oncology clinics

Duska, Linda R.; Mueller, Jennifer; Lothamer, Heather; Pelkofski, E.; Novicoff, Wendy M.

doi:10.1016/j.ygyno.2015.07.001

Cited by 29 publications

(26 citation statements)

References 18 publications

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“…With patient wait times in the VA achieving national prominence, lean methods may be helpful in reducing backlogs and streamlining inefficiencies in the VA system, as they have done in other areas of health care. [17][18][19]24,25 This study demonstrated that there were improvements in the volume of general surgery patients seen both in the clinic and the OR. Part of this improvement involves the adoption of e-consultations, which can be used as a formal form of communication between physicians, residents, and nurse practitioners within the electronic medical record.…”

Section: Discussionmentioning

confidence: 99%

Effect of Lean Processes on Surgical Wait Times and Efficiency in a Tertiary Care Veterans Affairs Medical Center

et al. 2017

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IMPORTANCEThere are an increasing number of veterans in the United States, and the current delay and wait times prevent Veterans Affairs institutions from fully meeting the needs of current and former service members. Concrete strategies to improve throughput at these facilities have been sparse. OBJECTIVE To identify whether lean processes can be used to improve wait times for surgical procedures in Veterans Affairs hospitals. DESIGN, SETTING, AND PARTICIPANTS Databases in the Veterans Integrated Service Network 11 Data Warehouse, Veterans Health Administration Support Service Center, and Veterans Information Systems and Technology Architecture/Dynamic Host Configuration Protocol were queried to assess changes in wait times for elective general surgical procedures and clinical volume before, during, and after implementation of lean processes over 3 fiscal years (FYs) at a tertiary care Veterans Affairs medical center. All patients evaluated by the general surgery department through outpatient clinics, clinical video teleconferencing, and e-consultations from October 2011 through September 2014 were included. Patients evaluated through the emergency department or as inpatient consults were excluded.EXPOSURES The surgery service and systems redesign service held a value stream analysis in FY 2013, culminating in multiple rapid process improvement workshops. Multidisciplinary teams identified systemic inefficiencies and strategies to improve interdepartmental and patient communication to reduce canceled consultations and cases, diagnostic rework, and no-shows. High-priority triage with enhanced operating room flexibility was instituted to reduce scheduling wait times. General surgery department pilot projects were then implemented mid-FY 2013. MAIN OUTCOMES AND MEASURESPlanned outcome measures included wait time, clinic and telehealth volume, number of no-shows, and operative volume. Paired t tests were used to identify differences in outcome measures after the institution of reforms. CONCLUSIONS AND RELEVANCE Improvement in the overall surgical patient experience can stem from multidisciplinary collaboration among systems redesign personnel, clinicians, and surgical staff to reduce systemic inefficiencies. Monitoring and follow-up of system efficiency measures and the employment of lean practices and process improvements can have positive short-and long-term effects on wait times, clinical throughput, and patient care and satisfaction.

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Section: Discussionmentioning

confidence: 99%

Effect of Lean Processes on Surgical Wait Times and Efficiency in a Tertiary Care Veterans Affairs Medical Center

et al. 2017

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“…We compare in this section our roadmap to other Lean methods. The majority of Lean methods [5], [8], [18], [20]- [22], [24]- [27], [29], [31]- [33], [36], [39] considered that the Lean approach is a set of tools to apply. [19], [37] emphasized on the principles to satisfy.…”

Section: Related Workmentioning

confidence: 99%

Lean Roadmap: A Step by Step Guide for a Process Manager

Tiamaz¹,

Souissi²

2019

IJITEE

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This paper aims to build a generic roadmap for implementing Lean in different domains in order to improve the business processes. The customization of this roadmap makes it possible to adapt the steps to be followed for Lean implementation, the process manager’s requirements and available resources. An application has been developed in order to facilitate the customization of this roadmap. An analysis of methods from a literature review for Lean implementation was conducted in order to identify the steps to be included in the roadmap. A rigorous approach based on set theory, was therefore proposed and followed to build the roadmap. This roadmap is defined as a set of phases associated with principles, and each phase is defined as a set of steps associated with tools. This roadmap shows to the process manager, the objectives to aim for, the Lean principles to satisfy, and the Lean tools to use.

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“…As many publications focus on very specific aspects, the fourth tendency is based around expanding these aspects to a more general level with respect to different processes, tools and target audiences, to only name a few (Abdelhadi 2015;Daultani et al 2015;D'Andreamatteo et al 2015;Duska et al 2015;Goodridge et al 2015;Simons et al 2015;Sugianto et al 2015). D'Andreamatteo et al (2015 and Holden et al (2015) demand the investigation of national differences, while Andersen and Røvik (2015) ask for adaption of Lean Philosophy to the local context.…”

Section: Future Research Tendenciesmentioning

confidence: 99%

State of research and future research tendencies in lean healthcare: a bibliometric analysis

2017

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The application of Lean Philosophy in a healthcare environment is still a relatively new field of research, but there already exists a considerable amount of literature on the topic. This article structures, analyzes and interprets the data of articles on Lean Healthcare from 2002 through 2015 bibliometrically. The databases used in order to realize the analysis are the main sources for citation data available: Elsevier's Scopus and Thomson Reuters' Web of Science. The scientific contribution of this article lies in structuring the literature on Lean Healthcare and summarizing future research proposals. Thereby it encourages the review and consolidation of existing directions in this field of research and the exploration of new ones. With respect to the article's applied contribution it helps hospitals and professionals which want to apply Lean Healthcare to deal with uncertainties and challenges before or during its implementation by granting easy access to the literature. It also allows adapting suitable findings of major publications for the practical implementation with the goal to improve the patient experience. As results of this bibliometric analysis it was found that J.E. Bassham and D.I. Ben-Tovim share the first place as most cited authors in Lean Healthcare and the Linköpings Universitet is the most cited institution. With respect to countries, the United States take the first rank. The most cited article is Trends and approaches in lean healthcare by L. Brandão de Souza which was published in the most cited journal, namely Leadership in Health Services. Four main tendencies for future research possibilities in Lean Healthcare were identified: Evaluate the implementation; Amplify basic knowledge; Investigate challenges and success stories; Expand the focus.

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Lean methodology improves efficiency in outpatient academic Gynecologic Oncology clinics

Cited by 29 publications

References 18 publications

Effect of Lean Processes on Surgical Wait Times and Efficiency in a Tertiary Care Veterans Affairs Medical Center

Effect of Lean Processes on Surgical Wait Times and Efficiency in a Tertiary Care Veterans Affairs Medical Center

Lean Roadmap: A Step by Step Guide for a Process Manager

State of research and future research tendencies in lean healthcare: a bibliometric analysis

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