Using Value Stream Mapping to improve quality of care in low-resource facility settings

Abstract

The Value Stream Map is a simple visual tool that allows organizations to engage staff at all levels to gain commitment around quality improvement efforts.

Research versus practice in quality improvement? Understanding how we can bridge the gap

“…Building capacity within implementing organizations through technical support provided by researchers for interested implementers can establish a viable infrastructure for practitioners and researchers to work together more effectively. For example, multi-year research practice partnerships in facilities in Kenya has led to sustainable QI programs with dissemination of methods and results through co-authored peer-reviewed journals and conference presentations [ 20 ] Similar results were seen for research capacity building targeting implementers in the Africa Health Initiative in five countries in Africa [ 21 ]. Support for practice-based researchers to build their capacity in QI and in process evaluation using implementation science methods can also increase the potential of improvement projects to produce the knowledge needed about the implementation to spread learning within and beyond their organization.…”

Implementing Lean Management Techniques at a Radiation Oncology Department

“…Hence, the current study was conducted to implement LM principles so as to improve efficiency and reduce unnecessary waste, thereby enhancing workflow and, ultimately, ensuring the delivery of treatment in a timely manner. 9,11 Prior to the application of LM techniques, the department utilised a 'push' system to book appointments for simulation. The radiation oncologist, as the individual who first saw the patient and decided to administer radiation therapy, would book the patient in for simulation, thus 'pushing' the patient through the system.…”

“…However, a VSM is quite different from other flowcharts in that it incorporates both materials and information. 9 In healthcare, LM is defined as "an organization's cultural commitment to applying the scientific method to designing, performing and continuously improving the work delivered by teams of people, leading to measurably better value for patients and other stakeholders". 11 The focus is on the movement of the patient through the system, rather than individual interactions between patients and healthcare providers.…”

“…12 In healthcare facilities, LM techniques have been documented to reduce costs, errors and time wastage as well as improve patient and staff satisfaction. 7,9 Moreover, one hospital in the USA reported that LM techniques resulted in the timely initiation of 99% of its operations, while another managed to reduce inpatient total care costs by 25% and improve patient satisfaction by almost 100%. 11 Prior to the delivery of radiotherapy treatment, multiple important steps must be completed; however, any initial setbacks or wastage is reflected in subsequent steps, resulting in treatment delays and decreased patient satisfaction.…”

“…Based on previous research, LM implementation was deemed an appropriate measure to help enable a smoother transition during this period. 9,11 This study was therefore undertaken to delineate the process of implementing LM principles to improve workflow and identify and eliminate sources of waste in the context of radiotherapy treatment.…”