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Healthcare Delivery

Working towards a Lean Healthcare system

The Value Stream Mapping (VSM) model is particularly designed for hospitals and healthcare settings that have direct influence on the admission of patients and their time of treatment

With the increasing emphasis on the application of concepts of lean management in hospitals across the world, gaining popularity as ‘Lean Healthcare’, Value Stream Mapping (VSM) is an elementary tool that allows one such implementation. The common principle behind lean management is ‘to do more using less’. The VSM model is particularly designed for hospitals and healthcare settings that have a direct influence on the admission of patients and their time of treatment. This article presents a case study of a tertiary care hospital of India where the ‘Lean transformation-VSM’ of the ‘Patient-admission’ process is administered for the reduction of time taken by the admission process. Efforts were made to reduce the admission of the patient for making the process smoother and faster when compared to the existing process in the hospital.

The first step involved in the experiment was to gather information of existing patient admission process followed in the hospital by: Direct observations, Interviews and Patient follow-ups. A comprehensive study of the patient admission operations was accomplished, which was later successfully utilized to recommend improvements to reduce delays. Analysis of the existing state was done using a ‘time-motion study’.

The non-value-added steps were identified in conducting the ‘Root-cause Analysis’ of every step involved in the patient admission cycle. A new process was designed by syndicating them, streamlining or reviewing the categorization of events to support greater competency or even discarding few steps. Efforts were made to implement the ‘Modified value stream process map’.

The result was astonishing! The entire experiment helped in bringing down the time of whole process of admitting the patients from an average of 25 minutes per patient to 15 minutes per patient. The hospital was able to achieve almost 40% of reduction in overall patient’s time for their admission process. This in turn offered the hospital with the earnings of higher patient satisfaction.

The understanding of recreation and the steps involved in conducting this recreational study built a strong groundwork for verifying and validating the simulation model-VSM.

John F. Kennedy said ‘We must use time as a tool, not as a crutch’. Efficient optimization with the help of Lean Management can enhance not only the operational efficiency but also the quality of care provided to the world. The experiment was just a drop into the wide oceans of Lean!

About the Authors


Dr. Feroz Ikbal
Assistant Professor,
Tata Institute of Social Sciences Mumbai campus
EmailID: feroz.ikbal@tiss.edu


Dr. Megha Jogi
Master of Hospital Administration (MHA),
Tata Institute of Social Sciences Mumbai campus
EmailID: meghajogi9@gmail.com
With the increasing emphasis on application of concept

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