Lean thinking to improving access to cancer patients in a Public General Hospital

Unbalanced treatment scheduling and overcrowding is a common problem for cancer centers in Brazil, with huge access restrictions due to system inefficiencies and poor assistance design. The purpose of this report is to show how lean thinking can be applied to healthcare by using lean methods and production leveling. The case study / report presented was adopted in order to describe the approach, techniques and findings of this project, as part of a lean initiative. Lean Value Stream Mapping tools and leveling tools improved unit performance by increasing unit capacity freeing treatment slots by leveling and decrease of waiting time for cancer treatment .The process redesign also eliminated unnecessary movement and overtime.

Lean healthcare

The case study / report presented describes how processes were improved using Lean Value Stream Mapping tools and Queue Theory tools. Major outcomes were focused on reducing waiting time for patient access to treatment slots and reducing daily waiting time for access to treatment slots. The performance improvement was in the order of 75% total access slots, reducing from two hours to 30 minutes; and access to care waiting time reduced from more than three months to same day access to special cases; and one week waiting time or “planned access” to all other. The process redesign also eliminated up to three hours of overtime daily.

Taking a step forward in continuous improvement

In order to overcome barriers to quality improvement and sustaining continuous improvement, services must plan and apply specific strategies. Especially in Brazil, both private and public systems face an urgent need to maintain successful improvements in the current scenario of increasingly restricted budgets through innovative approaches. Therefore, the purpose of this paper is to present a narrative view of strategies to sustain continuous improvement. Methods: This article describes a narrative review of literature on the following databases: Emerald, Scopus (Elsevier), OneFile (GALE), Technology Research Database, Web of Science and Engineering Research Database, using the terms: 'sustainability' and 'continuous improvement '. Findings: This study selected 18 articles from 2003 onwards, showing a yearly growthin number of publications, which pointsan increasing presence of continuous improvement initiatives worldwide. Discussion: This literature review shows a growing concern to provide a reliable framework for evidence-based improvements, combined with innovation and a system wide approach. This literature review should assist other scholars and practitioners who are interested in substantiating their improvement efforts.