A general framework for lean transformation of hospitals

The quality of healthcare services has been negatively affected by long waiting times in hospitals. Additionally, surging patient care demand, caused by a growing and aging population, results in pressures of high cost and increased capacity requirements in healthcare services. With limited resources and increasing demand, healthcare institutions are exploring approaches to do more with less. Lean is one such technique, aiming at creating continuous flow by eliminating waste while maximizing customer value. Although healthcare practitioners have been proposing different lean implementation solutions for healthcare services in different types of clinics, the applications are fragmented and cannot be generalized in all healthcare settings. In this paper, three systematic lean frameworks are defined based on various healthcare features and traditional lean systems, specifically replenishment pull and sequential pull systems. Three healthcare domains, the emergency department, outpatient clinic and inpatient unit, are studied to help develop these frameworks. The purpose of proposed frameworks is to provide a guideline to transform traditional healthcare systems into lean systems. A case study in an outpatient clinic is presented subsequently. After current processes are mapped and analyzed using value stream mapping, an improved patient flow is achieved by applying the outpatient clinic lean framework.