Lean methodology application in the redesign and implementation of non-face-to-face flow systems

Abstract

Background: The aim of the present project was to simplify complex circuits that increase the cost of healthcare processes due to the large number of associated administrative procedures by applying Lean methodology and process reengineering. This study was conducted in the outpatient area of Hospital Sant Joan de Déu de Martorell, in Barcelona. Methods: This quantitative, pre-experimental, analytical, retrospective study was based on the conceptual model of structure, process and outcomes proposed by Avedis Donabedian and reviewed the main healthcare circuits and administrative procedures affecting users. Lines of action were established, such as a review of healthcare circuits and circuit redesign by applying reduction of time cycles and resource optimizationDescribe briefly the main methods or treatments applied; Results: The review revealed that the processes showing the greatest benefit were hospital admissions, with a 53% reduction in admitting time, preoperative assessment, which, by creating a single assessment, reduced the time for scheduling distinct tests and patient travel by 75%, and planning of surgery, outpatient visits and diagnostic tests, which reduced the time incurred by patients by 100% since, on leaving the consultation, they returned home without having to return to the appointments desk. Conclusions: Lean methodology can be successfully used to streamline administrative circuits, reduce queues and waiting times and to implement non-face-to-face care, thus significantly enhancing patient care.