Value Stream Mapping for Flow in Healthcare (part 1)

The consultants in our Lean Healthcare practice are speaking with an increasing number of hospitals and healthcare organizations interested in Lean. As we all know, healthcare costs are high and patient wait times are long. Anyone who has had experience sitting in a waiting room, examination room, or in a hospital bed can attest to the fact that there is a distinct lack of flow in the way healthcare is provided today.

One of the key ideas in Lean is to increase velocity, or the amount of profit generated over a period of time. Velocity is increased by examining the revenue generating sequence of activities called Value Streams. When waste such as delays, errors, transportation, motion, and so forth are eliminated from these operations what remains is the ability to provide the same value in less time. Flow is the key to increasing velocity.

Assuming that assets such as beds, medical equipment, and surgery rooms are fixed, the revenue generated through these over a set amount of time must increase. We usually cannot add resources without spending money. We cannot increase the amount of time available to us in a 24 hour day. We must increase velocity by speeding up the flow of value through the system. This is done by examining and eliminating the non-value-added and waste (muda) elements of the process of providing care.

What is the impact of better patient flow for hospitals? As waiting time is reduced, the healthcare experience for the patient improves, reducing waiting time and speeding recovery. As patients flow from process to process (from sickness to health) beds turn faster, and more patients can be served. More patients served equals to more revenue for the hospitals. By increasing revenue with the existing fixed costs (rooms, beds, overhead) hospitals can increase profitability.

The first step is to identify the healthcare value streams that are the target of conversion to flow by asking the following questions of process and service mapping: What types of care does the hospital provide? What volumes of patients are experienced for each? What are the resources needed for each? What is the sequence of steps to provide care?

Then, we design a ‘just in time’ system through a relationship of “one-piece pull” of work (patients, samples, x-rays, etc.) at the pace of customer demand (takt time). We do this through a live simulation by walking a patient through the process of care without delay, one at a time. The results are documented, challenges and problems are identified, and a system to support smooth patient flow is defined.

For more information on implementing or learning flow through our Value Stream Mapping classes and simulation please contact us- Office- (704) 274-2050 email-

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Huntersville, NC 28078


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