Value stream mapping in healthcare: analysis and simulation in a cancer hospital
Keywords:Value Stream Mapping, Lean Healthcare, Simulation, Lean Production,
AbstractThe value stream mapping in association with the discrete-event simulation have been of great contribution to the service operations. In Brazil, the demand for oncology services is expected to grow in the coming years. Taking into account that the Brazilian health services have already been facing some deficiencies, this field has opportunities still not explored to apply the tools mentioned in the hospital context. The objective of this article was to propose improvements to the outpatient clinic of a Brazilian cancer treatment hospital. With that purpose, in loco visits were made to analyze the activities developed in the area, followed by the construction of a value stream map for the current state, the identification of opportunities to improve, and, finally, the proposal and simulation of a future state map. The main problems identified in the hospital were the queues in the medical triage, the use of patients as means to transfer necessary information, loss of patients’ records, non-optimized chemotherapy schedules, and long waiting times to clinical appointments. The proposals for the future state map have shown opportunities to reduce the average lead time of the treatment from 57 days and 16 minutes to 33 days and 6 minutes. The simulation of one of the proposals for the outpatient clinic has shown promising results, with possible execution of the improvement without investments in new resources. On the other hand, a shorter treatment period seems to lead to an expressive increase in the waiting times and the average number of patients in line.
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