Operational aspects of lean thinking in health care
Most lean implementations start with the introduction of
lean instruments, aimed at redesigning operational aspects of
the care delivery process [2, 3, 15, 16]. Such an approach is
suitable in some organizations. A more integrative approach
would be to search for instruments already available in health
care, which are also in line with lean thinking, for example
Care Programmes and Integrated Care Pathways. Both can
be based on patient-in-process analyses.
To improve on an operational level, lean makes a distinction
between value and non-value adding activities. To
achieve this, a ‘patient in process analysis’ [31] can be
helpful. In this analysis, a patient’s journey through a health
care system is analysed based on different categories
(Table 3), identifying non-value adding activities. The results
can be used as a starting point for further improvements.