Evaluation of outpatient oncology services using lean methodology.

T he Lean Transformation Process is a methodology created by the Toyota Production System that focuses on the elimination of nonvalueadded operations in the workplace to create flow and quick response to customer demand. The process improvement strategy, when applied to the healthcare setting, can enhance the patient experience by cutting out waste (nonvalue added work) and providing a safer, streamlined visit (Lean Enterprise Institute, 2011). Because providing chemotherapy is a multistep, interdisciplinary process, it is ideal for Lean evaluation. The goal of this application was to improve the overall efficiency of the multidisciplinary chemotherapy process in an oncology infusion center by implementing changes that would decrease patient wait times and improve communication across disciplines. The Lean initiative was implemented at an oncology infusion center in a suburban Milwaukee, WI, medical center in August 2010. Expectations included improving the overall patient experience by decreasing the patient wait time prior to chemotherapy infusion and enhancing the flow of the patient’s experience through the treatment process. The process included check-in, laboratory draw, and doctor visit or RN assessment, followed by the administration of chemotherapy. The Lean methodology is a principle that also is used by the Aurora Health Care organization in the operational improvement department to help increase the value of the patient experience while decreasing the waste that creates redundancy and delays work flow (Kenny, 2011). Time is precious for a patient with cancer, and the oncology staff wanted to make the time spent at the center as valuable as possible. Lean Methodology in Healthcare Delivery