Optimizing Patient Flow Using Value Stream Mapping in the Chemotherapy Unit: Quality Improvement.

Purpose: Inefficient patient flow in chemotherapy units is often caused by improper resource allocation, delays, and excessive workloads. Lean healthcare practices offer process visualization and waste reduction, addressing these issues. This project aims to optimize chemotherapy patient flow by improving care coordination, reducing waiting times, and shortening hospital stays.

Methods: The project employed Value Stream Mapping methodology from May 2022 to May 2023. The team mapped the chemotherapy administration process, identified inefficiencies, and evaluated factors influencing patient flow, including delays and resource utilization.

Results: Prior to the intervention, the percentage of value-added time from patient admission to discharge was 47.35%. After applying lean principles, the total hospital stay was reduced by 56.8%, treatment duration decreased by 31.57%, and unscheduled patient visits decreased by 22.93%. The evaluation of test results, chemotherapy drug transfer, and drug preparation processes were identified as the least efficient, with value-added time percentages of 12.87%, 17.12%, and 28.89%, respectively. The longest waiting time was recorded before the start of chemotherapy, averaging 72 minutes.

Conclusions: Lean practices were effective in reducing waiting times and hospital stays, improving patient flow. Key improvements included enhanced coordination, streamlined drug preparation, and reduced delays in patient assessments. The project is reinforced with field data, which enhances the applicability of the findings in clinical practice. The success and sustainability of these improvements are dependent on ongoing management support and the adoption of lean practices across the hospital. Implementing lean practices in high-volume units is recommended to further enhance operational efficiency.