Improving the Operational Efficiency of Opd using Lean Method -- Value Stream Mapping.

OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and hospital staff. Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow-up. Hence the scope of OPD services extends to not only treatment but also preventive and promotive services. However the OPDs are plagued with the problem of process delays like long waiting time. It's often one of the most frustrating part about the healthcare delivery system. Waiting time for elective care has been considered a serious problem in many healthcare systems since it acts as a barrier to efficient patient flow. This contributes to poor service delivery and a lackluster work environment. Non-value-adding activities result in, inter alia, long cycle and waiting times, and low staff morale. A study was carried out in a Tertiary Care Hospital (TCH) in Pune to study the operational efficiency of the OPD by mapping the flow process and suggest means to improve it. In order to improve operational efficiency by reducing bottlenecks in the workflow of the OPD a lean method -- Value Stream Mapping was employed. With Lean thinking, health care managers can tackle specific issues to improve operational efficiency. The entire OPD patient flow was mapped using a time motion study for a sample of 500 patients. Value Stream Mapping consisted of drawing the process flow as it was happening at present. It consisted of both Value Added & Non- Value Added activities. A Value Stream Improvement Plan was made to eliminate these bottlenecks or reduce the activities that do not add value, with reducing the delays as the Value Stream Objective. AIM: To improve the operational efficiency of the Out Patient Department using the lean method. OBJECTIVES: * To map the current OPD flow process * To identify the value adding and non-value adding activities * To study and analyze the causes for "waste" or delayed process time. * To create a value stream improvement plan to optimize the flow process. SCOPE: * The study examines the impact of Lean on operational efficiency only in the OPD; it does not extend to other departments in the hospital. * The bottlenecks leading to increased waste or delayed process time in the OPD will be identified and reduced using lean (VSM). * Streamlining the OPD flow process for maximization of efficiency will be achieved. * The applicability of Lean is determined for the duration of the study, and the effect on cycle and waiting times and staff attitudes is looked at, but the sustainability thereof is not explored. LIMITATIONS: * Patients visiting multiple doctors were excluded. [ABSTRACT FROM AUTHOR]