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Oncology Adopts Lean Practices


Children's Hospital Central California recently introduced Lean management strategies to yet another outpatient practice by implementing several timesaving policies and procedures to the Craycroft Cancer Outpatient Center.

Based on the Toyota Production System, Lean management emphasizes eliminating steps that do not add value to a process. The Hospital’s oncology practice brought together a multidisciplinary team, which included two oncologists, to observe clinic flow and identify bottlenecks and inefficiencies. The Lean team’s findings led to a number of changes designed to enhance patient satisfaction.

Lean strategies include the following:

  • electronic kiosk that  tracks patients in real time as they move through the clinic
  • fulltime phlebotomist present in the clinic so patients no longer must visit the lab
  • physician visits patient at start of appointment rather than waiting for lab results
  • “fast pod” for certain patients with a port so they can quickly see one nurse for their blood draw and infusion therapy
  • method of assigning duties rather than patients to more efficiently move patients through the clinic

These program enhancements may shorten a patient’s appointment duration from as many as six hours to as few as 55 minutes.

“Our team here is great,” said Kimberly Ling, registered nurse, oncology, Children's Hospital Central California. “No matter what system we implement – like Lean management or anything else – we’re going to find a way to maintain those relationships with our patients because of how we view these families.”

Dedicated staff members like Ling will keep the systematic improvements far from turning the practice into a so-called assembly line. “Seeing patients as our family will always be the case, no matter what the system is,” said Ling.

The oncology practice’s efforts to minimize wait times and improve care delivery through the implementation of Lean management strategies proved successful during a 60-day trial run. Children's Hospital Central California fully implemented the new procedures on Dec. 3, 2012.