Implementation of Value Stream Maps in the Improvement of In-hospital Patient Trajectories

Abstract

Introduction: The lean philosophy has evolved in its implementation from production systems to services. In the health sector it allows to eliminate all those activities that do not add value during patient care.

Objective: To improve in-hospital patient trajectories in a Urology Department by implementing value stream maps.

Methods: The research paradigm is quantitative descriptive, with the purpose of improving patients' trajectories in the operative stage of a Urology service at the Faustino Pérez Provincial Clinical and Surgical Teaching Hospital, based on the implementation of value flow maps. A four-stage structured procedure for the improvement of patient trajectories with a lean approach was developed.

Results: The main deficiencies related to patient trajectories in the operative stage of the Urology service were identified and corrective actions were proposed and modeled on the basis of value flow maps. The application of the procedure allowed optimizing waiting times between activities by 41 minutes, which represented an efficiency improvement of 84.81%.

Conclusions: The implementation of the value flow maps allow improving the intra-hospital trajectories in the operative stage of patients in the urology service, this tool facilitates the comprehensive analysis of flows, supports the process of patient-centered decision making and optimizes patient care and waiting times during care.