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The effects of a lean transition on process times, patients and employees

Pascale Simons (Department of Radiation Oncology (MAASTRO), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands)
Huub Backes (Department of Radiation Oncology (MAASTRO), Maastricht, The Netherlands)
Jochen Bergs (Faculty of Business Economics, Hasselt University, Hasselt, Belgium)
Davy Emans (Department of Radiation Oncology (MAASTRO), Maastricht, The Netherlands)
Madelon Johannesma (Healthcare Innovation, CZ Insurance, Tilburg, The Netherlands)
Maria Jacobs (Department of Radiation Oncology (MAASTRO), School for Public Health and Primary Care-Health Services Research, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands)
Wim Marneffe (Faculty of Business Economics, Hasselt University, Hasselt, Belgium)
Dominique Vandijck (Faculty of Health Sciences, Hasselt University, Hasselt, Belgium) (Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 13 March 2017

1257

Abstract

Purpose

Treatment delays must be avoided, especially in oncology, to assure sustainable high-quality health care and increase the odds of survival. The purpose of this paper is to hypothesize that waiting times would decrease and patients and employees would benefit, when specific lean interventions are incorporated in an organizational improvement approach.

Design/methodology/approach

In 2013, 15 lean interventions were initiated to improve flow in a single radiotherapy institute. Process/waiting times, patient satisfaction, safety, employee satisfaction, and absenteeism were evaluated using a mixed methods methodology (2010-2014). Data from databases, surveys, and interviews were analyzed by time series analysis, χ2, multi-level regression, and t-tests.

Findings

Median waiting/process times improved from 20.2 days in 2012 to 16.3 days in 2014 (p<0.001). The percentage of palliative patients for which waiting times had exceeded Dutch national norms (ten days) improved from 35 (six months in 2012: pre-intervention) to 16 percent (six months in 2013-2014: post-intervention; p<0.01), and the percentage exceeding national objectives (seven days) from 22 to 17 percent (p=0.44). For curative patients, exceeding of norms (28 days) improved from 17 (2012) to 8 percent (2013-2014: p=0.05), and for the objectives (21 days) from 18 to 10 percent (p<0.01). Reported safety incidents decreased 47 percent from 2009 to 2014, whereas safety culture, awareness, and intention to solve problems improved. Employee satisfaction improved slightly, and absenteeism decreased from 4.6 (2010) to 2.7 percent (2014; p<0.001).

Originality/value

Combining specific lean interventions with an organizational improvement approach improved waiting times, patient safety, employee satisfaction, and absenteeism on the short term. Continuing evaluation of effects should study the improvements sustainability.

Keywords

Citation

Simons, P., Backes, H., Bergs, J., Emans, D., Johannesma, M., Jacobs, M., Marneffe, W. and Vandijck, D. (2017), "The effects of a lean transition on process times, patients and employees", International Journal of Health Care Quality Assurance, Vol. 30 No. 2, pp. 103-118. https://doi.org/10.1108/IJHCQA-08-2015-0106

Publisher

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Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited

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