oa Using lean principles and process analysis techniques to reduce congestion in out patient departments

Background and Objectives: Congestion in outpatient departments (OPD) in Qatar's public hospital system is a major problem due to the demographics of the country. Despite the congestion in the general registration and assessment areas, the utilization of doctors' time is considerably low. This paradigm is propagated by (i) the inefficiencies in the appointment system, (ii) the allocation of the resources in the service design, and (iii) behavior patterns of the patients. Methods: We investigated the problem through a case study in a public hospital. First, through a careful walk-through of the patients' flow process, we identified the disruptions in the patient flows using lean principles. Simultaneously, through extensive data collection, we measured the patient flow times and resource utilization, and classified the value added- and non-value added times for the patients. Based on the observations and data collected, we propose changes for the appointment systems, patients' flow process, and allocation of resources. We benchmark the impact of our suggestions through simulation. Results: The improved solutions reduce the patient flow times by 30%. Conclusions: The patients' flow experience in public hospitals' OPDs can be significantly improved through better design of the appointment system and by eliminating wasted time in the patient flow process without investing in more resources.