Background – Outpatient services in oncology wards have become a central point in cancer patients’ treatment, who may experience long waiting times from the moment they enter the hospital until the end of the day treatment.

Objective – The aim of this research paper is to assess the treatment process (activities and actors) of an outpatient service in order to improve the patient flow.

Method – The study was conducted in the outpatient service of an oncology hospital to identify all elements relative to the patient flow process. Data was extracted and structured following problem structuring methods through interviews and observations. First, the decision context was assessed through the development of a cross-functional diagram. Then, a value stream mapping was developed, based on lean technics, to identify wastes and bottlenecks in the different treatment activities.

Results – The first part of the analysis presents and links the five steps of the treatment process (check-in, doctor’s appointment, treatment prescription, pre-treatment and treatment) with the four medical actors (receptionists, doctors, pharmacists and nurses). Different care pathways were identified. Then, value stream mapping shows how each activity influences the treatment process and thus impacts patient waiting time.

Conclusion – The application of problem structuring methods in conjunction with lean management can improve the patient flow in outpatient services. Results of this study will be used for future work on decision making analysis.

Annabelle Glaize

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How to improve the patient flow process in outpatient services of a hospital: A problem structuring and lean management approach