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This Issue: Ensuring High-Quality Care | Table of Contents: Fall 2016 | Download this issue

In the News

Lean processes cut wait time

A study documenting ways in which lean processes improved wait times for surgical procedures at VA hospitals was publicized in MedicalXpress and other news outlets in early September.

The study, by researchers at the Richard L. Roudebush VA Medical Center and the Indiana University School of Medicine, appeared online in JAMA Surgery Sept. 7. It discussed the results of a 2013 analysis based on "lean processes" by VHA's surgery service and systems redesign services.

"Lean" is a management philosophy that focuses on aggressive, continuous improvement guided by the customer's perspective.

During the analysis, multidisciplinary teams identified strategies to improve interdepartmental and patient communication to reduce canceled consultations and cases, diagnostic rework, and no-shows.

Pilot projects implementing these strategies were then launched. The research team found that as a result of the new strategies, average patient wait times for surgical procedures decreased from 33 days in FY 12 to 12 days in FY 14, a threefold decrease.

Operative volume increased from 931 patients in FY 12 to 1,072 in FY 14. Combined clinic, telehealth, and e-consultation encounters increased from 3,131 in FY 12 to 3,517 in FY 14, while the number of no-shows decreased from 366 in FY 12 to 227 in FY 14.

The article quoted the study's authors as concluding that "improvement in the overall surgical patient experience can stem from multidisciplinary collaboration among systems redesign personnel, clinicians, and surgical staff to reduce systemic inefficiencies. Monitoring and follow-up of system efficiency measures and the employment of lean practices and process improvements can have positive short- and long-term effects on wait times, clinical throughput, and patient care and satisfaction."

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