Using lean concepts to reduce waiting time in outpatient department at Nonghong hospital

Abstract

Nonghong Hospital is a 30-bed medium-sized community hospital serving 48,133 people who reside in Nonghong District Area. On average, the number of outpatients was 285 patients per day. Currently, the hospital is facing problems of crowded clinic in the morning, especially in outpatient department and non-communicable diseases clinics (NCD). As patients came to the hospital at the same period of time, mostly at 08.00-09.00 am, the clinic became crowded and patients started to complain about long waiting time. To date, there was no time-lapse appointment system. In 2019, we had applied some technology to shorten the waiting time in outpatient services such as queue system and online queue reservation. Unfortunately, these methods were unable to solve the problems of crowded clinics and long waiting time.

This study was conducted using LEAN concepts to improve the outpatient service system and NCD clinics. The main aim was to reduce the service waiting time. In August 2020, LEAN concepts were introduced to all healthcare professionals and support team by personal training. Problems of the entire organization system were analyzed and strategies to improve quality of services in the outpatient clinic were discussed. In September 2020, LEAN concepts were implemented using the database system from Hospital and Experience program (HOSxP). The obtained data were analyzed by Qlikview12 and RStudio program. The paired t-test was used for statistical analysis. We found that implementation of LEAN concepts for improvement of hospital service system at Nonghong Hospital can significantly reduce the average service waiting time in the outpatient and NCD clinics (p-value < 0.05).