Lean Review of Outpatients Department

Client: Christie Hospital NHS Foundation Trust
Duration: 4 weeks

Project Overview
As a result of a lean review of chemotherapy treatment, it was identified that various elements of the patient pathway required further attention if the benefits of the initial review were to be realised. The particular problem identified in this instance was in the clinical preparation section of outpatient, where it was identified that patient files for clinics were often unavailable until late the day before clinic. This situation resulted in major ‘over production’ of staff time, which in turn caused longer patient waiting times.

CPC’s Role
CPC was tasked with the following:
• To map current processes and identify all areas of waste within the clinic preparation system
• To engage with outpatient managers and clinic preparation staff to ensure that waste identified was validated and that all recommendations for change were agreed.
• To maximise the use of staff and other resources and to streamline the patient pathway and improve the patient experience (via a Rapid Improvement Event)
• To provide new, lean (sustainable) processes for future use in outpatients.
• To ensure that all patient files were available at chemotherapy clinics.

Client Benefits
The following benefits were realised:
1. Waste of over £50,000 identified, providing a minimum return on investment of 10:1 for the client
2. A streamlined patient pathway and much improved patient experience, with some 4 steps removed from the simple clinic preparation process alone
3. A new way of working within the clinic preparation office, which focuses on the lean demand pull principle
4. Fully engaged outpatients and clinic preparation staff, all of whom are driving change
5. Key change tasks for outpatients – linked into an overall lean change programme
6. Reduced patient waiting times and increased % of patient notes available at chemotherapy clinics.

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