Effect of Lean on surgical wait times, efficiency in a VA hospital

Editor's Note

The implementation of Lean system redesigns was associated with a significant and sustained wait list reduction from 33.4 days to 12.0 days for patients waiting for elective general surgery in a Veterans Affairs (VA) hospital, this study finds.

Along with the three-fold decrease in wait times from 2014 to 2012, operative volume increased from 931 patients in 2012, to 1,090 in 2013, and 1,072 in 2014.

Combined clinic, telehealth, and e-consults increased from 3,131 in 2012 to 3,517 in 2014, and the number of no-shows decreased from 366 to 227 in the same time period.

The authors say that by reducing systemic inefficiencies, they achieved increased patient throughput, decreased wait lists, and improved patient access in a cost-neutral manner.

Importance There are an increasing number of veterans in the United States, and the current delay and wait times prevent Veterans Affairs institutions from fully meeting the needs of current and former service members. Concrete strategies to improve throughput at these facilities have been sparse.