value stream mapping

Value stream mapping (VSM) is one of the most important and widely used tools for lean thinking to identify non-value adding activities and improve the service delivery process. The aim of this study was to design a value stream map to improve the sonography service process in a military hospital..

Methods :

Value stream mapping (VSM) is one of the most important and widely used tools for lean thinking to identify non-value adding activities and improve the service delivery process. The aim of this study was to design a value stream map to improve the sonography service process in a military hospital.

The results showed that on average, the waiting time for sonography was 42.6 minutes and the main service cycle time was 30.6 minutes. On average, the total time for each sonography procedure was 73.3 minutes. The most frequently waste in the sonography process was related to “correction waste”, such as unclear sonography orders, incomplete registration of sonography orders, and mistakes in specifying the type and organ of sonography by the referring physician. Finally, the possibility of sending a prescription for appointment scheduling and receiving responses through social networks (such as WhatsApp, etc.), precise scheduling and appointment booking, and training clinic physicians for prescription and strengthening information technology infrastructure were introduced as some of the main solutions..

cause of time wastage, and most of the patient's attendance time is spent waiting. Therefore, it is necessary to reduce patients’ waiting time with management measures such as queue management and appointment scheduling systems as well as the use of new technologies.

This study aimed to identify improvement opportunities in emergency department processes by value-stream mapping in Imam Reza hospital of Birjand.
This qualitative study was carried out in 2017. Data were collected through observation and interviews. Time consumed for each step from registration to disposal was measured and documented on the value-stream map. Then in a group discussion session consisted of emergency personnel, the value-stream map was drawn and analyzed and the source of waste were identified. It was designed using Lean thinking techniques, and Edraw Max 6.7 software.
The results showed that the total attendance time in the emergency department was an average of 216.29 minutes, 143.6 minutes of which was spent on waiting for receiving services. After investigating the sources of waste, a suitable solving tool was proposed. In order to reduce the waiting time for reception and overcrowding, the "5Whys" method was used and further coordination with the Emergency Management Center and activation of overflow system was suggested. To reduce attendance time in the emergency department, "visual management" and "arrangement system "methods were proposed.
The Lean thinking system is an approach to analyze processes and improve efficiency by focusing on the staff in order to provide the maximum value to the patient and improve patient's progress.

The goal of lean thinking is value creation and the eradication of waste. The purpose of this paper was systematic study of items and rate of implementation the lean management tools and techniques in Iran’s healthcare system. In this systematic review that was conducted in December 2014, by searching keywords related to lean management in Iranmedex, Magiran, Irandoc, SID scientific databases and Google search engine, attempted to search the Research has been conducted in Iran’s healthcare centers regardless of the time of publication. A total of 10,550 Research was found. After reading them, 10478 Research were excluded from the study because of the irrelevant, repetitive and lack of access to the full text and abstract. Then attempted to classify and statistical analysis of 72 remaining researches via Excel 2010 software. 5S(6.9 percent), Kaizen(8.3 percent), visual control(1.4 percent), value stream mapping and simulation(18.1 percent), value stream mapping (2.8 percent), simulation(5.6 percent), Poka-Yoke(9.7 percent), Hospital Information System(26.4 percent), Maintenance and Repair(5.6 percent) and identification the waste(15.3 percent), were identified as the most important lean off practices in Iran healthcare centers. 84.7 percent of the researches were published in 2007 onwards. The findings showed that the much of the tools related to Lean Management has been applied in Iran’s healthcare centers in the last eight years. The computers have played the greatest role in lean off. The interest of Iranian researchers has increased about lean healthcare. Deployment, collateralizing and propagation of lean healthcare with the help of industrial engineers are the main offers to policy makers in the healthcare sector.