Applying the Lean Thinking in Health Economics to Improve the Healthcare Delivery

This research investigates one delivery process called the transactional flow process at the health economics department. This research proposes a process improvement framework using Lean philosophy and associated tools already successfully implemented in both the manufacturing and service sectors. With the aim of end-to-end process improvement, the proposed framework follows a scientific process investigating the transactional flow process and identifying various factors affecting the process. An existing model of a transactional flow process from the health economics department at King Saud Medical City in Riyadh is adopted to validate the research methodology. This process is known as the Cash Income Collection Procedure. The research identifies several causes of waste in the transactional flow process, such as activities’ over-processing, missing or wrong information and system breakdown. To investigate the current and future state, the research adopts ‘process mapping’ to identify value-added and non-value-added activities. This research also utilises discrete event simulation to emulate the real cash income collection procedure as a transactional flow process model. The next step implements Taguchi Orthogonal Arrays to test the simulation model with scenarios systematically to understand variability’s effects on the Cash Income Collection Procedure process. The results’ significance is validated by statistical analysis. Finally, the research adopts the 4-Rules of the Toyota Production System to improve the transactional flow process model and generate end-to-end value. The current state’s results show defective form over-processing, defects percentage and rework cycle time are the highest statistically significant factors affecting activities in the process. Consequently, the results after applying the 4-Rules of the Toyota Production System to improve the process show a reduction in printing defective forms (Throughput) at the “Getting Patients’ Information” activity by 15.25%, and 9.90% in the (Cycle time). The outputs also show a reduction in printing defective forms (Throughput) at the “Procedures Print” activity by 2.06% and 0.40% in its (Cycle time). The results for the “Pay and Discharge” activity showed minimisation by 24.74% in its (Cycle time). Outputs show a reduction at the “Accountant Rework” activity by 24.81% in its (Cycle time). The results also show an increase of patients’ receipts throughput at “Accountant Attestation” activity by 9.68%.